Katrina Bramstedt

Since I last wrote (Antibodies as Currency: COVID-19’s Golden Passport), I note that my own manuscript closed by stating, “The ethical call is to proactively reflect on these antibody-related matters to create systems which are clinically safe and fraud resistant and avoid discrimination.”

Indeed, I’ve done some reflection, especially considering that I wrote that manuscript while living in Italy–a coronavirus hotspot–and witnessing the near-death of my husband from COVID-19. I’ve also experienced two weeks of expensive, yet, prison-like hotel quarantine, and being locked down multiple times in Australia–a country which perilously chose border closure (rather than vaccination) as its first-line of viral defense. I am furious and mystified at Australia’s lack of benchmarking that has cost lives and jobs, and crushed freedom of movement (harshly restricting arrivals, and preventing departures).

What else have I reflected on in the past 15-months since writing the manuscript? I’ve witnessed the successful use of “vaccination passes” (e.g., EU Digital COVID Certificate, https://ec.europa.eu/info/live-work-travel-eu/coronavirus-response/safe-covid-19-vaccines-europeans/eu-digital-covid-certificate_en) as an incentive to boost vaccination rates, restoring jobs and reviving economies which had been crushed by the virus. I’ve witnessed friends and family worldwide being freed from the prison of their homes and allowed to travel (post-vaccination), taking lengthy and much needed physical journeys to soak up the sun, mineral waters, and nature for rejuvenation.

With these vaccination passes, the focus is not on antibody titres, and admittedly some travellers won’t have a response or even a suitable threshold to battle an antigen cascade. Some might encounter a coronavirus variant that their antibodies cannot defend against. These vaccination passes are “vaccination passports” not “antibody passports” as their only metric is vaccination, not antibody status. And while no system is 100% perfect, these “vaccination passports” do have quality assurance elements for matters of identity verification and fraud deterrence.

Ultimately, vaccination passports have been easily accessible in countries which have them digitized and connected to electronic medical records. They’ve been proven to significantly boost vaccination rates as they are incentives which bring people freedoms that are also wellness promoting. Also, these passports are not compulsory in that people can (generally) choose to remain unvaccinated (limiting venue accessibility and movement).

In sum, COVID (in one or more variants) will always be with us, thus the goal of zero-cases to enable freedom of movement is futile and harmful. Accepting this reality, there is fairness and other benefits to allowing vaccinated persons continued movement and social interactions (within reasonable “Terms and Conditions” of vaccination passport programs). The way forward is “living with COVID” and vaccination passports are just one of the tools of “our new life.”

Katrina Bramstedt is Adjunct Professor at the Faculty of Health Sciences and Medicine at Bond University, Australia; CEO of AskTheEthicist; and Journal of Bioethical Inquiry Associate Editor, Innovation and Technology Ethics.

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Find links to:

• all the #free2read articles from the “Social and ethical implications of the COVID-19 pandemic” special symposium
• related author discussions on the podcast JBI Dialogues, and
• other author reflections in “Since I last wrote”

here: https://bioethicalinquiry.com/symposium-social-and-ethical-implications-of-the-covid-19-pandemic/.

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