Vaccine yes, vaccination passport no

 

From Paolo Bellavite & Carmelo Ferlito

Vaccines are very useful in preventing infectious diseases and they have to be prescribed to the population and inoculated after a careful evaluation of the needs of the individual under observation.

However, a source of concern is the announcement by the President of the European Commission Ursula von der Leyen on March 1 for the adoption of the so-called “Digital Green Pass”, a digital vaccination certificate.

The “digital pass” (the reason it should be labelled “green” is obscure) would have the purpose of giving “proof that the person is vaccinated”, containing “the results of tests that he/she can still be vaccinated” (probably antibody tests that prove a recent disease) and “information on recovery from Covid-19”.

Similar solutions are under discussion in different parts of the world. The risk is that, despite the Covid-19 vaccination not being mandatory in several countries, including Malaysia, it may become so as a precondition to be authorised to travel, at least internationally.

A first issue with the proposal is that it poses serious risks in terms of privacy. This digital tool is designed as a pass to be exhibited in order to travel and move from one country to another. It could be easily adopted even within states, to control access to public offices, meeting places, transportation, etc.

The extension of vaccination obligation to such a tool would weigh on the daily lives and the freedom of movement of people. This would be an unnecessary and discriminatory measure, all the more because Covid-19 vaccination is discouraged for certain people, in particular those with a weak immune system (such as cancer patients). What will happen to those people who cannot get vaccinated but are required to travel for work?

Besides that, there is no evidence that the vaccines approved so far actually reduce the virus’ transmission. Evidence of transmission reduction is currently very scarce.

And we still don’t know how useful vaccines will be for individual and public health, because Phase III studies have yet to be completed and a large trial is underway (Phase IV or post-marketing).

The Covid-19 virus seems to mutate very quickly. Where there is immune resistance in the population, the virus “tries” to equally infect the cells and, after many attempts, the strain that manages to overcome the initial obstructions will prevail.

This also happens with other diseases, because those who have had the disease are more resistant to the strain that originally infected them and are instead susceptible to variants.

However, there is a difference: other typical diseases create an immune barrier throughout the respiratory tree, starting with the nasopharynx and mouth (salivary glands and tonsils), while the vaccine, which is injected intramuscularly, creates a more “internal” defence and leaves the mucous membranes unguarded.

Therefore, in theory, (there are still no studies on this, but preliminary data with monoclonal antibodies seem to confirm it) a virus could instal itself in the airways of a vaccinated subject, without being able to spread inside the body, but it would have all the time to make mutations.

It would then allow the new strain to spread not just in the vaccinated body but can also be transmitted to others. Even if this happens in just a few cases, it’ll be enough for the mutated strain to spread among the population, vaccinated and unvaccinated.

This is one of the reasons why we shouldn’t rely only on mass vaccinations to overcome the pandemic. Better to integrate with other forms of prevention and effective therapies, even if not decisive, which prevent aggravation of the situation (for example, the fight against the HIV virus was almost won without vaccines but with information, hygiene and good drugs).

As mentioned earlier, the vaccine passport would be a discriminatory choice because it would penalise those who for legitimate personal reasons, such as conditions predisposing to allergies or cardiovascular diseases (let’s not forget that these vaccines can interact with the receptors and enzymes that control blood pressure), choose not to adhere to a vaccination plan where the result is still uncertain, both for the individual and community.

If it were adopted for entry into public places or the use of public transport, the pass would be unnecessarily discriminatory. In fact, those who have been vaccinated should not have anything to fear when coming into contact with those who have not, even more so if they are healthy and follow the standard operating procedures.

Apart from that, vaccination passes would be harmful especially in terms of social coexistence, because the pass would inevitably be equated with a certificate of good behaviour and, conversely, not having it would become a mark of social deviance and a reason for exclusion.

More voices are rising against this type of vaccination obligation. On Jan 28, the Council of Europe promulgated the report “Covid-19 vaccines: ethical, legal and practical considerations”, which was approved by a very large majority.

The report highlights that “states must inform citizens that vaccination is not compulsory and that no one must be vaccinated if they do not want it”, and it is necessary “to ensure that no one will be discriminated against if they are not vaccinated”.

The parliamentarians voted almost en bloc to insert an amendment which states their disagreement with the use of vaccination certificates as passports.

We stress that we are not against vaccination, which is indeed useful to reduce the risk of infection. We are against mandatory vaccinations and threats on personal mobility which can put jobs at risk. We want for the citizens to be properly informed about the risks and benefits of the vaccines which are backed by rational and scientific arguments.

Our suggestion is to abandon every discussion on vaccination passes and to focus on different solutions, which would be more respectful of individual choices and less risky and costly in the long run. - FMT

Dr Paolo Bellavite is a professor of General Pathology at the University of Verona, Italy, and Carmelo Ferlito is the CEO of the Center for Market Education, Kuala Lumpur.

The views expressed are those of the writers and do not necessarily reflect those of MMKtT.