Mass vaccination against coronavirus has not yet started in Ukraine, as the Minister of Health hinted at the imminent start of issuing a new document, which should ease the tourists’ lives during a pandemic. This is a passport for vaccinations against covid. Some state about the inequality that changes in the tourism sector can provoke, and about the reluctance of every second Ukrainian to get vaccinated. At the same time, there is no alternative to the document that would stimulate the lifting of quarantine restrictions in the world.
"I think that in February... we will really start mass vaccination in our country. And everything you say about passports, about all other documents that citizens of the European Union will receive, will also be received by citizens of Ukraine," Minister of Health Maksym Stepanov noted.
Traveling abroad with a Covid-passport?
The idea of introducing a document that would provide travelers with a number of benefits is not new. Back in April last year, the possibility of introducing so-called "health passports," which would be based on the presence of antibodies to coronavirus, was actively discussed. It was assumed that such passports would be issued on the basis of ELISA testing for immunoglobulins G, that is, for the most long-term antibodies. However, in most countries, the implementation of such a document remained at the level of discussion, because it is not a fact that a month after the ELISA test, the patient is guaranteed not to be a source of infection with latent forms of the course of the coronavirus.
With the approach of mass vaccination in a number of countries, officials started talking about the introduction of such a document already on the basis of vaccination. In general, this idea is not new either, because previously such passports were used to travel to the tropics. They included data on the yellow fever vaccine.
So far, there is no single format for the proposed passport. But many countries independently decide to launch such a document in various forms. In Russia, for example, from January 1, the vaccination register is available on the public services portal, and there you can also download the vaccination certificate. Several other countries use QR code generating software.
Those countries that have already approved the idea of introducing a vaccination passport are so far only discussing the possibility of introducing additional benefits for those vaccinated against coronavirus, but not additional prohibitions for those who have not carried out this vaccination.
The main advantage that various variations of this document will give in different countries (at least in Poland, Denmark, Hungary) relates to tourism. However, in Israel, a special application will give you the opportunity to attend cultural and sports events, go to work and go shopping without restrictions, in Poland - to use medical services without additional testing.
Lithuania and Spain went from the opposite: a register of those who refused to get vaccinated would appear; it will be available to other countries too. What sanctions will await such citizens is still unknown.
However, not all countries are united in their plans to implement such a document. Despite the fact that until recently, when discussing passports based on ELISA testing, the UK proposed to launch a special application confirming vaccination, the rhetoric has changed again. London has denied plans to introduce "passports for the vaccinated." In France, too, the idea has been abandoned so far.
Officials of those countries that have not yet made a specific decision at the government level (including Ukraine), most often appeal to the decision of the World Health Organization, distancing themselves from assessing such a largely scandalous initiative.
If the WHO decision regarding passports based on ELISA testing after a long discussion turned out to be negative, then regarding vaccination passports it is positive. The head of the immunization unit at the WHO European office said the organization was considering creating such an electronic certificate with member countries. In addition, Estonia is already developing a similar project in collaboration with WHO. However, the launch of such passports may be delayed: the representative of the organization Melita Vujnovic says that it is too early to introduce them.
However, the president of the Ukrainian Medical Tourism Association Violetta Yanyshevska is confident that such a universal passport will still be created in the future.
The Greek Prime Minister has already called on the European Commission to urgently develop such a single certificate for the EU countries. He plans to raise this issue at the summit on January 21. And the International Air Transport Association (IATA) has planned the release of a Travel Pass with information not only about vaccinations but also about a negative PCR test.
While the creation of a universal vaccination passport remains at the level of an idea, chief sanitary doctor Viktor Lyashko announced the collection of data on all vaccinated in a certain electronic health system. According to him, after the introduction of vaccination passports at the international level, Ukrainian doctors will be able to promptly issue some "confirming certificates."
Inequality due to vaccination: what about the Ukrainians?
Although countries have not yet announced that a vaccination passport may become a mandatory document for crossing the border, human rights activists emphasize that, to some extent, vaccination is becoming mandatory. Especially for a number of people whose work is related to systematic border crossings. Thus, those people whose convictions do not correspond to vaccinations find themselves in a disadvantaged position.
While Ukrainian officials do not publicly focus on the issue of inequality, this is done by representatives of other countries. For example, the President of Romania states that this document will divide the population of Europe into two categories. And Thomas Mertens, head of the Standing Commission on Vaccinations in Germany, believes that privileges should be implemented only when vaccines are available. And only in the spheres of culture and services, but not in medicine and transport.
Poor countries in Asia and Africa still do not know where to find money and how to solve the logistics problem in order to vaccinate at least a small part of the population. Ukraine also faced difficulties. Considering the vaccination plan published by the Ministry of Health, only those at risk will be able to get access to free vaccines. Most of the tourists and those who travel for work do not belong to it.
At the same time, the purchase of a vaccine may not be affordable for Ukrainians. Although the average price of a vaccine is now around 40 USD, the price could rise significantly. This is directly confirmed by the WHO because demand will clearly outstrip supply.
"The introduction of a vaccination passport can be called the right measure since the declared effectiveness of vaccines is quite high. But at this moment I see a certain threat of the introduction of such passports for Ukraine, since the European Union, USA, Israel have already started vaccination, and after about 3 months most of the population has already Ukrainians will not be able to get the vaccine in the near future. I have little faith in mass vaccination in February 2021. Most likely, it will be extended in time at least until the end of the year, and at most until the end of 2022. Thus, Ukrainians risk becoming hostages of the situation," Yanyshevskaya emphasizes.
Moreover, there is one more pitfall. Even if Ukraine in record time massively vaccinates the entire population, it is far from the fact that our citizens will be able to get the same universal passport from the World Health Organization.
Most likely, the main condition for obtaining such a document will be vaccination with a drug that has received WHO approval. Today it is only Pfizer/BioNTech. The Sinovac vaccine, which is being purchased by the Ukrainian authorities, is unlikely to join the ranks of those certified by WHO in the future: in Brazil, it was shown that its effectiveness was 50.4%, in Indonesia - 65%. These indicators are clearly not enough for the approval of WHO.
The batch of vaccines that our country should receive under the COVAX initiative (16 million doses) has not yet received a certificate from WHO. However, the chances that after passing the last phase of testing AstraZeneca, Novavax or Johnson & Johnson in the spring will still receive a "like" from the WHO, higher. By the way, it is still unknown whether there will be abuse in the choice of vaccines that are suitable for issuing a passport.
Passport contributes to the spread of the coronavirus?
The scandalousness of the introduction of the new passport lies not only in the issue of the availability of the vaccine but also in its effectiveness. It is not known how safe people with a covid passport will actually be in society.
The maximum effectiveness of vaccines, which manufacturers declare, is from 92 to 96%. Thus, at least about 4-5% of people at risk can still get sick even if they are vaccinated. Even if vaccines are effective enough, there is a risk that, depending on the characteristics of the vaccinated organism, antibodies will be produced within a shorter period than the manufacturers declare. And now they are talking about the period of "immunity" from six months to a year.
Post-vaccination antibody tests can also fail. There is a risk that they will react to antibodies that protect against other coronavirus infections. After all, the new virus belongs to the whole group of coronaviruses. For how long the vaccination passport will be valid is still unknown.
In addition, epidemiologists emphasize: a person is vaccinated against only one of the virus strains. However, covid is able to mutate, so that the risks of disease in vaccinated people increase.
Considering all these factors, the introduction of a vaccination passport, on the one hand, can contribute to the fight against a pandemic, since more people will want to get vaccinated against covid and receive privileges. On the other hand, the effect can be the opposite, because it can give its owner and others false confidence in safety. In addition, there is a risk of data fraud, which will also negatively affect the spread of the virus.
"The issue of the reliability of such a passport can significantly complicate its implementation. The media periodically reports about attempts by Ukrainians to save money on the PCR test to travel abroad. The agency does not have information that this is happening en masse, but we cannot rule it out," Maryana Oleskiv, the head of the State Agency for Tourism, says.
In theory, digitalization should help avoid these risks. Big Tech plans to create a single digital vaccination passport for more than just coronavirus. It is planned that vaccination data will be stored in a digital wallet. Back in October, WHO and Estonia agreed to collaborate on the creation of a "certificate of vaccination", an electronic "yellow card". However, a corruption factor can work in the Ukrainian system, when deliberately false information can be entered into the register by the medical workers themselves.
"Vaccination passport" and medical tourism
Due to the unexplored risks of vaccination, the issue of introducing such passports is acute for medical tourism. On the one hand, it can save many patients with severe disease. On the other hand, vaccination can be risky for them.
"Today, a medical tourist in many countries needs to self-isolate. This is an additional financial and time cost. And most often people with serious illnesses simply do not have time to be in quarantine. For example, those who decide to go to Israel for treatment are now obliged for 10 days to be in the quarantine zone. And only after that, with a negative PCR test, patients enter treatment. In terms of the privileges that a vaccination passport can give, it will have a positive effect for millions of travelers and thousands of medical and health tourists for prompt travel abroad," says the President of the Association of Medical Tourism of Ukraine.
However, Violetta Yanyshevska emphasizes that it is necessary to carefully assess the feasibility of vaccination for medical tourists.
"We, as the Association of Medical Tourism, first of all, stand on guard of the health of patients. Now the world is only at the beginning of the path of vaccination and the long-term effects of the vaccine on different groups of the population in six months or a year are not yet known. Already now we see cases in some countries when patients elderly people with a set of chronic diseases died after vaccination. It is not yet known whether it is possible to vaccinate people, for example, with active oncology or active oncohematology, who are in immunosuppression," Yanyshevska assures.
The President of the Ukrainian Association of Medical Tourism also notes: if a health passport becomes a requirement for entering a number of countries, some urgent patients will have to choose a country where there will be no such requirement. This will significantly complicate the access of patients to medical services. Therefore, it is necessary to develop criteria for the special status of patients and specific alternative procedures (for example, testing for coronavirus), which will allow them to travel to other countries without barriers.
In general, the tourism industry is considering the possibility of introducing a new vaccination passport with a positive. Despite all the pitfalls of introducing a vaccination passport, it is difficult to imagine an alternative to such a document. Therefore, the State Agency for Tourism Development suggests that mass vaccination will be the start for opening borders and restoring travel. Although head of the All-Ukrainian Association of Tour Operators Ihor Golubakha is less positive about the influence of the passport on the sphere.
"Real benefits for tourism can hardly be expected in the near future. It will be easier for Ukrainians to cross the border and travel if our state, first of all, clearly builds a system of both vaccination and testing. Then we will be more understandable for international partners," he says ...
This also applies to falsification of the results of PCR tests, and international scandals, such as the presence of an expired test from Minister of Infrastructure Vladyslav Krykliy, who did not allow him to meet with the Prime Minister of Kazakhstan.
Therefore, until Ukraine has high-quality access to mass vaccination and the reliability of data on its implementation is not confirmed, covid passports will carry more risks for the country than benefits.