We are learning a great deal about what the world will be like even after the major nations on earth are able to get large swaths of their populations vaccinated. There are a few harsh realities that will impact international travel for the next few years. First, with vast numbers of people in so many countries around the world unable to access vaccines at any level, global herd immunity is simply not going to happen. Add to this fact are the large numbers of anti-vaxxers and vaccine skeptics even in countries where sufficient vaccine access exists, particularly in countries like France and the United States.
Statistically, 50% of those who voted for Donald Trump and 10% of those who voted for Joe Biden have expressed an unwillingness to get vaccinated. Even as the United States deploys enough vaccine for every adult to at least have a scheduled appointment by May 1st, the Biden plan, there is enough skepticism such that achieving herd immunity even in the U.S. is increasingly unlikely. What’s worse is that the United States is far behind most of the other developed countries in contact tracing – resisted by right-wing zealots as somehow violative of their rights – and post-inoculation tracing. But without understanding the effectiveness of our inoculation effort, we truly cannot make good decisions on how to contain a virus that threatens to linger amongst us for years. Reaching people by smart phone or computer will continue to fall short.
“The digital divide can be deadly. That has been the stark lesson of the COVID-19 pandemic, which has revealed how decades of underinvestment in digital infrastructure have left millions of Americans cut off from help during COVID-19. This has prevented many from finding vaccine appointments, it has thwarted efforts to release contact-tracing apps, and now it’s undermining the safety of the vaccine.
“The COVID-19 vaccines have been widely heralded as incredibly safe and effective, far exceeding even the most optimistic hopes for how quickly and effectively we could develop the jab. But given the historic speed with which the vaccines were rolled out, more data is needed. This is why the CDC developed v-safe, a long-term vaccine surveillance program.
“Post-injection surveillance is crucial, not only to monitor for side effects (which are quite rare and mild), but also to remind users about their second dose and monitor how long the vaccines remain effective. The problem is that the CDC made a crucial error, one that could undermine v-safe and lead to blind spots in the data it collects. You see, v-safe requires a smartphone.
“That may not sound like a big hurdle, but the truth is that at least one in five Americans lacks access to a smartphone. These patients not only lose out on follow-up information, such as second dose reminders, but they also can’t easily record their side effects or report any future COVID-19 diagnosis…
“This need is particularly acute for those over 65. While nearly all senior citizens have an SMS-capable smartphone, roughly half don’t use a smartphone. Yet at the same time, seniors are one of the groups where we need post-vaccination data the most. Those over 65 are more than 1,000 times more likely to die of COVID-19 compared to teens and children. Even a small reduction in vaccine effectiveness over time for this cohort could lead to a massive increase in mortality. And those over 65 also can respond differently to the COVID-19 vaccine.” Albert Fox Cahn and William Owen writing for the March 15th FastCompany.com. The CDC is working on alternatives.
And while many Americans resent any intrusion into their medical history or being forced to get inoculated, for years many countries have required specified inoculations as a condition to entry, often noted on yellow WHO forms appended to passports by official governmentally approved seals or stamps. Typhoid. Yellow fever. Etc. For many Americans expecting to travel, they are increasingly likely to be required to have some form of acceptable proof of a viable COVID vaccination. This is hardly a simple challenge. Ruth Reader, writing for the March 15th FastCompany.com, explains:
“Vaccine passports—proof that you’ve been vaccinated against COVID-19—are at this point an inevitability. Countries including Seychelles, Cyprus, Georgia, Romania, Poland, Iceland, and Estonia will require travelers to have a COVID-19 vaccination to enter. Now, lots of tech companies are working on building apps that certify a traveler is vaccinated. But there are a few problems with vaccine passports, and the World Health Organization has voiced its distaste for the concept… The main concern is that vaccine distribution is not globally equitable and vaccine passports could create social stratification.
“‘At the present time the use of certification of vaccination as a requirement for travel is not advised because quite simply vaccination is just not available enough around the world and is not available certainly on an equitable basis,’ said Michael Ryan, head of the WHO’s health-emergencies program, at a press conference. The organization says that it thinks providing vaccinated people with an official certification is valuable for public health purposes, but that vaccination should not entitle a person to more freedoms than an unvaccinated person. This is particularly true, the WHO notes, because there is still little data about if any of the COVID-19 vaccines prevent transmission of COVID-19.
“‘Inequity and unfairness can be further branded into the system if we continue to make decisions on what people can and can’t do, where they can and can’t go on the basis of being vaccinated, when being vaccinated itself is not something that everyone has equal access to,’ said Ryan.
“Another problem with vaccine passports is that there is not yet a universal standard for vaccination certification. That means that certifications can be easily faked… “It should be the government that takes the lead,’ said [Roderick Jones, the chairman of Concentric, a security firm based in Washington State]. ‘I think it should be the United States that takes the lead.’…
“As part of the COVID-19 response, President Joe Biden has asked the departments of Health and Human Services and Homeland Security to explore ways to certify COVID-19 vaccination that are digital and are interoperable with existing vaccination authentication methods. The head of the Office of the National Coordinator for Health Information Technology, Micky Tripathi, recently confirmed that the office is indeed working with various federal agencies to come up with a workable standard that can be used for travel.” The European Union is exploring the same issue for both its residents and those seeking entry into the EU. Whether we like it or not, we are undoubtedly going to face travel restrictions from a rising number of nations, despite the unfairness or the vaccine skepticism, where proof of vaccination will become a condition to cross a border and enter a country.
I’m Peter Dekom, and perceived “rights” of Americans to make vaccination choices will fall on even deafer ears in other countries that have a strong interest in stemming the spread of disease into their countries.
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