As more and more governments are mulling the idea of trialing the possibility of providing people with health passports to enable them to travel again, we thought it would be helpful to do this short article that explains what they are. We will see how they work, who the major players in this arena are, and look into some of the privacy and other concerns raised about this emerging field.

How It All Began

Discussions among authorities, researchers, and tech firms started as early as April last year over how to implement and what standards need to be used in these health or immunity passports that could allow people to freely move about their countries, as they considered lock-down exit strategies. Initial solutions that were proposed included those similar to China’s QR-coded health app that used data from antibody tests specific to COVID-19 to allow people to travel. But this lost traction as concerns were raised by the World Health Organization (WHO) and other health authorities pointing to a lack of evidence to prove that people who develop antibodies after recovering from COVID-19 are immune to a second infection.

Now, with the emergence of vaccines providing longer immunity and with a better understanding of the pandemic’s behavior, technology groups and governments have started developing the frameworks and standards. Digital health passports are quickly emerging as one of the biggest components that might aid the rebound of travel. Test result documents could be forged, and checking paperwork is highly time-consuming and almost impossible. But digital health passports can solve these critical blocks that come that between testing, vaccines, and travel, by providing foolproof methods for airlines and border officials to verify results and certificates.

So What Are They?

A health passport is a verifiable credential that could be used to confirm to airline staff or border control that a particular individual is at low risk of acquiring or transmitting the virus. It’s a modern take on the International Certificate of Vaccination or Prophylaxis (ICVP), also known as the Yellow Card, which is an official vaccination record created by the World Health Organization (WHO). As a travel document, it is a kind of ‘medical passport’ that is recognized internationally and may be required for entry to certain countries where there are increased health risks for travelers.

Here’s where it gets complicated and exciting. The ICVP is only valid for vaccines approved by the WHO and follows a model provided by them in 2005. The advancements in technology could help make this ‘health passport’ more scalable, easier to use, and secure. But a lot has changed since and mostly just in 2020. The Covid-19 pandemic and various vaccinations that have come out complicates the scenario – which authorities accept which vaccines and from who? What standards are accepted in verification and what frameworks should be used? What technologies are best and how secure are they? These questions are further complicated by privacy advocates and tech lobbies.

The authorities and tech firms will need to address all these concerns. The new systems are simplified using technology and hence, ‘Digital Health Passport’ which could be an app, or online certification, that displays a traveler’s Covid-19 or other test results or vaccination records. They will provide a viable method of checking who’s eligible to enter a country, depending on a country’s recognition of the type of tests or vaccinations. Successful implementations of these verifiable credentials (VCs) platforms for health could pave way for a faster recovery of the travel and other struggling industries.

Major Initiatives

The International Air Transport Association (IATA) has developed its own solution – IATA Travel Pass app – that Emirates, Etihad, and Singapore Airlines have all been trialing the Travel Pass app, with Qatar Airways, Copa Airlines, and Government of Panama planning to start trials soon. The app stores encrypted data, including verified test or vaccination results on the traveler’s mobile phones. The traveler then has full control of what information is shared from their mobile devices with airlines and authorities. The app also verifies the user’s government IDs, test results, and vaccination information.

The Covid Credentials Initiative (CCI) is another notable health passport. It is hosted by Linux Foundation Public Health (LFPH) and is an open-source software that helps deploy privacy-preserving verifiable credential projects in order to mitigate the spread of COVID-19 and strengthen our societies and economies. The focus on privacy and transparency by giving complete control of personal data to the user makes such initiatives better acceptance at a global stage.

VeriFLY by Daon is a smart digital health passport that allows a real-time verification of COVID-related credentials, such as health questionnaires and diagnostic lab test results on smartphones. Designed for a wide array of organizations and use cases, their HIPAA-compliant solution removes the burden from organizations to structure agreements for lab results in multiple locations. It’s currently being trialed by British Airways and American Airlines.

Other major digital health passports include AOK Pass by the International Chamber of Commerce (ICC), CommonPass by The Commons Project Foundation, CoronaPass by Bizagi, Passport for Covid by Hired Help, V-Health Passport, and a health passport by iProov and mvine among others.

How They Work

From the end-user perspective, digital health passports are simple and rather easy to use. Travelers download the app on their mobile devices from trusted sources and connect the app with their travel provider or provide the travel itinerary. Based on the details provided the app provides details as to what verification credentials are required for the trip. Then the traveler proceeds to complete the required procedures like getting the Covid-19 vaccinations that are accepted at the destinations. The results are then received on the app either automatically or updated through QR codes sent to the traveler, confirming their eligibility and validity.

These credentials are then presented at the airline check-in counters and border securities at the time of travel. Some apps allow greater control of the data than others at various stages, allowing them to customize what data is passed on at each verification point. The personnel at the check-points verify these credentials and allow the users to continue their travel. Tech firms are also working on simplifying the processes such as the requirement of standalone apps or limitations faced by families and groups.

Some Concerns

All health passport platforms collect and store private and highly sensitive information about passengers. This raises various concerns, particularly about the provisions to preserve privacy. Some point that immunity passports of future would be radically different from its predecessor the ICVP (or Yellow Card) in that while the There are also concerns that while vaccination certificates incentivize individuals to obtain immunity, these newer passports incentivize infection.

There are also concerns that passports would impose an artificial restriction on who can and cannot participate in social, civic, and economic activities. This might create a perverse incentive for individuals to seek out infection, especially people who are unable to afford a period of workforce exclusion, compounding existing gender, race, ethnicity, and nationality inequities. Some are afraid that it could even exacerbate the harm inflicted by COVID-19 on already vulnerable populations.

Acceptance and Future

Currently, the acceptance of these is limited due to the difference in protocols followed by various governments and authorities. Organizations and businesses including airports, airlines, tech, and even healthcare follow various standards when it comes to fighting the pandemic. Apart from a few common measures like social distancing, wearing masks, and washing hands, governments follow different approaches when it comes to most other issues – from lock-down restrictions and travel bans to vaccinations preferred.

On a different note, the willingness of the public to get vaccinated is another factor. Recent surveys by various organizations including travel advocacy groups point to varying levels of acceptance among people in different countries. While 80% or more from countries like China and Brazil are happy to get vaccinated, many are not so confident. The figure was about 50% in the case of South Africa, while Russia and France were only 40% accepting. 60% of Indians prefer to wait when it comes to taking the jab. Worries include side-effects, efficiency, and trust of some of the vaccines.

However, the concept of digital health passports as a solution to restart the travel and tourism industry is gaining traction among governments and airlines. As the initial confusions regarding standards begin to settle, more platforms will be able to offer secure data sharing methods. This we hope will allow wider application of health passports. Most countries will also eventually approve multiple platforms so as to ease travel restrictions and reboot their economies. We can also hope they will be more accepting of other vaccination options. And with these changes in government policies, airlines companies, and other travel-related companies will also be able to open up to the global travel community.