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--:-- Sean Rameswaram: Almost 200 million doses of COVID-19 vaccinations have been administered in the United States. Something like 75 million people have been fully vaccinated. Almost a billion people have received a shot globally. And with so many people itching to get back to normal, it's inevitable that we start talking about proving you have the vaccine.
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--:-- Sean Rameswaram: Some call this proof a vaccine passport. But our guest today will explain why that's a bit of a loaded term.
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--:-- Sean Rameswaram: Yeah. So one of the big challenges with this discussion is that a whole bunch of things are now being bucketed into this term vaccine passport.
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--:-- Sean Rameswaram: Our guest today is Rebecca Highwell from Recode.
--:-- Rebecca Highwell: So broadly, it essentially just means a record of the fact that you have received an inoculation or a vaccine.
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--:-- Rebecca Highwell: Recently, it's come to refer to the idea that this record might be on your smartphone. It might be on a pass that you carry, you know, in the pandemic.
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--:-- Rebecca Highwell: And it would basically include a record from maybe a health provider that's given you that vaccine or a government or a state health authority that confirms that you have had this vaccine and you've been inoculated for COVID-19.
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--:-- Rebecca Highwell: But one thing I'd really, really push against is actually calling them vaccine passports.
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--:-- Rebecca Highwell: One of the challenges has been that that term implies that it means you can actually go places and it's going to give you all these privileges, which is part of it.
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--:-- Rebecca Highwell: But I think a lot of the things that are being rolled out right now are simply digital records of the fact that you've been vaccinated and aren't, you know, so different from a paper version of the same thing or the record of the fact that you've received a vaccine that exists with your health care provider.
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--:-- Sean Rameswaram: Okay, so this isn't going to get me into Canada necessarily. What will this do? Why would you need a so-called vaccine passport or a digital record?
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--:-- Rebecca Highwell: So there are a separate slew of initiatives that are trying to take those records to enable life to sort of return to normal again.
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--:-- Rebecca Highwell: And so we've seen this airport security company, Clear, try to roll out using these vaccine records for venues and, you know, returning to sports games and things like that.
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--:-- Rebecca Highwell: Meet Jane. She's eager to cheer on her favorite team at the stadium, get back to her favorite restaurant and even get back to the office.
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--:-- Rebecca Highwell: HealthPass is the solution for your business to allow safer access while providing Jane the confidence to get moving.
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--:-- Rebecca Highwell: You know, it's possible some small businesses might want to look at it, or even cruise lines might want to use a vaccine record in order to make sure that you're vaccinated before getting on board for two weeks with a bunch of other people.
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--:-- Sean Rameswaram: So the idea is that this is going to help us get back to normal, whatever that looks like, but it's not necessarily for traveling abroad just yet.
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--:-- Rebecca Highwell: So maybe get you into a concert one day?
--:-- [Sound effects: A brief pause]
--:-- Sean Rameswaram: Yeah, potentially, though it's worth keeping in mind.
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--:-- Rebecca Highwell: Remember concerts, Rebecca? Yeah, I think back in those days fondly.
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--:-- Rebecca Highwell: The thing to keep in mind also is a lot of the apps that are actually rolling out to do something like that also have other functionalities built into them that allow you to just test negative for COVID and do the exact same thing.
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--:-- Rebecca Highwell: So it gets really complicated because there are so many apps, there are so many different initiatives, and they're all doing slightly different things, but everyone's calling them vaccine passports.
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--:-- Sean Rameswaram: Hmm. What is required for a true vaccine passport? What does it look like?
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--:-- Rebecca Highwell: So the first thing that you need is a record that you've been vaccinated.
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--:-- Rebecca Highwell: One of the challenges with this is that we've been getting these little paper cards with the CDC insignia. They're famous now, but they're not set up to be double checked.
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--:-- Rebecca Highwell: It's not like if you're hosting an Ariana Grande concert, you can just call up the CDC and say, hey, someone should be this card. Is that right?
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--:-- Rebecca Highwell: That's not how the system is set up.
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--:-- Rebecca Highwell: So we have to use all these different records that might exist with your healthcare provider or whoever gave you the vaccine to make sure that you have in fact been vaccinated.
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--:-- Rebecca Highwell: So you need that record and then you need some sort of level of trust between whoever's looking at that record, like a concert, and the provider of that record.
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--:-- Rebecca Highwell: So there's sort of a two-step process here.
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--:-- Rebecca Highwell: And those CDC cards, to be clear here, not a vaccine passport.
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--:-- Sean Rameswaram: So what's weird is some places have been using them as proof of vaccination, but a lot of people don't see them as completely trustworthy because of the problems that I just mentioned.
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--:-- Rebecca Highwell: They've also been forged.
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--:-- Rebecca Highwell: They look like they be really easy to forge
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--:-- Sean Rameswaram: I reported on how easy they are to forge in the past
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--:-- Rebecca Highwell: According to cybersecurity firm Checkpoint this listing on the dark web offering a fake vaccine certificate for $150, claiming not everybody will like to take the COVID-19 vaccine and we provide proof of having been vaccinated.
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--:-- Sean Rameswaram: You know, that's why we've had all of these initiatives to build a digital system that would do somewhat of a similar thing.
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--:-- Rebecca Highwell: Who is pushing for a better system right now? Who is pushing for some sort of legitimate vaccine proof of purchase?
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--:-- Rebecca Highwell: So what's interesting is that the federal government has said basically they're not going to be involved in offering a standard credential of vaccination, and they're not going to be forcing people to prove that they've been vaccinated.
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--:-- Rebecca Highwell: The Biden administration has basically opted out on this.
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--:-- Rebecca Highwell: So now we have different states that have moved ahead and trying to offer this themselves.
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--:-- Rebecca Highwell: So we've seen New York State roll out something called the Excelsior Pass, which Andrew Cuomo is really sort of pushing ahead.
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--:-- Sean Rameswaram: Excelsior, huh? Yeah. Sounds fancy. New York State pride.
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--:-- Rebecca Highwell: Yep, the city is coming back all right.
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--:-- Rebecca Highwell: Now the state is hoping its new Excelsior app can help speed things up even more.
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--:-- Rebecca Highwell: You know, Hawaii is talking about having a vaccine passport program this summer for travelers.
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--:-- Rebecca Highwell: And there's been some discussion in North Carolina as well.
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--:-- Rebecca Highwell: But what's also interesting is that the people who have been rolling out apps the quickest are actually these sort of collectives of nonprofits, healthcare companies, and sort of health record companies, tech companies trying to come up with standards for this.
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--:-- Rebecca Highwell: So it's actually the private sector that's leading on this.
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--:-- Rebecca Highwell: And that's created this problem where you have, you know, a million different initiatives trying to do the exact same thing.
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--:-- Rebecca Highwell: And there's no standardization across that, which makes the prospect of having a universal vaccine passport system seem really unlikely in the U.S.
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--:-- Sean Rameswaram: So just like everything else over the course of this pandemic, we're looking at a likely patchwork of verification of vaccination?
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--:-- Rebecca Highwell: Yeah, it's very patchwork.
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--:-- Sean Rameswaram: Why is the federal government not into this?
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--:-- Rebecca Highwell: The Biden administration has said that they're worried that instituting some kind of federal or government-based vaccine credential system would make people less trusting of the vaccine process and less likely to actually get the vaccine.
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--:-- Rebecca Highwell: As these tools are being considered by the private and nonprofit sectors, our interest is very simple from the federal government, which is Americans' privacy and rights should be protected so that these systems are not used against people unfairly.
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--:-- Rebecca Highwell: And they've said, you know, we think Americans will not trust a government-backed system here.
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--:-- Rebecca Highwell: It's better to leave it up to the private sector.
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--:-- Sean Rameswaram: And to some extent, that has played out in sort of some of the outrage that we've seen about the idea of a vaccine passport.
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--:-- Rebecca Highwell: Outrage, you say? Tell me about the outrage.
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--:-- Rebecca Highwell: Yeah, there's a lot of legitimate concerns about vaccine passports, which we should get to.
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--:-- Rebecca Highwell: But there have also been a lot of sort of culture war-like concerns that have been brought up as well.
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--:-- Rebecca Highwell: Not necessarily in good faith, but we've seen the Republican governors of Florida and Texas have recently banned vaccine passports to various extents.
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--:-- Rebecca Highwell: We are not supporting doing any vaccine passports in the state of Florida.
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--:-- Rebecca Highwell: Government should not require any Texan to show proof of vaccination and reveal private health information just to go about their daily lives.
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--:-- Rebecca Highwell: You want to go to a movie theater? Should you have to show that? No.
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--:-- Rebecca Highwell: You want to go to a game? No.
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--:-- Rebecca Highwell: We've also seen legislation proposed by one Republican in Congress that would ban the federal government from issuing or requiring vaccine passports, which, again, the federal government is not trying to do.
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--:-- Rebecca Highwell: And it plays into this whole thing of like fear of government surveillance.
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--:-- Rebecca Highwell: You're limiting my freedom.
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--:-- Sean Rameswaram: Arguments about get a government overreach and things like that.
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--:-- Rebecca Highwell: Other countries, we have seen state-backed, government-backed initiatives that basically involve a vaccine passport system.
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--:-- Rebecca Highwell: But vaccine passports of an idea have been picked up by conservatives as sort of a way to sort of start a fight and create a giant argument.
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--:-- Sean Rameswaram: So it sounds like there's a culture war over a federally mandated vaccine passport.
--:-- [Sound effects: A brief pause]
--:-- Rebecca Highwell: But is there a culture war over like private, not-for-profit or even for-profit entities taking up this cause?
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--:-- Rebecca Highwell: I think the broader culture war has kind of sort of trickled down to include anyone who wants to ask for vaccine records or proof of COVID-19 vaccination.
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--:-- Rebecca Highwell: So people aren't just upset about a government role in this.
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--:-- Rebecca Highwell: They're upset that, you know, a venue might ask for proof of vaccination.
--:-- [Sound effects: A brief pause]
--:-- Sean Rameswaram: But again, it's all predicated on this idea of vaccine passport, which refers to several different initiatives that are all doing different things and might be as simple as just giving you a printout or like a phone record of the fact that you received a vaccination, which is a record that your health care provider already has.
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--:-- Rebecca Highwell: Right. So it could be as simple as that.
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--:-- Rebecca Highwell: And that's being called a vaccine passport.
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--:-- Sean Rameswaram: The CDC card is being called a vaccine passport.
--:-- [Sound effects: A brief pause]
--:-- Rebecca Highwell: And it's all factoring into this argument where no one's quite being clear about terms and really referring to one specific thing.
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--:-- Sean Rameswaram: Beyond politics, you mentioned there are some legitimate concerns about these kinds of vaccine certifications.
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--:-- Rebecca Highwell: Well, one of the questions is supply. Right.
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--:-- Rebecca Highwell: And this is a criticism that the World Health Organization has brought up in regard to international travel.
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--:-- Rebecca Highwell: And they have said you know as long as there are lots of people in the world who cannot get the COVID vaccine yet instituting a system in which some people can travel freely between countries because they gotten vaccinated and other people can creates really significant questions about equity and questions about you know incentivizing people from wealthier more privileged countries taking up more vaccine doses so they can go vacation while other people who are maybe more at risk still haven gotten the vaccine
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--:-- Rebecca Highwell: You know, there are questions about privacy, this going digital, and what does it mean to have this record on a phone or in a database?
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--:-- Sean Rameswaram: But that's not often the criticism that's being brought into the mainstream in the U.S. that we're talking about.
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--:-- Rebecca Highwell: But it's important to acknowledge those questions as well, because they are important.
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--:-- Sean Rameswaram: I hear that.
--:-- [Sound effects: A brief pause]
--:-- Rebecca Highwell: Also worth noting, there are already vaccine certifications out there in the United States and all over the world, right?
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--:-- Rebecca Highwell: Yeah. I mean, people have to show proof of vaccination to do a whole lot of things.
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--:-- Rebecca Highwell: You know, if you ever went to summer camp or you probably had your parents show or get some forms from a doctor's office proving that you had some kind of a list of vaccines that you're required to get or school or whatever.
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--:-- Rebecca Highwell: So credentials for vaccinations certainly aren't new.
--:-- [Sound effects: A brief pause]
--:-- Rebecca Highwell: What's new is the pandemic.
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--:-- Rebecca Highwell: And what's new is COVID-19 and the question of whether we want that kind of system to be applied here, how it should be applied and whether this is something we want.
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--:-- Sean Rameswaram: They might be controversial in 2021, but vaccine passports have been around in some shape or form since vaccine number one.
--:-- [Sound effects: A brief pause]
--:-- Sean Rameswaram: That's in a minute on Today Explained.
--:-- [Sound effects: A brief pause]
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--:-- Sean Rameswaram: Okay, so in the year of the ox 2021, vaccine passports are stirring up all sorts of controversy around the world and in Florida and in Texas.
--:-- [Sound effects: A brief pause]
--:-- Sean Rameswaram: Also, maybe don't call them vaccine passports, but whatever you call them, it's important to remember they're not new.
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--:-- Sean Rameswaram: They've been around just about as long as vaccines have.
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--:-- Sean Rameswaram: We reached out to historian Jordan Taylor for a reminder.
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--:-- Jordan Taylor: The first thing we need to do is talk about smallpox.
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--:-- Jordan Taylor: The smallpox vaccine is really the first vaccine introduced into the Western world.
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--:-- Jordan Taylor: And by the late 19th century, the design of the smallpox vaccine was pretty straightforward.
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--:-- Jordan Taylor: And we've talked about this a little bit on the show before, but remind people what a smallpox vaccination looked like.
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--:-- Jordan Taylor: Yeah. So someone would scrape you across the arm with a lancet or something like that that was abrasive and smallpox vaccines would leave a scar.
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--:-- Jordan Taylor: You would get a sore and that would leave behind a really distinctive looking scar.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: According to people in the 19th century, you could really tell a vaccine scar from smallpox apart from other scars.
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--:-- Jordan Taylor: It was really distinctive looking.
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--:-- Jordan Taylor: Some people said that it looked like a peach pit.
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--:-- Jordan Taylor: If you have an older relative or an older friend, you can probably ask them to see theirs because most people who were born in the first part of the 20th century probably have a smallpox vaccine scar.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: And I can only assume giving people scars would pull poorly in the present day, but were these smallpox scars in a way the first vaccine certifications?
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--:-- Jordan Taylor: Yeah, absolutely.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: For people in the late 19th and early 20th centuries, the fact that these vaccines left a scar was kind of a godsend.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: It meant that it was really pretty easy to tell who had been vaccinated and who hadn't been vaccinated.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: Anytime you were traveling, anytime you were entering an institution like a school, or even moving into a new employment situation, you might be asked to prove your vaccination status by showing your scar.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: And so in a lot of ways, it did function almost exactly like the vaccine passports that are being debated and proposed today.
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--:-- Jordan Taylor: And like today, there was some controversy.
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--:-- Jordan Taylor: Yeah. Some people didn't want to get vaccinated because it was uncomfortable.
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--:-- Jordan Taylor: Some people didn't like the scar.
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--:-- Jordan Taylor: Some people just were uncomfortable with the whole idea of being vaccinated.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: Remember, this was, you know, the first vaccine and it was pretty new.
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--:-- Jordan Taylor: And the idea of putting a strain of a virus into your body on purpose seemed pretty counterintuitive to a lot of people
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--:-- Jordan Taylor: And so as there is today there was a small but pretty vocal and well group of what we might call anti who thought that vaccines weren healthy and weren't a good idea.
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--:-- Jordan Taylor: There was a newspaper in New York in 1901, I think, that had this story about people who were manufacturing these fake vaccine scars with plaster and selling them.
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--:-- Jordan Taylor: There were also reports about physicians and other people who were forging vaccine certificates saying that you had been vaccinated when you hadn't because there was a big market for people who wanted to evade these restrictions.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: But lots of people still ended up getting the shot.
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--:-- Jordan Taylor: How? Yeah, it was enforced in all kinds of ways.
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--:-- Jordan Taylor: So there was no national policy.
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--:-- Jordan Taylor: Every kind of state or local government or institution had its own sort of rules.
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--:-- Jordan Taylor: Some places experiencing deadly outbreaks of smallpox would mandate compulsory vaccination.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: In other words, forcing everyone in a neighborhood or community where an outbreak was happening to get vaccinated and prove that they had been vaccinated.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: Occasionally, there are a few examples where this actually got violent.
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--:-- Jordan Taylor: There are at least a couple examples of reports of Boston police forcibly vaccinating people on the streets who wouldn't comply.
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--:-- Jordan Taylor: Overall, though, that was pretty unusual.
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--:-- Jordan Taylor: And it's certainly not a precedent that I think anyone wants to follow today.
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--:-- Jordan Taylor: And we actually recently ran an episode from our friends over at the Experiment podcast in which they talked about one of these original anti-vaxxers and how his case, I think it was Jacobson, ended up at the Supreme Court, right?
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--:-- Jordan Taylor: Yeah. So there was a Swedish immigrant. A guy named Henning Jacobson.
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--:-- Jordan Taylor: Who lived in Cambridge, Massachusetts in 1902, who refused to be vaccinated even though his city had required that everyone be vaccinated.
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--:-- Jordan Taylor: They argued that vaccination was dangerous, that compulsion was unnecessary, that this was a violation of every individual's right to make choices about their own bodies.
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--:-- Jordan Taylor: In his case, as you said, it worked its way all the way up to the Supreme Court, where a majority, I think it was a seven to two ruling.
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--:-- Jordan Taylor: They ruled that, and this is a quote from the decision, they ruled that a community has a right to protect itself against an epidemic of disease which threatens the safety of its members.
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--:-- Jordan Taylor: So the government has this Supreme Court precedent when it comes to mandating vaccines, but it doesn't feel like we're getting anywhere close to that right now.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: Was there something different about the smallpox pandemic?
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--:-- Jordan Taylor: Yeah, there are a lot of differences.
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--:-- Jordan Taylor: Probably the most important thing to point out is that smallpox and COVID are very different diseases.
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--:-- Jordan Taylor: As horrible as COVID is, smallpox was just absolutely horrifying.
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--:-- Jordan Taylor: It had a 30% mortality rate.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: In other words, if you contracted smallpox, there was a 30% chance that you were going to die.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: It was deadly enough that even extreme measures seemed to be pretty well justified.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: Unlike today, where there is a lot of misinformation circulating about COVID being nothing more than the flu or something like that.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: No one doubted the severity and the deadliness of smallpox.
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--:-- Jordan Taylor: But maybe the two most important differences between the reaction to the smallpox epidemics of the 19th and the 20th century and today is the politics and the way that people thought about personal liberty.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: Anti-vaxxers in the 19th and the early 20th century didn't have the vehicle of a major political party to spread their message like they do today.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: The anti-vaccination campaign wasn't entangled with the partisan politics of its moment.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: Compared to today, the anti-vaxxers, they were loud, but they were pretty marginal.
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--:-- Jordan Taylor: And the second thing I think that's worth pointing out is that a century or so ago, Americans were living through what we now call the progressive era, which evolved in part out of an increasingly expansive understanding of what liberty meant, what freedom meant.
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--:-- Jordan Taylor: Today, we often think of liberty as being sort of the absence of restraint or interference by the government, right?
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: But there's also another way of thinking about it, what the philosopher Isaiah Berlin calls positive liberty, being able to live your life, being able to flourish and determine your own destiny.
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--:-- Jordan Taylor: And as we've seen over the past year, I'm sure all of us have experienced this, it's really hard to flourish in quarantine.
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--:-- Jordan Taylor: So I think there's an important case to be made that vaccine passports aren't just restrictions on personal liberty.
--:-- [Sound effects: A brief pause]
--:-- Jordan Taylor: They're a way of ensuring that we all have the liberty to determine the direction of our own lives and to live without fear of being infected by our neighbors.
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--:-- Sean Rameswaram: Jordan Taylor teaches history at Smith College in Northampton, Massachusetts.
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--:-- Sean Rameswaram: I'm Sean Ramos-Furham.
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--:-- Sean Rameswaram: This is Today Explained.
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