The Accelerating Rollout of COVID-19 Vaccines Makes Domestic 'Immunity Passports' Largely Irrelevant

Vaccine hesitancy will decline as more family, friends, and neighbors get vaccinated.

Nearly 181 million doses of COVID-19 vaccines have been distributed in the United States, and more than 143 million of those have been administered. More than 93 million U.S. residents have received at least one dose of a COVID-19 vaccine, and more than 51 million people have been fully vaccinated—including 5 million inoculated with the Johnson & Johnson one-dose vaccine. This means that slightly more than 28 percent of the American population has gotten at least one dose, and 15.5 percent are fully vaccinated.

"When Israel hit about 25 percent of their population vaccinated, that's when they started to see the [case] declines that were ascribed to the vaccination. We're right about at that tipping point," former Food and Drug Administration Commissioner Scott Gottlieb said on CNBC's Squawk Box.

The latest real-world data show that both the Pfizer/BioNTech and Moderna vaccines are 80 percent effective at preventing both symptomatic and asymptomatic COVID-19 infections after one dose; after two doses, the effectiveness rises to 90 percent. Since both vaccines prevent asymptomatic disease, vaccinated people are unlikely to harbor undetected infections that could transmit the virus to unvaccinated people.

In clinical trials, the Johnson & Johnson vaccine was 85 percent effective at preventing severe disease and the AstraZeneca vaccine 76 percent effective at preventing symptomatic illness. All four vaccines are basically 100 percent effective at preventing COVID-19 hospitalizations and deaths.

Most epidemiologists believe that somewhere between 70 to 85 percent of the population will need to be protected through infection or vaccination to achieve herd immunity against the virus. With herd immunity, the epidemic abates because people who remain susceptible to infection are increasingly surrounded by immune individuals who serve as a barrier, preventing the microbes from reaching them.

Various polls suggest that about 30 percent of Americans are reluctant to get vaccinated against COVID-19. A recent Pew Research poll finds that the percentage of people saying that they will get vaccinated has been increasing as the vaccine rollout proceeds. Nevertheless, this still high percentage of vaccine-hesitant people threatens to undermine the possibility of getting back to normality through achieving herd immunity.

So how to persuade vaccine hesitant folks to get vaccinated? One suggestion is to issue immunity "passports" to fully vaccinated or fully recovered people. This has been happening since last month in Israel, where public health authorities are issuing Green Passes that grant vaccinated or recovered citizens access to social, cultural, and sports events as well as to gyms, hotels, and indoor dining at restaurants and bars. The passport system appears to have encouraged more people, especially the young, to get vaccinated.

Wouldn't such immunity passports discriminate against people who want to be vaccinated but aren't able to yet? George Washington University physician and health policy professor Leana Wen and her colleagues acknowledge that concerns about that kind of discrimination are real, but they point out that the "lack of access to vaccines will be a problem for just a matter of months as the distribution speeds up." Leana and her colleagues argue that the bigger worry is "continued lack of herd immunity," since that "could extend the current crisis for years to come with significant impacts on all communities."

My Reason colleague J.D. Tuccille rightly worries that public health authorities could abuse such immunity passports. Nevertheless, since COVID-19 vaccination rates will vary greatly across the world for at least the next couple of years, some form of proof of vaccination will be undoubtedly required for international travel.

Beyond that, the accelerating distribution and administration of COVID-19 shots could make the incentive value of COVID-19 passports more or less moot. President Joe Biden just today announced that 90 percent of American adults will be eligible for the vaccination by April 19. The cohort of vaccine-hesitant Americans will shrink as ever more happily and now safely immune family members, friends, and neighbors urge them to protect themselves and others by getting vaccinated.

Disclosure: I am now two weeks past my second dose of the Moderna vaccine, from which I experienced no side effects whatsoever.