Mandates for COVID-19 vaccine passports have been contentious, with many states banning the practice and a handful endorsing it. California has not yet made vaccine passports a requirement. However it has rolled out a vaccine verification system.
Many think that California will endorse COVID-19 vaccine passports as private venues, workplaces, academic programs and governments are now requiring proof of vaccination.
While the intentions might be good, it will be extremely important for governing bodies to determine what is considered COVID-19 immune and COVID-19 vaccine exempt.
Governing bodies must ensure they follow the current science to maximize public safety without creating spurious mandates. For example, there is growing systematic and peer-reviewed evidence that those with prior documented SARS-CoV-2 infection have equal or greater protection against COVID-19 as those who were not previously infected but vaccinated.
The prominent journal Science even highlighted an Israeli study that found that people who once had a SARS-CoV-2 infection were much less likely than those vaccinated to get infected, develop symptoms or become hospitalized with the highly contagious delta variant.
Given that natural immunity may provide equal or better protection against infection than vaccination, many physicians might consider prior infection as a bona fide medical exemption to President Joe Biden’s newly proposed vaccination requirements.
It is also important to ensure that people who cannot get a vaccine, i.e., those with potentially life-threatening allergic responses to vaccine ingredients, can find ways to access public services without being discriminated against for their medical condition.
COVID-19 passports are meant to increase public safety. With the knowledge that prior infection is as good if not better than vaccination to protect an individual from COVID-19, it is reasonable that those with prior infection should qualify for a passport. However, to properly implement that, lawmakers must be careful to ensure that only people who have had documented SARS-CoV-2 infection qualify for COVID-19 passports because there are already many cases of counterfeit vaccination cards.
Those with prior COVID-19 infections need to be able to prove they had a documented infection with either a positive polymerase chain reaction (PCR) test or a positive antibody test. While there might be some concern about loss of antibody positivity over time, it has been found that people with prior COVID-19 and a negative antibody test still have durable protection against infection.
With the continuation of the COVID-19 pandemic, we agree that passports are reasonable. However, the implementation of COVID-19 passports must be done judiciously and scientifically. With our current knowledge, it would be disingenuous for lawmakers to exclude people who have recovered from SARS-CoV-2 infection from COVID-19 passports.
Dr. Noah Kojima is a resident in internal medicine at UCLA Health. Dr. Jeffrey D. Klausner is a professor of medicine, population and public health sciences at Keck School of Medicine of the University of Southern California. They wrote this for CalMatters.
