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Report COVID-19 technologies

Checkpoints for vaccine passports: Public legitimacy

Public confidence will be crucial to the success of a COVID vaccine passport system, and will be highly locally contextual

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Black outline of certificate in red circle

Another consideration for any COVID vaccine passport scheme is its perceived legitimacy. Illegitimate systems are undesirable both because they lack a sufficient political justification and because an illegitimate system will be likely to face significant resistance to its implementation. Legitimacy is a contested concept, and different attributes will be required for a system to be legitimate in different cultures and under different moral and political philosophies. Here, we are concerned with legitimacy in democratic pollical systems.

In part, legitimacy in democratic political systems can come from following due process. This includes debate by representatives in a legislature and subsequent legislation, or by ensuring proportionality and respect for human rights in accordance with existing legal and constitutional frameworks, as we have discussed in previous chapters. However, another important of legitimacy in democratic political systems is the consent of citizens and public support for particular measures. This means understanding what the public are willing to endorse and continuously involving the public at each stage of development.

Checkpoints for vaccine passports

This is one of six requirements for a socially beneficial vaccine passport system, as outlined in a report based on an extensive review of the key debates, evidence and common questions around digital vaccine passports

Polling

One approach to public legitimacy of vaccine passports would be through surveys and polls. Polls conducted in the UK suggest that public support for COVID vaccine passports varies depending on the availability of vaccinations, the particular use cases, and the providers of
certification:

  • An academic study of UK public opinion during March–April 2020, the height of the first wave of COVID-19 in the UK, found most people did not object to immunity passports (introduced as ‘imply[ing] that you are now immune and therefore unable to spread the virus to other people’) and 60% of people wanted one (to varying degrees), although 20% thought them unfair and opposed them completely.1
  • Polling by Deltapoll in January and February 2021 found support for restrictions at an international level. At a domestic level, January polling found narrow support (42–39%) for vaccinated people being allowed to do things (meeting friends, eating in restaurants, using public transport) that others could not.2 Support had risen 12 points by the end of February, although passports and certificates were not explicitly mentioned.
  • Polling published by YouGov in March 2021 found support for a vaccine passport system, but with greater opposition in younger age groups, varying levels of support for different use cases (from 72% in favour of use at care homes, to 31% at supermarkets) and opposition to private companies being allowed to develop their own systems. Support was higher for passports once everyone had been offered a vaccine, compared to during vaccine rollout – which, as discussed above, is when the scientific case for using them is weaker.3 Somewhat contradicting the general support for certification is a separate YouGov poll from early March. This found that 79% of respondents thought those vaccinated should still be subject to the same COVID-19 restrictions as others, until most people had been vaccinated.4
  • Ipsos MORI polling in March 2021 found support for ‘vaccine passports’ was highest for international travel (78%) or visiting relatives in a care home (78%) or hospital (74%), but also high for theatres and indoor concerts (68%), visiting pubs and restaurants (62%) and using public transport (58%, though 25% were opposed). Nonetheless, one in five of those polled thought the ethical and legal concerns outweighed any potential benefits to the economy, with the young and ethnic minorities more concerned.5
  • Research conducted by Ipsos MORI at the end of March 2021, for King’s College London and the University of Bristol, found 39% of those polled thought unvaccinated people would face discrimination (28% did not), with 44% worried that vaccine passports would be sold on the black market. Half of those polled didn’t think passports would have a negative impact on personal freedoms, though a quarter thought they would reduce civil liberties. Just over a fifth of people thought passports would be used for surveillance by the Government, while more than two fifths did not, but concern was much higher among minority ethnic groups.6
  • A survey by De Montfort University, Leicester, found 70% agreed with the need for vaccine passports to travel internationally, but only 34% agreed with such a need for pubgoers or diners (compared to 45% against).7
  • Cultural sector consultancy Indigo found around two-thirds of people would be comfortable with passports or testing to attend live events (with a fifth and close to a third uncomfortable, respectively), but that 60% of people would be uncomfortable if this meant that other public health measures or restrictions inside the venue were dropped.8
  • Polling for the Serco Institute found broad support for passports across different settings, assuming there were ‘appropriate protections and exemptions for people who are precluded from taking the vaccine due to medical conditions’.9

The Ada Lovelace Institute’s own polling, with the Health Foundation, found more than half (55%) of those polled thought a vaccine passport scheme would be likely to lead to marginalised groups being discriminated against. 48% of people from minority ethnic backgrounds and 39% of people in the lowest income bracket (£0-£19,000) were concerned that a vaccine passport scheme would lead to them being discriminated against. While twice as many respondents (45%) disagreed with a ban on vaccine passports compared to those agreeing there should be a ban (22%), a third of respondents (33%) were undecided.

Taken together, these polls point to a lack of societal consensus on the way forward for vaccine passport schemes. Publics in the United States and in France show similar divisions.10

Deeper engagement

Surveys and polls are a powerful tool for measuring mass trends in attitudes, establishing broad baselines in opinion, or understanding what proportion of the public agree with particular statements. The information they provide helps us to understand the pulse of a population’s attitudes. But these methods fail to give comprehensive understanding of people’s perspectives on complex topics, such as the ethical and societal challenges of COVID vaccine passports and related digital technologies, and risk boiling these complex issues down into
statements which can be answered with ‘yes’ or ‘no’, ‘strongly disagree’ or ‘not sure’. Framing questions as simply about vaccine certification schemes also risks focusing on one possible measure rather than taking a holistic view of other measures that governments could deploy.

If governments want to understand what the public thinks about these issues and what trade-offs they might be willing to make in a deeper way, they need to provide a space for them to do so through more deliberative means.

Citizens’ juries and councils enable detailed understanding of people’s perspectives on complex topic areas. For example, the Ada Lovelace Institute has recently undertaken a year-long Citizens’ Biometrics Council to understand public preferences on the use and governance of biometrics technologies.11 Focus groups or engagement workshops can better capture the nuance in people’s opinions and creates complex data to analyse and describe in reports and recommendations. Qualitative and deliberative methods complement the population-level insights provided by polling by offering greater detail on why people hold certain opinions, what values or information inform those views, and what they would advise when informed.

This will be particularly important given the access to government decision-makers that other groups – lobbyists for particular industries, private companies building vaccine passport solutions – may have already had.12 In the UK, lobbying and corruption is currently towards
the top of the news agenda: given the importance of public trust to making government plans for lifting lockdown work, and in deploying new technology, it is vital that governments understand the position of different publics and hold their trust.

Recommendations and key concerns

 

We recommend undertaking rapid and ongoing online public deliberation that is designed to be iterative, across different points of the ‘development’ cycle of COVID vaccine passports, starting before any decision has been taken to implement such a scheme and continuously engaging with diverse publics through the design and implementation of any scheme if and as it develops.

 

Key groups to involve (beyond nationally representative panels of the population) include any groups disproportionately affected by the pandemic to date, and ‘non-users’ that could be excluded from a system, including those who were unable to have a vaccine. Governments should use existing community networks to reach people where they are located.

 

Public engagement to understand what trade-offs the public would be willing to make should be seen as a complement to, and not a replacement for, existing guidance and legislation. It should consider COVID countermeasures in the round (not just COVID vaccine passports) and should be clear about what is and what is not up for public debate.

 

Public engagement is important at all stages of development:

  • Deliberation should be undertaken before any decision on implementation is made, on the ethical trade-offs the public is willing to make and whether they think it’s acceptable for it to go ahead.
  • If deliberation establishes that such a scheme is acceptable or a decision has already been taken to implement a scheme, then public deliberation should be undertaken based on a clear proposal, to stress test the scheme and ask what implementation of vaccine passports would be most likely to engender benefit and generate least risk or harm to all members and groups in society.
  • If a scheme is implemented, then governments should continue to engage with the public to assess the impact of the technologies on particular groups within society, reflect on the experiences of individuals using the scheme in practice, and to inform and guide decision-making about whether such a scheme should continue, how it should be brought to an end or how it should be extended. Deliberation should include future risks and global consequences.
  • All stages are important, but even if deliberation is not possible at one stage, itcan still be implemented at other stages.

Requirement six: Future risks and global consequences

Read about the sixth of six requirements that governments and developers will need to deliver to ensure any vaccine passport system deliver societal benefit

Footnotes

  1. Lewandowsky, S. et al. (2021) ‘Public acceptance of privacy-encroaching policies to address the COVID-19 pandemic in the United Kingdom’, PLOS ONE, 16(1), p. e0245740. doi: 10.1371/journal.pone.0245740.
  2. 165 Deltapoll (2021). Political Trackers and Lockdown. Available at: http://www.deltapoll.co.uk/polls/political-trackers-and-lockdown (Accessed: 7 April 2021).
  3. Ibbetson, C. (2021) ‘Most Britons support a COVID-19 vaccine passport system’. YouGov. Available at: https://yougov.co.uk/topics/health/articles-reports/2021/03/05/britons-support-COVID-19-vaccine-passport-system (Accessed: 7 April 2021).
  4. YouGov (2021). Daily Question | 02/03/2021 Available at: https://yougov.co.uk/topics/health/survey-results/daily/2021/03/02/9355e/2 (Accessed: 7 April 2021).
  5. Ipsos MORI. (2021) Majority of Britons support vaccine passports but recognise concerns in new Ipsos MORI UK KnowledgePanel poll. Available at: https://www.ipsos.com/ipsos-mori/en-uk/majority-britons-support-vaccine-passports-recognise-concerns-new-ipsos-mori-uk-knowledgepanel-poll (Accessed: 9 April 2021).
  6. King’s College London. (2021) Covid vaccines: passports, blood clots and changing trust in government. Available at: https://www.kcl.ac.uk/news/covid-vaccines-passports-blood-clots-and-changing-trust-in-government (Accessed: 9 April 2021).
  7. De Montfort University. (2021). Study shows UK punters see no need for pub vaccine passports. Available at: https://www.dmu.ac.uk/about-dmu/news/2021/march/-study-shows-uk-punters-see-no-need-for-pub-vaccine-passports.aspx (Accessed: 7 April 2021).
  8. Indigo (2021) Vaccine Passports – What do audiences think? Available at: https://www.indigo-ltd.com/blog/vaccine-passports-what-do-audiences-think (Accessed: 7 April 2021).
  9. Serco Institute (2021) Vaccine Passports & UK Public Opinion. Available at: https://www.sercoinstitute.com/news/2021/vaccine-passports-uk-public-opinion (Accessed: 7 April 2021).
  10. Studdert, M. H. and D. (2021) ‘Reaching agreement on COVID-19 immunity “passports” will be difficult’, Brookings, 27 January 2021. Available at: https://www.brookings.edu/blog/usc-brookings-schaeffer-on-health-policy/2021/01/27/reaching-agreement-on-COVID-19-immunity-passports-will-be-difficult/ (Accessed: 7 April 2021). ELABE (2021) Les Français et l’épidémie de COVID-19 – Vague 33. 3 March 2021. Available at: https://elabe.fr/epidemie-COVID-19-vague33/ (Accessed: 7 April 2021).
  11. Ada Lovelace Institute. (2021) The Citizens’ Biometrics Council. Available at: https://www.adalovelaceinstitute.org/report/citizens-biometrics-council/ (Accessed: 9 April 2021).
  12. UK Ethics Accelerator, Response to Ada Lovelace Institute call for evidence

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