Vaccine passports should be free, private and secure, White House says. But who will be issuing them?

The federal government shouldn't be involved in verifying that people have been vaccinated against COVID-19, the White House says, but whatever process is developed should be free, private and secure. 

"It's not the role of the government to hold that data and to do that," Andy Slavitt, White House senior adviser for COVID-19 response, said in a briefing Monday.

While Americans need a way to reliably demonstrate that they’ve been vaccinated, the government shouldn’t be the one issuing such a certification, Slavitt said.

“It should be private. The data should be secure. Access to it should be free. It should be available both digitally and in paper and in multiple languages. And it should be open source,” he said.

As more people are vaccinated, both here and around the world, it will likely become more important to provide proof of vaccination – to get on a plane or a cruise ship, hold certain jobs or even enjoy a night out.

Israel already has a "green card" to prove people have been vaccinated; other countries are contemplating requiring proof of vaccination for entry; and the World Health Organization is reviewing the idea of certification.

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"Therefore we'd better do it right," said Dr. Tom Frieden, former director of the U.S. Centers for Disease Control and Prevention and president and CEO of Resolve to Save Lives, an initiative to prevent epidemics and cardiovascular disease. 

By "right," he means a secure, accurate and voluntary system, where the government doesn't keep track of who is vaccinated and who is not, "so that people aren't tempted to not get vaccinated because they don't want this thing," he said. "It should never become a disincentive to get vaccinated."

Even though the COVID-19 vaccines have been shown to be extremely effective, no vaccine is 100% protective, Frieden said, and some vaccines are less protective against some variants.

So just as it's safer if everyone is wearing a mask, people who have been vaccinated will be better protected if they're surrounded by other vaccinated people, he said.

Although people are given a paper card that records their vaccinations, something more permanent and official would be helpful in many contexts.

"I've told people to laminate those cards," said Art Caplan, a bioethicist at New York University Langone Medical Center and the founding director of the school's division of medical ethics.

Realistically, people can't consistently keep track of paper documents, said Dr. Julie Morita, executive vice president of the Robert Wood Johnson Foundation, a health-focused philanthropy.

"We know people lose their paper records so easily," said Morita, also a member of President Joe Biden's COVID-19 Advisory Board and former commissioner of the Chicago Department of Public Health. A pediatrician, Morita said she recently had to go to her son's doctor for proof of his vaccinations because she'd lost track of his paper records.

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A vaccine passport would provide proof that a person has been vaccinated against COVID-19 and might also include data on any recent negative tests for the coronavirus.

Right now, repositories of vaccine data – pharmacies, community health centers, medical offices and state and federal vaccination centers – don't have a way to share such information and don't collect data in a standardized way, Morita said. That challenge will need to resolved before passports could be issued.

Equity is another challenge for vaccine certification, she and others said.

Vaccine passports need to be free, Morita emphasized, and available to people who don't have internet access or smartphones. 

In Israel, people who prove they've been vaccinated with a "green pass" app can get access to restaurants, gyms, hotels, theaters and concerts that remain off-limits to the unvaccinated.  

It's not clear how long a vaccine passport might be needed.

At the moment, it's probably too soon to need one, Caplan said, because not enough people have been vaccinated to make it useful. Eventually, when the vast majority of people have been vaccinated, certification may not be necessary because infection rates will be low.

But no one knows how long protection from a COVID-19 vaccine will last.

And if other countries require vaccine "passports" for Americans, it's likely that the U.S. would do the same, said Dr. Leana Wen, an emergency physician and public health professor at George Washington University.

It would also be important to have generally accepted standards for what constitutes adequate protection, said Wen, who previously served as Baltimore's health commissioner. Someone needs to decide, for instance, whether a Chinese vaccine that doesn't have strong scientific support should count, or an antibody test that showed a certain level of protection.

In the absence of a very active role for government, she said businesses that stand to financially benefit will likely be the ones pushing for certification. A cruise line might insist, for instance, that all its passengers and crew show proof of vaccination or a recent negative test. Even a restaurant or hotel might use it as a selling point if all their staff and guests were vaccinated.

"I could see businesses seeing it in their best interest," she said.

Wen said she worries that the removal of COVID-19-related restrictions in some states will discourage some people – particularly those not concerned about catching COVID-19 – from getting vaccinated.

"They need to be given the carrot," she said. But the window of opportunity to tie getting vaccinated to a less restricted lifestyle is closing. "If everything is reopened and you can do whatever you want regardless of vaccination, some people might think, 'What's the point (of getting vaccinated)?' "

That could lead to more infections, more variants and more loss from COVID-19, Wen said.

"If we squander this opportunity now, how tragic will it be?" she said. "How can we let that happen now?"

Contact Karen Weintraub at kweintraub@usatoday.com.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.