COVID vaccine passports must protect against counterfeits


Sheldon H. Jacobson

After the Pfizer and Moderna COVID-19 vaccines received emergency use clearance from the FDA in December, the first priority was to create a national vaccine supply chain to bring vaccines into the hands of the health workers and populations at risk. As the supply of vaccines increased, the footprint of eligible recipients grew. In April, anyone over 16 could get the vaccine for free at many facilities like their local pharmacy.

Following:Many Indianapolis Locations Require Vaccines or Negative COVID Tests: What You Need to Know

As with any new program, such a rapid ramp-up has had unintended consequences.

The one causing headwinds and confusion in society, as well as slowing the virus’s transition from pandemic to endemic, is vaccination status verification, commonly referred to as a vaccination passport. The UK has announced that it will not pursue such documentation. Some states use SMART health cards as part of the Vaccination Credential Initiative.

Vaccine passports offer many interesting features. Commercial sites want to ensure the safety of their staff and customers. It is desirable to require proof of vaccination. The problem is that there are few reliable and widespread mechanisms for doing this.

Those vaccinated were given a handwritten vaccination card from the CDC, which can be altered to create fakes. This makes all of these cards unreliable for checking immunization status.

Looking back from 20-20, what was needed was a database system that provided a standardized format for immunization information, such as type of vaccination, location and dates for each person vaccinated. This database would then be accessible through a dashboard or web application.

To ensure confidentiality, each individual vaccine record would be protected by a PIN code, much like the way ATMs or payment cards access funds.

The problem with the vaccine rollout was that the CDC was a key player in the process, but they lacked the infrastructure to develop such a verification system. The CDC and state public health agencies have focused on getting vaccines on people’s arms. Checking immunization status was not the priority.

Unfortunately, populating such a database on immunization status would take a long time and could be inaccurate. However, given that such a public health system may be needed in the future, now is the time to create the infrastructure to build and support it, using COVID-19 vaccinations as a test bed.

First, who should build such a database management system? The financial industry already manages financial privacy and security. They are well positioned to launch the backbone of such a database and access system, thus creating a standardized model. While this brings them into a new area, they are ideally suited to evolve their existing infrastructure to create a secure public health database and information system.

This begs the question, why not hand this responsibility over to companies that create electronic health records? The problem is that such systems are designed to make health insurance billing easier for medical centers. As such, their products are oriented inward to meet the needs of the medical community, not outward to serve the general population who will need access to information.

Second, how can the database be populated? Booster shots are now starting for part of the population, making this an ideal time to achieve them. The organizations that have administered the vaccines have all the information about those they have vaccinated. They can upload this information to the database in a standardized format with appropriate protections, in accordance with HIPAA requirements. Once this information is placed in the database, vaccinees can confirm their information and create the necessary security PIN to access it.

When such information is accessed to confirm a person’s immunization status, the reported data should also provide a score based on its likelihood of being accurate and reliable, using the multiple steps of retrieving, loading and confirming the information. .

It is not an ideal situation. The problem is that if such a system is not created today, it will not be available in the future.

The rush to get vaccines on people’s arms has saved lives. This haste unintentionally created headwinds to move our economy and society forward. A national public health database is needed now and in the future, to provide a mechanism to keep public health information safe for all. The time to launch such a system is now.

Sheldon H. Jacobson is Professor of Computer Science and Carle Illinois College of Medicine at the University of Illinois at Urbana-Champaign

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