Vaccine Passports – A step too far?

[Please note this article is written as a personal piece and is not written in my role as Convenor and Chairman of Agora: Elim’s Public Theology, Justice and Pastoral Ethics Taskforce, nor does it necessarily reflect the views or position of the Elim Pentecostal Church in General or Dundonald Elim Church in particular. Any errors are my responsibility and I am happy to be corrected on any data or research contained herein.]

Should vaccine verification, or vaccine passports as they are described more commonly, be required of us as a means of managing the Covid19 pandemic? I have been, and remain, fully committed to vaccination. I have had three full jabs, and will receive a fourth as a booster in six months. I am also happy to carry a vaccine-certificate and have downloaded one already, registered with the Public Health Authority and carry the certification on my phone. I will encourage people to carry a vaccine certificate and fully support attempts to promote the idea. I am, however, opposed to both compulsory vaccination and compulsory vaccine-certification. I want to try and explain why.

The Context of the Discussion

On the 14th February 2021, the Royal Society produced 12 key criteria for the development and use of Covid certification (1). Those criterion are that certification should:

1. Meet benchmarks for COVID-19 immunity.
2. Accommodate differences between vaccines in their efficacy, and changes in vaccine efficacy against emerging SARS CoV-2 variants.
3. Be internationally standardised with 
4. verifiable credentials for 
5. defined uses.
6. Be based on a platform of interoperable technologies.
7. Be secure for personal data.
8. Be portable.
9. Be affordable for individuals and governments.
10. Meet legal standards.
11. Meet ethical (equity and non-discrimination) standards.
12. Have clearly understood conditions of use that are accepted by passport holders.

There seems little doubt to me that these are all important criterion if you accept the principle of covid certification and that if it should be introduced these ‘benchmarks’ should be adequately addressed. My question, however, is whether the principle of covid certification can be adequately defended as mandatory. The Church of England have set out their response (2) which concludes:

While the Church is, in principle, opposed to making use of ‘vaccine passports’, it should adopt a flexible approach to their limited wider use with the important caveats that such use ought to be demonstrably beneficial to society as a whole, protective of the vulnerable in particular, non-discriminatory in nature and proportionate in use. (3)

The Ethics of Vaccine Verification, Church of England

Earlier in their report, the Church of England sets out the four criteria (4) used in their approaches to issues of medical ethics, namely:

1. Affirmation of life
2. Care of the Vulnerable
3. Building a caring and cohesive society 
4. Respecting Individuals

Their conclusions are that the case must be made for the efficacy of vaccine certification in  protecting the vaccinated and reducing the transmission of the virus (5). It seems to me that vaccination has been proven to protect the vaccinated (6), and that there is an emerging body of evidence to suggest that it reduces transmission of the virus (7). However, in discussions that are increasingly polarised and consistently present a ‘them’ and ‘us’ othering, we must be careful to understand that whilst evidence is strong and emerging, assumptions must be avoided. We must be careful to see and hear one another in what premises to be an increasingly polarising discussion. In their research exploring the dichotomies and polarisation associated with Covid19 discussions, Kevin Escandón, Angela L. Rasmussen, Isaac I. Bogoch, Eleanor J. Murray, Karina Escandón, Saskia V. Popescu & Jason Kindrachuk are careful to remind us that there are many false dichotomies and even more uncertainness in Covid19 research (8). We may be keen to win an argument, but we must not caricature one another in the process. We must also be careful, as always, not to allow our a priori  ideological positions to determine how we read the evidence.

Professor Jonathan Montgomery and his team at the Ada Lovelace Institute highlight public health, personal liberty, economic benefit and future implications as ethical questions that must be considered in assessing vaccine certification (9). Their report was published in the first three months of 2021, but they are careful to place their conclusions within the context of an emerging picture. The conclusion of their interim report argues that before vaccine certification is mandated, the UK Government should:

1. Set scientific pre-conditions based on vaccine efficacy and transmission, durability and generalisability.
2. Identify the urgent use cases, such as for frontline workers and employment in general so that the benefits and risks can be assessed if the scientific pre-conditions are met.
3. Offer urgent clarification on the current legal status of the development and use of vaccine passports, in particular with regard to data protection, equality and discrimination, health and safety and employment law.
4. Consult a wide group of experts and perspectives including those likely to be involved in the practical implementation of any use case. This understanding is a necessary condition for both policy development and effective public engagement.
5. Engage publics on any potential uses to understand impacts, build trust and legitimacy, and understand what trade-offs the public is willing to make, particularly engaging with those groups who are likely to face disadvantage, discrimination or unique risks through the roll out of such technologies.
6. Work through the World Health Organisation on international travel use cases (10).

Freedom of Religion and Belief and Individual Conscience

Whilst all of these arguments, hypotheses and positions are helpful, there is a more fundamental question that I want to address, that of freedom of belief and religious liberty. The Church of England report helpfully highlights this (11) as an area of concern and further notes that a Christian response will also consider the impact of vaccine certification on our identification with the poor and marginalised; our respect for individuals’ dignity; our belief in grace and mercy, not judgement; and our commitment to equality.

I am not convinced that Covid certification has been adequately evidenced as required rather than strongly encouraged (as far as I am aware the only parliamentary committee to investigate this has been the Public Administration and Constitutional Affairs Committee which concluded, on the 12th June 2021 that there is ‘no justification for them in the science and none in logic.’(12) Furthermore the UK Government’s ‘Covid-Status certification review’, in July 2021, determined that Covid certification would be disproportionate and should not be enforced practice(13)) but assume with me that the case for covid certification has been made scientifically. That does not address issues of conscience, issues of belief and issues of freedom.

(1) Consistency

It is entirely possible, as in my own case, to be a strong advocate of vaccination and willing to carry a covid vaccination certificate whilst at the same time being opposed to mandatory vaccine certification. Even as a strong advocate of vaccination, I recognise that there are some whose conscience leads them to a different position, and they have chosen not to be vaccinated. I have sought not to caricature those who adopt this position because I know that for many the issue is one that they belief, because of personal conviction, they cannot justify. Similarly, I have a vaccine certificate and am more than happy to use it but I cannot justify a blanket mandating of vaccine certification any more than I can justify a blanket requirement for vaccination. There is a connection between these two stances that I think is being overlooked. We have not mandated vaccination – so how can we mandate vaccine certification? If we accept that vaccination is, at least in part, an issue of conscience, then it follows that the same is to be true for vaccine certification. It is simply illogical to have two different stances on these two connected issues. Either both are issues of conscience or neither are.

(2) Limits of obedience

We are called, as Christians, to follow the laws of the land, to pray for those in authority and to live as good citizens (14) . Yet at the same time, we are reminded that there may be times when authorities ask us to do something that goes against the call of God to follow his purposes and plans (15). The key question is when does the call of a national government or an external agency contravene the call to faithfulness to God? My answer would be that such contravention occurs when the issue of our conscience, conviction and belief, rooted in Scripture, is required to be abandoned in favour of a statutory or external policy. Vaccination, had it been mandatory, would have fallen into this category for me. Whilst I have freedom of conscience in my decision to be vaccinated and urged others to be vaccinated too, I also vehemently defend the right of individuals to choose not to receive vaccination, however much I disagree with them, provided their reasons are based on truth, conscience and conviction and not on conspiracy, scaremongering or fear. Exactly the same, for me, applies to vaccination certification. To urge it, to encourage it and to argue for it are perfectly acceptable. To demand it, to mandate it, to require it, is a strike against conscience and against individual liberty. This is a position of theological conviction for me and one of democratic principle. For others it will be a philosophical position, for others an issue of belief. It is particularly true in the face of un-evidenced arguments for vaccine-certification that are based on assumption rather than fact.

(3) Discrimination

Vaccine-certification is being demanded in certain settings such as care and hospital workers. Whether or not such demands end up in court remains to be seen, but it is clear that huge pressure is being placed on health care workers and care workers and in other sectors for evidence of vaccination if employment is to continue. I understand this argument, although I do not fully accept it. I am committed to supporting those in my care who are managing such situations – as employers and employees. I have the deepest respect and profoundest love for political leaders, civil servants, NHS leaders and staff whom I know (some of whom I pastor and offer prayerful support to) who are leading through these challenging days and, in some cases, implementing these difficult strategies. My thoughts are not a criticism of them nor a polemic against them. They have my support. I respect them deeply and uphold them in prayer as they navigate this difficult terrain. My reflections are not a polemic, but an attempt to open a reasoned, respectful but robust discussion on this issues involved. I wonder whether the years to come will prove the invalidity of the mandatory stance? I would be first in line to support any campaign to encourage certification, enable it and educate around it, but mandating it will, I think prove counterproductive. The idea that to oppose it or question it is to be unkind to the NHS, unloving to the sick and vulnerable or uncaring about society is a gross misrepresentation of those (like me) who believe that they should raise concerns precisely because they support the NHS, want to love the sick and the vulnerable and care deeply about society. I do not believe that mandatory vaccine certification will be effective in any of the above – but I do believe that encouragement, education and enabling of vaccine certification will. Certainly I think that the protection of the vulnerable and the at-risk is a justifiable reason to require vaccine certification, but I am not sure it is a justifiable reason to sack someone. Could roles and responsibilities not be temporarily changed? Could specific areas of work not be enabled to protect the conscience of the carer and the safety of the cared-for? If there is an area of mandatory vaccine-certification that I can understand it is this area, but even then, I wonder if the rush to make blanket requirements actually discriminates and victimises those who have made a choice because of their conscience.

It may be the case that mandatory vaccine-certification for health and care workers could also lead to social and economic exclusion for a large number of people such as younger people, where uptake is lower and slower due to reduced risk; global majority groups and migrants, particularly black and Asian people, where vaccine access may be lower, hesitancy higher, and the risk of social exclusion and stigmatising higher. In September 2021, the London School of Hygiene and Tropical Medicine suggested that mandatory vaccine certification may actually deter certain groups form vaccination at all and this could undo some of the good work of vaccination itself (16). Additionally, some religious groups where hesitancy is higher or where their beliefs may reject medical interventions; disabled people, as some medical conditions may prevent individuals from being able to receive a vaccination; and pregnant or breastfeeding women, where hesitancy is particularly high. In all these cases the minefield of UK human rights law lies ready to create one explosive case of competing rights after another. Our human rights legislation is woefully ill-equipped to deal with the undifferentiated and competing rights of different groups and mandatory vaccine-certification will evidence these ideological IED’s in the weeks, months and years ahead.

When Michael Gove reported to PACAC in May 2021, he argued that vaccine-only passes were not being considered, citing the “risk of either direct or indirect discrimination (17) and vaccines Minister Nadhim Zahawi called vaccine passports “discriminatory and wrong” (18) in a Westminster Hall debate earlier in the year, and as recently as July stated on Twitter that Covid passes would be discriminatory, yet he had changed his position by the time he answered question in the House of Commons in September, without fully justifying the change (19).

Lastly, the requirement to evidence vaccination may well have a direct discriminatory impact on the livelihoods and workers’ rights. Additionally, workers face questions about their personal medical choices and many risk losing their jobs if they decline or delay vaccination reversing long-held protections for employees’ medical privacy. 

(4) Longer-term implications

I am concerned that the mandating of vaccine-certification is a Rubicon, and once we pass it, we will have altered our social fabric and our collective commitments unalterably. Without sounding fatalistic or pessimistic, I am concerned that a short-term decision has disastrous implications for our long-term freedoms. If we require evidence of vaccination now, later will we deny treatment to someone who needs treatment for lung cancer because they were a smoker? Will every public role become one which can demand certain medical treatments, vaccinations or waivers? How does one draw back from such a decision? Furthermore, what are the criterion by which vaccine-certification will be required? Nightclubs and parties – but what about churches and mosques? Parties and banquets, but what about wakes and baptisms? I have long believed that we have forgotten that the Covid19 virus does not know when a small group becomes a crowd or when a crowd becomes a gathering. We are being indiscriminate in our definitions, lax in our decision making and fear-driven in our policy formulation if we think that mandatory vaccination-certification will adequately address the issues of Covid19. We now need to learn how to live with this virus. We need to move to a place where our management of the virus and its spread is more akin to how we manage flu. I do not mean by that a disregard for the seriousness of the virus. I mean that we use encouragement, exhortation, example and enabling to help people choose certification. Forcing it upon them will have a negative impact not only on public life but on management of the virus itself. In mandating vaccine-certification we are allowing ourselves to be driven by fear and we are using the wrong method to combat our common enemy. We need better thinking that this.

(5) Over-reach

Lastly, I am concerned that the mandating of vaccine-certification is a step into the interference of state with freedoms of worship. I struggle to see how I can, with a clear conscience, require congregants to evidence their right of entry to an act of public worship through mandatory vaccination certificates when vaccination itself is not mandatory and my church leadership team and denomination have worked so tirelessly to ensure safety and precautions at every stage of the pandemic. We have been determined to ensure safety at every stage and upheld the highest standards of hygiene, distancing, mask-wearing, isolation, lockdowns, track and trace and every other thing the PHA have recommended. But I simply do not feel able to support this mandatory step. Education – yes. Enabling – yes. Encouragement – yes. Example – yes. But forcing and coercing – no. 

Conclusions

As a pastor and a public theologian who has tried to encourage, facilitate and advocate for vaccination at every turn, I now find myself being asked to go further – and this is a step I simply do not think I can take. To require evidence of vaccination before permitting entry to worship, to a funeral seems to me not only counter-productive, but cruel. I can hear the voices of those whom I have tried to persuade to receive vaccination already. They will say that control and coercion was always the agenda. They will suggest that when the state starts to intrude on the conscience of individuals, both liberty itself and conscience are sacrificed. If Daniel was unwilling to participate in Persian acts of worship, Paul and Peter were unwilling to eat meat offered to idols, and early Christians were not willing to call Caesar Lord, I think I am unwilling to force vaccine-certification. If Chinese, Russian and Cambodian Christians refused to join the Communist Party or left it after their conversion,  and knew that it would mean a risk to their lives, I need to think carefully about whether or not I can, with a clear conscience before my Saviour and Creator, force people to prove they are vaccinated before I will let them come to church.

Rev Malcolm J. Duncan, 16th November 2021. County Down

Endnotes

(1)  See https://royalsociety.org/-/media/policy/projects/set-c/set-c-vaccine-passports.pdf?la=en-GB&hash=A3319C914245F73795AB163AD15E9021. Accessed on 16th November 2021.

(2)  COVID-19: The Ethics of Vaccine Certification (‘Vaccine Passports’). See https://www.churchofengland.org/sites/default/files/2021-07/COVID-19%20The%20Ethics%20of%20Vaccine%20Certification%20%28Vaccine%20Passports%29.pdf. Accessed on 16th November 2021.

(3)  ibid, p6.

(4)  ibid, p4.

(5) idid, p5.

(6) Various reports and data, used by the Center (sic) for Disease Control can be viewed at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness/work.html. Accessed on 16th November.

(7) See https://www.newscientist.com/article/2294250-how-much-less-likely-are-you-to-spread-covid-19-if-youre-vaccinated/. Accessed on 16th November 2021. See also Petter, E., Mor, O., Zuckerman, N., Oz-Levi, D., Younger, A., Aran, D. and Erlich, Y., 2021. Initial real world evidence for lower viral load of individuals who have been vaccinated by BNT162b2. MedRxiv.

(8) Escandón, K., Rasmussen, A.L., Bogoch, I.I., Murray, E.J., Escandón, K., Popescu, S.V. and Kindrachuk, J., 2021. COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection. BMC Infectious Diseases, 21(1), pp.1-47

(9) See https://www.adalovelaceinstitute.org/summary/covid-19-vaccine-passports/. Accessed on 16th November 2021.

(10) idid.

(11) COVID-19: The Ethics of Vaccine Certification (‘Vaccine Passports’), p4.

(12)  See https://committees.parliament.uk/committee/327/public-administration-and-constitutional-affairs-committee/news/155788/no-justification-for-covid-passports-say-committee/. Accessed on 16th November 2021.

(13) See https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/999408/COVID-Status-Certification-Review-Report.pdf. Accessed 16th November 2021.

(14)  Romans 13; 1 Timothy 2:11; Titus 3:1-2.

(15) Daniel 1, 3, 6; Acts 5, 7.

(16) See https://www.lshtm.ac.uk/newsevents/news/2021/vaccine-passports-may-lower-overall-number-people-uk-willing-get-vaccinated. Accessed 16th November 2021.

(17) See https://committees.parliament.uk/committee/327/public-administration-and-constitutional-affairs-committee/news/155788/no-justification-for-covid-passports-say-committee/. Accessed on 16th November 2021.

(18)  See https://www.politicshome.com/news/article/coronavirus-vaccine-passports-government-denial. Accessed 16th November 2021.

(19)  See https://www.zahawi.com/parliament/covid-19-update. Accessed 16th November 2021.