Proof of immunization against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may soon be required in many parts of the globe. The authors discuss how immunization passports could work, what Canada needs to do, and potential barriers and limitations in a CMAJ (Canadian Medical Association Journal) commentary.

“We expect that immunization passports may be imminently introduced for international travel,” writes Dr. Kumanan Wilson, Department of Medicine, University of Ottawa and Bruyère and Ottawa Hospital Research Institutes, with Colleen M. Flood, University of Ottawa Centre for Health, Law Policy & Ethics, Ottawa, Ontario. “Canada will need to ensure alignment with global standards for security, authentication, privacy and data exchange developed by the WHO Smart Vaccination Certificate initiative.”

The World Health Organization (WHO), International Air Traffic Association and World Economic Forum have been exploring standards for these digital passports, indicating they may be used first for international travel but could also be required for large gatherings and within some workplaces.

A properly constructed approach to immunization passports could help to limit the spread of SARS-CoV-2 while allowing society to reopen and the global economy to be revitalized. The foundation must be an accurate, comprehensive vaccination record that allows individuals access to their records and those of their children and family members.

Elements key to implementing immunization passports include

• Technological capacity
• Adherence to international standards
• Ability of provincial and territorial governments to issue secure digital immunization records that meet pan-Canadian standards
• Input from legal and ethical experts and the development of standards to ensure that those who can’t be vaccinated are not discriminated against or denied access to services
• Safeguards to protect the privacy of personal information

“If governments do not develop the necessary capacity to implement immunization passports, it is likely that private corporations (e.g., airlines and large event venues) will develop their own requirements and systems, potentially leading to problems related to equity, privacy and coercion,” the authors write.

“Implementing digital passports for SARS-CoV-2 immunization in Canada” was published March 3, 2021.