The European Union is about to launch a digital pass system that will let residents prove they have been vaccinated against COVID-19, recovered from the disease or recently tested negative for the virus, allowing them to travel freely among all 27 member nations.
For months, Israelis used a similar digital pass system, showing their vaccination status to enter restaurants, gyms and other venues. Australia has rolled out a digital proof of vaccination certificate, and Japan plans to issue one as soon as this summer.
But don't expect the United States to go that way.
With the federal government unwilling to take the politically charged step of creating or endorsing a universal digital health pass or app, several companies are trying to fill the void. That might mean Americans will need several digital passes, like so many credit cards in a wallet. It could also mean employers, businesses and venue operators will each have to decide which works for them — or might not bother using any at all.
Since the COVID-19 vaccine rollouts began, governments, trade groups and technology companies have offered ways of supplementing the paper vaccine cards issued by clinics and labs with a digital version that can be uploaded to a smartphone and read by a digital reader. The paper cards, approved by the Centers for Disease Control and Prevention, do not include a unique marker, number or QR code, making them easy to forge, experts say.
Some digital passes are already in use or are being tested, but none is expected to be universally accepted across the country like a Social Security card or a passport. Why? The Biden administration has made clear that it won't create or endorse a digital pass, deferring to the private sector. Administration officials have cited concerns over privacy and security if the federal government took a role in the process.
In addition, the U.S. does not have a national database for immunization records that could act as the source of vaccination data for use in digital passes. A national system to create a unique identification number to link the health records of every American has been banned since 1998, spearheaded by then-Rep. Ron Paul (R-Texas), who said such a system would be an unwarranted privacy intrusion.
As a result, healthcare experts predict Americans are not likely to get one universally accepted digital vaccination pass.
"I think it's stupid and, frankly, ineffective if you need to download five to seven apps," said Nicolas Graf, a professor and associate dean of the New York University School of Professional Studies.
The concept of vaccine proof is not new. Many countries require that travelers carry “yellow cards” verifying inoculation against yellow fever or other diseases. In the U.S., children have long been required to be vaccinated to attend schools and camps.
New York is the only state in the nation offering government-issued digital proof of COVID-19 vaccination or of a negative coronavirus test result, known as the Excelsior Pass. It was designed by IBM with health data provided by the state's and New York City's vaccine databases. Madison Square Garden and Yankee Stadium have begun accepting it, though they also accept the CDC-approved paper vaccination cards.
More than 2 million people have downloaded the digital pass, according to the state's health department. Businesses that accept it must download a separate app, Excelsior Pass Scanner, to scan the QR code created by the pass. Users of the app must also show a photo ID to prove their identity.
California, like many other states, operates a vaccine registry that holds the vaccine data of most of its residents. But the state has yet to decide whether to partner with a technology company for use of the data in a digital pass.
"We are actively assessing the appropriate equitable, ethical, and privacy considerations for standards for COVID-19 vaccine or test verification/credentials that are provided digitally," the state Department of Public Health said in a statement.
Digital passes are already accepted at arenas and stadiums across the country as proof of a vaccination or a negative test result, but so are CDC vaccine cards and paper documents from testing labs.
How rigorous businesses will be about verifying vaccination information or test results will depend, experts say, on the setting and on the sentiments of their customers. Customers on tightly packed cruise ships or in indoor restaurants may insist that all employees and patrons show proof, while fans at baseball stadiums and outdoor concert venues may not.
"A lot of businesses will just say, 'Wear a mask' because they don't want to get in the business of enforcing it," said Vin Gupta, an affiliate assistant professor at the Institute for Health Metrics and Evaluation at the University of Washington.
The Chase Center in San Francisco, home of the NBA Golden State Warriors, began in April to admit fans who have been vaccinated or can show proof of a negative test result. The arena offered to provide ticketholders with a free at-home COVID-19 test by Lucira Health. Fans could then enroll in a digital health pass created by Clear, a New York technology company, to show proof of the test results at the arena.
At Dodger Stadium, fans who want to sit in the vaccinated section are supposed to show a CDC vaccination card or a photo of a vaccination card. The team does not accept a digital pass.
The Las Vegas Convention Center welcomed its first major convention since the start of the pandemic Wednesday but proof of a vaccine or a negative test result was not required of convention-goers.
Universal Studios Hollywood began in April to allow out-of-state visitors into the theme park as long as they can show proof they are fully vaccinated. The park has been accepting CDC vaccination cards, digital photos of a vaccination card or other documents from a healthcare provider.
Disneyland and Disney California Adventure in Anaheim plan to start admitting out-of-state visitors Tuesday, the day California is scheduled to loosen its pandemic restrictions on most businesses. The Anaheim parks won’t require proof of vaccination or of negative COVID-19 test results.
In all of the new or proposed digital passes or apps in the U.S., people who have been vaccinated or received a negative test result must first consent to have their information uploaded into the pass or app.
A universally accepted digital pass is also unlikely in the United States because in some parts of the country, requirements to show proof of vaccination are considered a privacy violation.
In April, Florida Gov. Ron DeSantis signed an executive order prohibiting the use of vaccine passports in the state. Texas Gov. Greg Abbott issued an order soon afterward forbidding state agencies or any entity receiving public money from requiring vaccine passports.
But developers of digital passes don't necessarily need states to actively cooperate with them. Some of them already have access to a trove of health data.
Carbon Health, a healthcare company with 75 primary and urgent care facilities across the country, has developed a digital proof of vaccination or negative test result called Health Pass. The vaccination records and negative test results provided by Carbon Health facilities are accessible — with the consent of the patients — via the digital pass, according to company founder and Chief Executive Eren Bali.
"My hunch is there will be dozens of others," he said of the pass.
Clear's digital health pass, meanwhile, relies on vaccine proof and negative test results provided by partner companies including Walmart, Sam's Club and Atlantic Health System. Users of the pass can also upload a photo of their CDC vaccination card and other information. More than 60 organizations in the U.S. accept the Clear pass, including MGM resorts, the San Francisco Giants, NBA arenas and the state of Hawaii.
The International Air Transport Assn., a trade group for the world's airlines, has developed a digital pass known as the Travel Pass that the trade group hopes can be used by airlines to confirm proof of vaccination or a negative test result for airline passengers who want to meet international pandemic travel guidelines. Thirty-six carriers are testing the app. None is based in the U.S.
This story originally appeared in Los Angeles Times.