Certificate of COVID Vaccination: Can We Do Better than the Yellow Card?

With several candidates in the late stage of development and testing, the world is getting closer to a COVID-19 vaccine, (although raising resources and building supply chains remain significant challenges). In addition, the global nature of the pandemic requires mechanisms to uniquely identify people who have been vaccinated. Without a trusted and portable credential that can serve as an on-demand proof of vaccination for both international travel and large domestic gatherings—anytime and anywhere—there is a real possibility of wasting time, effort, and resources even as countries are struggling to overcome the severe economic crisis caused by the global pandemic.

Qantas has become the first airline to require proof of vaccination for international travel. In another taste of what is to come, the Gabon football team had to sleep at the Banjul airport in the Gambia the night before their African Cup qualifying match because some players did not have their test results printed out; needless to say they lost the game.

Can technology help? At the most basic level, a COVID ID would be a digitized version of the Yellow Card, the paper-based International Certificate of Vaccination or Prophylaxis that many international travelers carry with them traveling to and from high-risk areas of the world. The WHO acts as the trusted intermediary enforcing the vaccination protocol through designated national health agencies, ensuring its reliability and acceptance at ports of entry. The scale of the COVID problem is immeasurably larger however, especially if proof becomes required for domestic gatherings as well as international travel.

The good news is that the massive scale-up of social assistance to mitigate the COVID economic shock has largely used digital mechanisms—databases, IDs, mobiles, and payments—to identify, screen, and pay beneficiaries, and in doing so provided a huge impetus to such uses of technology. According to the most recent update from the World Bank, since March a total of 200 countries and territories have planned or put in place over 1,000 social protection measures, with social assistance accounting for more than 60 percent of them. New or scaled-up COVID-19 cash transfers now reach nearly 1.1 billion beneficiaries—nearly one in every six people in the world—largely designed, financed, and implemented by developing countries themselves. India has already unveiled plans to use its digital Vaccine Information Network for COVID vaccine distribution and delivery, using SMS to inform people of when and where to get shots and linking each person in the immunization list to their unique Aadhaar ID number to avoid duplication and track delivery.

A COVID ID would need three attributes: trackability, verification, and portability. The first objective would be to track each vaccine vial and its delivery to a unique individual at a unique location and point in time. This information should be securely stored with access provided to authorized “gatekeepers” for specified purposes. Verification would need to be on-demand, and able to work through both online and offline modes. It would also need to be portable both within and across borders, through a set of common global standards, and linked to passport information for cross-border use. The ID should be a single source of truth—information is fed into the system only once and then can be verified through multiple modes (biometric authentication, QR codes, card readers, paper copies, etc.) as needed. This would provide flexibility for governments and their citizens while at the same time reducing dependence on a particular technology such as biometric readers or smartphones. These are demanding requirements, but advances in technology, including the use of mobile phones, offers the possibility of a wide range of verification mechanisms and the calibration of queries to reveal the minimum information needed—which in most cases be only a simple Yes/No.

On the implementation side, the capacity of such a system would need to keep pace with a vaccine rollout that is expected to cover the entire world’s population by 2024. The multiplicity of potential vaccines and their delivery protocols makes it a complex logistical challenge. A COVID ID could reduce loss in follow-up for vaccines that require multiple doses (both the Pfizer and AstroZeneca vaccines require two doses) weeks apart). For developing countries in particular, we see several spillovers but also areas of caution. On the positive side, a COVID ID can set the foundation for a population-wide digital health ID that, over time, could be used to provide better health services, both public and private, including other immunization outcomes. It could also be linked to other digital services, including cash transfers to incentivize take-up of the vaccine if necessary.

Even if not all of this plan is feasible today, we need to think ahead and build the necessary infrastructure to enable citizens to effectively manage their vaccination status. COVID-19 is not the world’s first pandemic; neither will it be the last.