Without Standards or Regulations, COVID 'Passports' Are Poised to Create Even More Confusion

Concerts, performances and other public gatherings are back on come April 15 — that is if attendees can prove they've been vaccinated or recently tested negative for COVID-19.

This announcement came on Friday, with no clear plan of how Southern Californians will prove their credentials.

Experts are worried about initiating this new strategy without a set of single standards or regulations. It raises a host of questions about forgery, health privacy records and accessibility.

"Each jurisdiction is kind of left to their own devices," said Rita Burke, an assistant professor of clinical preventive medicine at USC's Keck School of Medicine of USC. "There's no one set of guidelines which — in a situation like this — would be really, really helpful."

On eBay, she said, scammers are already selling replica vaccine cards for around $200.

The landscape of vaccine passports has evolved into an unregulated, crowded market. At least four Los Angeles entities have created their own, some working with others, including UCLA and health care startups Carbon Health and Healthvana.

President Biden's chief medical adviser Dr. Anthony Fauci said Monday on Politico's podcast that the federal government will not require the credentials for businesses or travelers.

And last week, the Biden administration said it's letting private companies take the reins over vaccine passports, opting out of creating a centralized system for verifications.

How California — and any other state — will use the digital tools is still unknown. And the state has remained quiet on its strategy.

New York officials have launched their own version called Excelsior Pass for concert and event-goers. Meanwhile, a Florida governor on Friday banned digital certifications for vaccines, citing concerns over privacy and "individual freedom."

"It's going to be hard for businesses to require a passport because nobody wants to be perceived as forcing people to take a vaccine," said Ken Mayer, co-founder and CEO of the health tech company SAFE Health.

The L.A. startup is working with IBM and a coalition called the Vaccination Credential Initiative to develop passports for people to show proof of vaccination or recent COVID-19 test via QR code. It's one of several tech companies working behind the scenes for what will essentially be a ticket to freedom for many.

But the system, some worry, could create a have-and-have-not world where those with the vaccination gain access to concerts, offices and international travel.

"I think COVID passports should not be a thing that further divides people and makes it even more difficult for people who are on the margins," said Jakub Hlavka, a fellow at the USC Schaeffer Institute.

Hlavka said that inequitable vaccine distribution — especially in rural areas unable to preserve vaccines at specific temperatures for long — will impact how freely people are able to travel internationally, or how families across borders will reconnect after the pandemic.

It's also raising concern about personal health record keeping.

"This is a new concept so it sounds simple until you get into the security and privacy details," said Eren Bali, the co-founder and CEO of Carbon Health, which runs L.A.'s vaccine appointment website.

Bali said that any digital application should be for a single use and not allow providers to store "random health data" such as diabetes or other personal medical information that is protected and has no bearing on public health.

The company recently developed its own digital certification card called Health Pass, which is automatically provided to individuals who completed vaccination through the city of Los Angeles.

"I think this is only relevant for highly infectious diseases," he said, pointing to yellow fever as another use case for a vaccine passport.

L.A.'s Department of Public Health did not immediately reply for comment, but in March, a spokesperson confirmed that the county was working with Healthvana to send out their own electronic passport.

Even if vaccine passports catch on, people will still receive a white vaccination record card after getting the shot. But it's unclear whether venues or businesses will accept them as proof, or how they'll be verified for authenticity.

Almost a third of California residents have been partially vaccinated. Health officials in Los Angeles County report 1.3 million people have been fully vaccinated, but that data doesn't include Pasadena and Long Beach.

One upside to a digital passport is that it could serve as an incentive for those yet to be vaccinated, said Assemblymember Jesse Gabriel, who represents much of the west San Fernando Valley and sits on the Assembly's Privacy and Consumer Protection Committee.

The committee oversees California's Department of Technology, responsible for partnering with state and local government to deliver digital services like MyTurn, the vaccination appointment portal run by the state.

"Hopefully it's something that'll motivate people who may be on the fence, knowing that they're able to do these things," he said.

But Burke says those who are skeptical about the vaccine are also the people wary of a vaccine passport.

Plus, proving a negative COVID-19 test "does not guarantee that you don't have COVID," she added. Venues and businesses should reconsider accepting days-old negative test results before letting customers inside.

"Showing a negative test is not really a good way of approaching this," Burke said. "Now, as we're opening up, we really need to focus on getting as many folks vaccinated as possible."

Keerthi Vedantam contributed to this report.

This story has been updated.