By David Ingram - NBC News
It's an intuitive idea: a digital app that provides proof that a person has received the COVID-19 vaccine
Many experts are working to make it happen.
Businesses of all sizes have been pouring resources into it: Microsoft, major airlines, Ticketmaster, leading nonprofits, security companies, and tech companies ... all are working on the technical development of what some call
passports. of vaccines
.
Apple and Google have also participated in discussions about how to
create digital certificates of vaccines against COVID-19
, according to what was said by sources, but they have not announced specific plans.
But behind the scenes, the state of medical records, privacy concerns and the virus itself make this option unlikely to be available in the coming months, experts say.
"This is something that almost no one can focus on right now," said Rebecca Coyle, director of the American Immunization Registry Association.
Coyle said that COVID-19 digital certificates may seem like "a nice gem," but they
may not be a reality for many months
.
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The challenges are marked by the way the pandemic has exposed the gap between what experts hope to achieve in development and the stark realities of responding to a national crisis.
Although all states and some cities maintain vaccine databases, few of them so far have been willing or able to adopt digital vaccine applications.
And with people ready to start receiving COVID-19 vaccines as early as this month, the proof that they received it will come in an older technology: paper.
Yellow paper cards have been used for years
as proof that people have been vaccinated.
International travelers who get vaccinated against yellow fever are given signed and stamped certificates to take with them on their trips.
"It's the same thing they did in 1918," said Billy Sparks, co-founder of Vacmobile, an Atlanta startup that is one of many companies and organizations working to make digital immunization certificates a reality.
Its application is being tested, so it will not be ready for deployment with the potential first wave of vaccines in the United States.
The likelihood that COVID-19 certificates are just paper, at least at first,
seems ridiculous to some
.
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"As a country, we have made the transition from paper health care to digital records. And now that we are in this public health crisis, we should use that infrastructure that we built, without going back to the technology of decades or even centuries past." said Ben Moscovitch of the nonprofit Pew Charitable Trusts.
A survey this year by the Pew Charitable Trusts found that 61% of adults said they would like to be able to download their medical records on mobile apps to manage their health.
Airlines as a trial test
But creating a digital vaccine certificate has proven to be an exhausting task, even as other types of medical records have been digitized and more and more people are getting used to storing them on their smartphones.
A network of tech companies called the COVID-19 Credential Initiative is trying to establish standards for vaccine certificates, while the Commons Project, a non-profit organization, is working with the World Economic Forum on a digital health certificate. which has undergone tests, some of them on flights between Hong Kong, Singapore, London and New York.
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Microsoft has published a framework
that it says would allow consumers to "store and manage their own COVID-19 vaccination or laboratory records, and present these records to another party in a verifiable way."
The company has posted details and a video online.
"Key use cases include the transmission of vaccination records or infection status at a specified time to return to work or travel," the company said in a statement.
Apple and Google have participated in similar discussions about COVID-19 digital vaccine certificates, experts said, but
the companies have not announced any plans
.
They declined to comment.
A big hurdle is that no one knows how long a vaccine's immunity can last, so it's impossible to say how long a proof of vaccination would last.
"What is the expiration date that we are going to put on that vaccination certificate?"
asked LJ Tan, head of strategy for the nonprofit Action Coalition for Immunization.
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"We know we need more data," he said, adding that the data might not be available until next summer.
Digital vaccination certificates are "a little premature."
Even once more details about vaccines are known,
the challenges are numerous
for those trying to make COVID-19 applications.
A national strategy on how to build them has not been outlined.
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Digital files will have to be protected against forgery and identity theft to be valid for third parties, such as airlines.
They will also have to be compatible for everyone, be it restaurants or concert venues.
And there has to be a secure way to transmit proof while keeping people in control of their data, privacy advocates said.
A simple
digital photo of a registry may not be enough
to believe that someone has been vaccinated, since it can be copied and shared.
"You can't just take a photo, like a barcode," Tan said.
States have the data, but little money
Immunization certificates would also depend on those who currently have immunization records: medical providers, such as doctors' offices, and immunization registries that operate at the state and local level.
Many do not have the resources to help with the proposed applications.
Vaccine registries established by states and cities (New York City has theirs, for example)
have been around for decades
, but they have never gotten the money they need to be complete or to keep up with changes in technology, the researchers said. experts.
Coyle of the American Immunization Registry Association noted that state registries want to meet the demand for digital vaccine certificates, but in addition to addressing the lack of resources, they want to ensure that any system meets the privacy requirements to which they they are used to, such as health-specific data exchange standards.
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She said she was encouraged by the fact that Apple and Google had participated in the discussions about digital certificates, as those companies have more experience than many others in Silicon Valley in the field of health applications.
But he said the challenges remain daunting, including building a system to prevent counterfeiting.
"You have to develop that kind of authentication system in any application that is going to be used for these purposes. And that is actually a huge challenge. I think it is a much bigger challenge than people realize," he said.
Apple already allows people to download
immunization records and other medical records to their devices if their providers have agreements with Apple.
There is a similar app for Google's Android operating system, developed by the nonprofit
Commons Project
, and it is connected to 230 healthcare systems.
But other applications in development may have greater capacity, such as sharing more easily with third parties.
Just an illusion?
Some worry that the apps could distract from public health priorities or, worse, compromise privacy or create two classes of people.
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"This is something that is being driven by the greed of tech corporations, not actual public health guidance," said Albert Fox Cahn, executive director of the Surveillance Technology Oversight Project, a New York-based group that addresses the issue of digital privacy.
Cahn compared the idea to the COVID-19 exposure notification apps that technologists came up with early in the pandemic, which haven't had much of an impact.
He also said there is no guarantee that digital vaccine records held by third parties will not end up in the wrong hands.
New York Governor Andrew Cuomo and others have expressed concern that vaccination records may end up in a federal database accessible to immigration authorities, for example.
"We continue to see the art of selling in Silicon Valley trump the bleak guidance of public health, and we really have to stop thinking magically," Cahn said, "the reason so much of this technology seems too much good to be true, it is. "
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A Seattle startup said in a statement that it planned to
sell digital COVID-19 vaccine certificates for up to $ 200
not for airline boarding but "for other social situations, such as an older person wanting to confirm their plumber is vaccinated before enter the house. "
Some skeptics may be prompting that idea.
The World Health Organization has opposed "immunity passports" for people who have recovered from Covid-19, due to a lack of knowledge about the duration of immunity, but is working with Estonia on possible "certificates. of electronic vaccination, "reported the Reuters news agency last week.
Ticketmaster, the giant of ticket sales and distribution, has moved in the opposite direction.
He told Billboard last month that he was exploring the idea of checking vaccination status, but later clarified on his website that it was "just a long-term idea and is not being implemented at this time."
Joe Berchtold, president of Ticketmaster's parent company, Live Nation, told CNBC this week that he didn't think proof of vaccination would be mandatory for next summer's live events, unless ordered by local health officials.
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But even after COVID-19 wears off, there will likely be demand for digital testing of older vaccines.
Jenny Wanger, head of the Implementers Forum at the Linux Public Health Foundation, said any system that is built now will have lasting effects, so you need to focus on privacy and transparency.
"Vaccine credentials are a very slippery slope," he said.
"If not done right, vaccine credentials will be a major data privacy violation for individuals, because you are carrying something in your pocket that is a critical piece of health data."