Maron Meyer
Northwest Asia Weekly
Nancy Jack
When Nancy Jecker, as a visiting professor at the National University of Singapore, conducted research on elderly people in need of care, she met immigrant caregivers—young women who had come from the Philippines, Sri Lanka, and India. She is now a professor at the University of Washington (UW) School of Medicine, and recently published a paper arguing that at a time when humans need to unite, vaccine passports have aroused opposition to health equity both domestically and internationally. She was thinking, partly because of the immigrant caregivers she met in Singapore.
“They have to live at home and take care of older Singaporeans. They have family sponsors, but now they cannot travel there because they cannot get the vaccine in the country they are from. Instead of requesting a vaccine, it is better to provide one 72 hours before the trip Flexible tools, such as negative tests?” Jack said.
85% of vaccines against the SARS-CoV-2 virus have entered the arms of people living in wealthy countries. Jecker cited a statistical data in her paper “Vaccine Passport and Health Disparities: A Dangerous Journey”, which was published In the “Wall Street Journal” medical ethics.
“What message does this convey to migrant workers who need to travel but cannot be vaccinated?” she asked.
This concern reflects the struggle between policy makers and their advisers, both hoping to introduce measures such as vaccine passports as soon as possible in the face of the pandemic, and understanding that these measures may ultimately be ineffective until the most vulnerable groups are taken care of.
“I’m just taking another view that concerns about fairness will not essentially disqualify the policy. At different times since the beginning of the pandemic, people have been worried about the fairness of lockdowns, vaccine launches and COVID-19 relief. But. Should these concerns prevent us from implementing these policies?” said Josh Liao, a doctor and director of the Value and Systems Science Laboratory at the University of Washington.
Josh Liao
Liao believes that a multi-pronged approach can also be more pragmatic. Different countries can implement different measures-and they have already done so. Some people who have full access to the vaccine may use a vaccine passport. In those countries, such as those where caregivers flying to and from work are needed like the women Jecker interviewed, there may be less disruptive measures, such as COVID testing and the requirement to wear masks.
“What we saw last year is that different countries, whether cooperating with each other or acting individually, will take their own measures to protect the public and people,” Liao said.
In a sense, these methods are not very different. Jecker called for the use of a “flexible pass” instead of a vaccine passport-which may be the masking and testing required by Liao. But for Liao, the vaccine passport is just another tool that should be implemented together with others.
“Even if you are vaccinated and get a passport, does this mean the end of the mask? Does this mean the end of the test? If you or a close contact develop symptoms, does this mean the end of quarantine? If you believe in mutations, breakthrough cases , And the policy needs to be adjusted for these two situations, then you can use the vaccine passport with other measures,” he said. “This is not an all-or-nothing situation.”
Jecker bases her argument on health equity and applies it globally and domestically.
She said that in the country, vaccine passports should not be used until vaccines are widely available and distributed fairly. Even so, Jecker is still worried about the possibility of security and racial profiling. In her article, Jecker pointed out that China’s mandatory testing of African nationals is a bad omen.
“It’s easy to think that this will not happen here. But the protests of “Black people’s fate” remind us how deep-rooted and widespread racism is, especially in the policing field, so I am worried about who will be responsible for law enforcement and in the long run. See what effect this might have on social trust,” she said. .
Dr. Tracy Hilliard
Dr. Tracy M. Hilliard, director of the non-profit organization Michigan Public Health Institute’s (MPHI) Cultural Response Participation Center, agrees that fairness should become an issue before policymakers and experts even start paying attention to any specific policies. Hilliard is also a clinical assistant professor of child, family, and population health at the University of Washington School of Nursing.
“For those with power and decision-making power, it is important not only to consult experts in the fields of medicine, policy or public health, but also those who are the furthest from justice and who are most affected by inequality. Our country wants Ask them what their point of view is, ask them what they think should happen,” she said.
“This way we can ensure that the needs and perspectives of those most affected are considered and prioritized.”
One consistent area is that, as the government’s message continues to change and scientific uncertainties about mutations and vaccine efficacy, the pandemic has created a “moving target”.
For Jecker, this is even more of a reason for rejecting vaccine passports. In fact, Jecker believes that vaccine passports may cause people to relax their vigilance and mix together, leading to more virus transmission. She cited the fact that people who are vaccinated can spread the Delta variant.
Stella Gran-O’Donnell
Dr. Stella Gran-O’Donnell, deputy director of the MPHI Cultural Response and Participation Center, said that the contrast between the pandemic in the United States and the poorer regions of the world highlights the catastrophic differences in equity. Gran-O’Donnell is also a lecturer and field lecturer at the School of Social Work at the University of Washington.
“Here, vaccination is an option. In contrast, developing countries such as the Philippines, Sri Lanka and India lack access to vaccines, hospitals and medical infrastructure, and continue to be plagued by a surge in new cases and deaths,” Gran-O’ Donnell said. “Although the United States has sufficient resources and over-vaccinations in certain areas, India broke the world record of more than 400,000 new cases in early May, and the number of deaths increased by more than 3,500.”
Gran-O’Donnell said that because of this difference, vaccine passports will hinder domestic and global vaccination.
“The issue of vaccine passports will place a disproportionate burden on those most vulnerable to COVID-19 and die from COVID-19, black and brown people, and colored communities in the United States, as well as their counterparts living in poverty and oppression. .Groups all over the world,” she said. “The eligibility of these types of passports and the fear of the government in communities of color, as well as the most common deportation among Mexican and other Latino immigrants, have led to lower vaccination rates and persistent disparities and inequalities.”
Jecker is a Fulbright American scholar in South Africa. He further believes that it is currently estimated that some low- and middle-income countries will not get vaccines until 2023 or 2024. She believes that imposing vaccination requirements on travel before being able to fly will create a “rich man’s club” and make the sky “unfriendly”.
“While discussing vaccine passports in the United States and other places is unfair to people who refuse to get vaccinated, in poorer countries, people worry about not getting the vaccine at all,” she said.
But Liao said that it makes sense to recognize the reality of different distributions of vaccines and that residents of countries that have access to vaccines are vaccinated first. He said that this approach will help global interests.
Nonetheless, Jecker said, vaccine passports may exacerbate the divide between rich and poor.
She said, for example, marginalized groups in the United States had fewer opportunities when they first introduced a vaccine. The more privileged counties-the “less socially vulnerable” areas-accepted them first. She said that vaccine passports may further alienate groups that are already “cautious” about vaccines, thereby further dividing people.
Liao clarified that his argument did not contradict Jack’s position. If anything, he would only emphasize that policymakers must consider the fairness of every part of the pandemic, from lockdown regulations to vaccine launches to COVID relief.
“The key is that there are fairness issues in many aspects of COVID policy. But these concerns are not a reason for not implementing the policy at all — they are a reason for implementing a fairness-centric policy,” Liao said. “In terms of public health, one of the eternal things we took away from the pandemic is that our health is not entirely in our own hands.”
This health series is funded by the Washington Department of Health, which has no editorial opinions or supervision of this content.
