A public health ethic should inform policies on COVID-19 immunity passports – Authors' reply
Authors: Rebecca C H Brown, Julian Savulescu, Dominic Kelly, Dominic Wilkinson
Journal: The Lancet Infectious Diseases (2020)

In their response to our Personal View,1Brown RCH Kelly D Wilkinson D Savulescu J The scientific and ethical feasibility of immunity passports.Lancet Infect Dis. 2020; (published online Oct 16.)https://doi.org/10.1016/S1473-3099(20)30766-0Summary Full Text Full Text PDF Scopus (66) Google Scholar Françoise Baylis and Natalie Kofler argue that our position is informed by a misguided emphasis on liberal individualism. By contrast, they argue that their insistence that immunity passports must be fought "tooth and nail"2Baylis F Kofler N Why Canadians should fight tooth and nail against proof-of-immunity cards.https://www.cbc.ca/news/opinion/opinion-pandemic-coronavirus-immunity-passport-1.5551528Date: May 7, 2020Date accessed: November 17, 2020Google Scholar is based on a more justifiable, communitarian approach to public health. Our concern for individual liberties is not, we think, extreme. We agree that individuals might be required to make sacrifices in order to promote the social good and, indeed, that the current situation demands many such sacrifices. Although it is unclear what, precisely, Baylis and Kofler's communitarian public health ethic commits one to, it does not (presumably) require a jettisoning of individual interests altogether. Individuals are, after all, components of communities. Our position with regards to immunity passports is that, if people are immune to COVID-19 and no longer a risk to others, their liberties should be restored precisely because they are not a threat to the greater good. Indeed, with their liberties restored, individuals are empowered to contribute to the common good. This appears compatible with communitarian thinking, and the assumption that a defence of immunity passports must be motivated by a commitment to liberal individualism is unwarranted. It is also worth noting that nearly all of Baylis and Kofler's arguments apply equally to vaccine-induced and infection-induced immunity, suggesting they would object to any lightening of restrictions for vaccinated individuals until herd immunity is established, or some other scenario in which the risks from COVID-19 become minimal. Although we very much hope such a situation will be achieved swiftly, we fear this stance could commit entire populations, including millions of immune people, to prolonged restrictions with little benefit. Disagreement about appropriate policy responses to COVID-19 is inevitable, and debate is valuable. However, imprecise speculation about "increasing risks for discrimination" and "stratifying society across a novel biological divide" is unhelpful. It is insufficient to simply state that there is a risk while offering no indication of how large, likely, or damaging that risk is. It also neglects the clear harm done (to both individuals and communities) by restricting people's freedoms unnecessarily. We declare no competing interests. The scientific and ethical feasibility of immunity passportsThere is much debate about the use of immunity passports in the response to the COVID-19 pandemic. Some have argued that immunity passports are unethical and impractical, pointing to uncertainties relating to COVID-19 immunity, issues with testing, perverse incentives, doubtful economic benefits, privacy concerns, and the risk of discriminatory effects. We first review the scientific feasibility of immunity passports. Considerable hurdles remain, but increasing understanding of the neutralising antibody response to COVID-19 might make identifying members of the community at low risk of contracting and transmitting COVID-19 possible. Full-Text PDF A public health ethic should inform policies on COVID-19 immunity passportsIn their Personal View, Rebecca Brown and colleagues1 argue for the implementation of so-called COVID-19 immunity passports to allow individuals presumed immune to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to move through society under reduced social distancing and other restrictions. Brown and colleagues contend that constraining these individuals' freedom of movement is a serious breach of personal liberty. We vehemently reject the political philosophy of liberal individualism that undergirds this argument and thus the conclusion in support of immunity passports. Full-Text PDF