Australian leaders are considering mandatory COVID-19 vaccination passes How would they work

Australians could soon be required to show proof of vaccination to enter pubs, grocery stores and sports stadiums, under a plan being considered by national cabinet.

Prime Minister Scott Morrison this week said state and territory leaders are in talks about the idea, which would take place under phase B of Australia’s COVID-19 exit plan, when 80 per cent of the population is vaccinated.

But experts say mandatory health passes in exchange for more freedoms isn’t necessarily the best strategy in charting our path out of lockdown.

What is a COVID green pass?

A COVID green pass would effectively be an Australian resident’s proof of vaccination.

A mobile phone pass with a person's vaccination details could be shown to business owners, including supermarket staff, to enter an establishment without having to take a mandatory COVID-19 test.

Last week, Mr Morrison outlined a new roadmap for Australia’s path out of the pandemic, which requires a minimum of 70 per cent of people vaccinated across all states and territories.

The second phase, by which 80 per cent of people are vaccinated, would allow greater freedoms for those who have received both COVID-19 vaccine doses.

Speaking to 5AA radio in Adelaide on Monday, Mr Morrison said state and territory leaders are considering the idea to give that vaccinated portion less restrictions on movements.

He stressed that while it's not currently legal for business owners to demand proof of vaccination from patrons, state governments can put those laws in place.

"Phase B of the plan is all about ensuring that those who have been vaccinated do get exempted from restrictions," Mr Morrison said. "And that plan is now being worked on by Northern Territory, Victoria and Tasmania. They're bringing back a series of proposals to us that would give that greater detail.

“Those powers don't exist at a federal level. They exist at the state level.

"But there certainly are things that are being discussed by the premiers and I and ... the way we wish to proceed, whether that's necessary."

"It's got nothing to do with politics or freedoms or anything like that," he added. "It's just simple: if you're vaccinated, then you're less of a public health risk."

On Tuesday, Venues NSW told 2GB radio it will seek government approval for a plan to require vaccination passports to buy tickets for rugby league, AFL, cricket or any big events at major stadiums and suburban grounds.

How have COVID green passes played out around the world?

The idea of COVID green passes is being trialled around the world as nations ramp up their vaccination rollouts. In some countries, health passes have been adopted with little fanfare, but in others, they’ve caused notable controversy.

In France, thousands of people have hit the streets in recent weeks to protest a rule that proposes banning access to cafes, supermarkets and public transport for people who haven’t been fully vaccinated.

The country has mandated coronavirus “health passes” for entry to a number of venues including museums, cinemas and swimming pools, with those who cannot produce proof of vaccination denied entry.

France’s parliament also approved a new law last week to make vaccinations mandatory for health workers and extend the health pass requirement to bars, restaurants, trade shows, trains and hospitals.

Thousands of people have taken to the streets of France, protesting COVID-19 health passes.

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Similar protests took place in Italy, with Prime Minister Mario Draghi likening the anti-vaccination message from some political leaders to “an appeal to die”.

Denmark pioneered vaccine passes with little resistance. Belgium will require a vaccine certificate to attend outdoor events with more than 1,500 people by mid-August and indoor events by September.

Germany and Britain have so far resisted a blanket approach, while vaccinations are so popular in Spain that incentives are not deemed necessary.

What do the experts say?

Epidemiologists say green passes are problematic in general because none of the COVID-19 vaccines make a person completely immune from catching the virus, or potentially transmitting it.

Professor Mary-Louise McLaws, a UNSW professor and advisor to the World Health Organization, said it's dangerous and inaccurate to assume that being vaccinated fully eradicates the possibility of virus transmission.

“The problem with this, first of all, is that it assumes that anybody who has been vaccinated is going to be 100 per cent protected from a vaccine breakthrough,” she told SBS News.

For Australia, she said such an idea shouldn’t be implemented while many in the population are still not able to get vaccinated.

“It assumes that everybody will have the chance to be vaccinated. At the moment with the rollout, there’s been very much a compassionate framework for those at risk of death and hospitalisation, and frontline workers,” she said.

“But you can’t start providing these releases from restrictions unless you’ve given everybody the chance to take up the vaccine. Otherwise it would appear as if, rather than taking advantage of the ability to have been vaccinated, it’s a privilege that is only given to the elderly, or to frontline workers.

“The timing has to be very equitable - has everybody had the chance to have had the vaccine before they start offering these privileges?”

Professor McLaws also stressed that, while the vaccine significantly “reduces your risk of death and hospitalisation”, it’s “not 100 per cent perfect”.

Professor Nancy Baxter, head of the School of Population and Global Health at the University of Melbourne, agreed such an idea might work better when there are very few unvaccinated people in Australia.

“One of the challenges to having a passport where you allow some people to do things, and not others, is it’s pretty hard to put that in place before you’ve given people access to vaccines,” she told SBS News. “If they did that now, it’s basically saying, people under 40, you’re out of luck, you can’t go to the movies or a game because you haven’t been vaccinated, when they haven’t really had the opportunity to be vaccinated.

“From a society-level perspective, it works better when you’re trying to get that last percentage [of people vaccinated] - so you’ve offered the vaccine, everyone who’s willing to get it has been able to get it, and then you’re trying to incrementally get the harder-to-reach people.”

Is Australia’s problem hesitancy - or availability?

Both experts said research shows Australians tend to take a more favourable approach to vaccinations than certain European countries.

“There’s hardly any vaccine hesitancy [in Australia],” Professor McLaws said. “I think Australians are good at taking up the vaccine, and I think young people will surprise authorities - they’ll be rushing for it. It’s all about supply, really - that’s one of the biggest problems.”

She said it’s “surprising” that it’s taken this long to consider prioritising younger Australians for the jab.

“We should have been able to look after both the vulnerable and those who are epidemiologically at great risk of the disease,” she said.

“But now that they’ve been woken to this, I’m looking forward to the young 20-to-39-year-olds being able to rock up and get priority.”

Professor Baxter suggested the lag of the vaccine rollout, combined with reports about rare blood clot deaths from the AstraZeneca vaccine, is the central issue - not hesitancy.

“In general, Australians are actually one of the least vaccine-hesitant people,” she said.

Canada, for example, has one of the highest rates of vaccine uptake in the world.

More than 60 per cent of the country's 37 million people have been fully vaccinated, and a further 11 per cent have received at least one dose.

“There’s a lot of similarities between Australia and Canada in terms of being pretty accepting of vaccines, and being trusting of government, and having confidence in their healthcare system,” Professor Baxter said.

The main reasons for the discrepancy between the two countries, she said, is because Canada has experienced COVID-19 more rampantly than Australia overall, and they also have a better supply of vaccines.

Do Australians really need vaccine incentives?

Earlier this week, Labor proposed a one-off $300 cash incentive for everyone who gets vaccinated in the next four months.

When national cabinet agreed to the vaccination targets, it encouraged uptake through incentives such as eased restrictions on vaccinated individuals when the 70 per cent is achieved.

Labor argues the incentives should be greater to fasttrack the process.

But Professor McLaws said incentives - whether they be eased restrictions or cash - miss the point.

Rather, she says Australians not getting vaccinated is moreso based on supply and access issues rather than hesitancy.

“Incentives communicate to me that this is a blaming of the community for not taking up the vaccine, rather than accepting that the rollout has been too slow for people to take it up,” she said. “If you look at the uptake of the over-50s, then certainly, they’ve had the opportunity and safety of taking up AstraZeneca and they haven’t.

“So the 50-59 year olds need to improve their uptake dramatically. They’re the second-highest group that is at a great risk of death.”

Professor Baxter agreed.

“A key point is are people hesitant? Or has there just not been enough supply, combined with AstraZeneca having a PR problem?” she said. “Once we have adequate doses of Pfizer, are we going to be having this conversation, or will everyone be rushing out to get vaccinated?”

She also pointed out that access is a key issue, particularly among less affluent communities.

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The federal government on Tuesday released data on regional vaccination rates to 1 August, showing Sydney’s COVID-struck south-west have some of the lowest vaccination rates in New South Wales.

By contrast, Sydney’s affluent northern suburbs had among the highest first dose uptake rate in NSW, with more than 50 per cent of the North Sydney and Hornsby regions having had at least one dose.

“It should surprise no one that the places that have the lowest vaccine take-up are the least affluent,” Professor Baxter said. “A lot of people ascribe this to multicultural and linguistic differences, but there are many, many more barriers than that.

“It’s being able to get the time, having the resources to make the booking. Even things like being able to - for older people - log in and get an appointment.

“Within the last two weeks, people have still been saying it’s challenging to get an appointment with their doctor to get the vaccine.

“So in terms of this debate about whether it’s hesitancy or supply, I think a lot of it is supply - and also access.”

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