Are vaccine passports fair?
Monday, 8 November 2021
OPINION: The recent announcement by the government introducing vaccine passports together with a traffic light system has come as a surprise to many New Zealanders including some of those that are already double vaccinated such as myself.
By excluding the unvaccinated from bars, cafes, restaurants, salons, gyms and events, we will divide our 'team of 5 million' effectively into either vaccinated or unvaccinated groups with each class afforded different levels of freedom in order to prevent the spread of Covid-19. It is through the lenses of psychology and philosophy/ethics that we can better understand the new government TLS and its application of vaccine passports.
Up until now, vaccination status has been a medical record that is considered personal health information. It is reasonable to question whether the public should have the right to know the vaccination status of each other.
Under the TLS, many businesses must demand vaccine status from their customers in return for the right to trade at different traffic light levels. Also under the TLS, individuals must provide their vaccine status in the form of a digital vaccine passport in order to access those businesses.
**READ MORE:
* How vaccine passports could impact festivals, cafes, work and our freedom
* How far should compulsory proof of vaccination go — and what rights do we have?**
Once we start sharing our medical records with each other using mobile app technology, how long will we need to do this for? Evidence tells us that the effectiveness of Covid-19 vaccines wane over time, therefore we should question whether the mandatory use of the app will extend to booster shots and whether its use will later be extended by government to other vaccines such as measles and mumps. There is no clear roadmap out of the TLS or the use of vaccine passports.
In addition to concerns related to health privacy, the next major issue to address is whether people who are vaccine hesitant are legitimately giving their consent to be vaccinated. In order to give medical consent, it must be voluntary and informed and the person consenting must have the capacity to make that decision for treatment.
Voluntary consent must not be influenced by pressure from medical staff, friends or family. An individual must be allowed to make a decision either to accept or decline healthcare services freely, without any form of coercion or constraint. Are vaccine-hesitant people really giving voluntary consent when they have been pressured into their vaccination by the government in return for additional freedoms or employment? It is one thing to justify the use of vaccine mandates in healthcare and aged care settings to satisfy the duty of care to vulnerable patients but does this same justification extend to non-essential workers who must now choose between being vaccinated or losing their careers?
In operant conditioning psychology terms, there are the concepts of positive reinforcement and negative punishment. The TLS on surface appears to reward people with additional freedoms in exchange for getting vaccinated. However, by the same token you could argue that you are only being rewarded with freedoms that have been withheld. Negative punishment involves taking something good or desirable away to reduce the occurrence of a particular behaviour.
The TLS for example, takes away particular freedoms of movement or employment in an effort to reduce vaccine hesitancy. The TLS uses freedom as a currency to reward or incentivise healthy people to get vaccinated even though freedom is a right that New Zealanders have. Rather than punish those that are unvaccinated, the use of vouchers or even cash incentives are a morally better reward as positive reinforcement to encourage the uptake of vaccines. Instead, the TLS coerces both businesses and individuals into getting vaccinated using a system perceived by some to be unfair because it creates a subclass within our society, some of which are trying to retain their medical autonomy.
Data published by the government shows that there are significant differences in uptake of vaccines between ethnic groups in New Zealand. We must therefore ask how the government will prevent vaccine passports from marginalising those ethnicities with lower vaccine rates. It is pleasing to see that the Human Rights Commission are now investigating this issue directly.
New Zealanders have worked hard to get our vaccination numbers up in order to combat Covid-19. If the government deems it both necessary and ethical to introduce the vaccine passports using the TLS for our greater good despite the above concerns on individual human rights, we need to know when, or indeed if, we can stop using vaccine passports before they are introduced in an effort to retain both our medical privacy and rights to medical consent as we work towards the return of our freedoms collectively.
Neal Thompson has a MSc in Health Psychology and Double Major BA in Psychology and Philosophy from the University of Auckland.