The European Union (EU) is mulling over a digital green pass which can be presented as proof of COVID-19 vaccination. There are several technical issues concerning the production and issuance of this type of pass. For example, which vaccines will qualify? Concerning how to prevent counterfeiting, the EU adopted guidelines for a unified set of standards back in January. However, another issue of concern is whether these passports will cause discrimination. There is heated discussion in the EU, but a conclusion has not been reached.
As the percentage of vaccination against COVID-19 will soon rise, whether there will be a difference in treatment towards people who have been vaccinated and those who have not and whether such different treatments will lead to discrimination must be considered in advance.
These differences in treatment can be divided into two aspects, one local and the other international. Locally, will one have to possess a vaccination certificate before one can participate in a mass social gathering? Will one have to produce a vaccine passport to enter a concert? During an interview, French Minister of Culture Roselyne Bachelot expressed her clear opposition, arguing that such a measure would be an attack on freedom. During the outbreak of a cluster of in-hospital infections at Tao Yuan General Hospital, there were incidents in which the restaurant required medical staff to take their food instead of having the meal inside. If there is a vaccine passport, will restaurants require customers to have been vaccinated to be allowed to eat inside? Will one be required to have a vaccine passport to take the MRT?
Apart from the possible impact on different aspects of people’s daily lives, can employers require employees to provide vaccine passports? As far as the protection of labor rights is concerned, discrimination against sick people in the workplace is strictly prohibited. Article 12 of the Communicable Disease Control Act states that “Government organizations (institutions), civic groups, enterprises or individuals shall not deny patients with communicable diseases their rights to education, employment, nursing care, housing or provide any other unfair treatment. However, this regulation shall not apply to individuals who are required to be restricted by competent authorities for needs of controlling communicable disease.”
Government can set differential treatment
Non-discrimination is therefore the principle. However, the government can set differential treatment. The competent authority can regulate whether vaccination against COVID-19 can be used as one of the conditions of employment based on the needs of infectious disease prevention.
The biggest impact of vaccine passports will no doubt be on international travel. It is hoped that travelers who have been vaccinated can be exempt from quarantine arrangements after they leave or enter a country. Will this mean the deprivation of unvaccinated people the right to travel internationally? Of course, we can say that those who are not vaccinated can still travel internationally – they will just have to be in quarantine. However, airlines might not allow passengers without vaccine passports to board the plane because they are at high risk of being infected or infecting others. But from the perspective of risk management, is the proof of no infection or cure after infection as effective as a proof of vaccination?
Apart from provisions about non-discrimination against patients, Taiwan’s Communicable Disease Control Act also contains stipulations about compulsory vaccination. But it is mainly bundled with entry into primary school. According to Paragraph 4, Article 27 of the Communicable Disease Control Act, “The legal proxies of children shall ensure children receive routine immunization on schedule, and present record of immunization when entering elementary school.” Paragraph 5 stipulates that “Elementary schools and pre-school (nurseries) institutions shall ensure non-immunized, new students complete the required immunization.”
Apart from that, under the existing arrangements for vaccination after students begin elementary school in Taiwan, both influenza and HPV vaccinations are voluntary. Without a doubt, COVID-19 has a much greater impact on physical and mental health than influenza or the HPV virus. After COVID-19 vaccines are popularized, should vaccination be made mandatory? For society to reach a consensus, this issue must be discussed extensively in the near future.
(Yang Che-Ming is a professor at the School of Health Care Administration of Taipei Medical University.)
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