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An immunity passport, immunity certificate, health pass or release certificate (among other names used by various local authorities) is a document, whether in
paper Paper is a thin sheet material produced by mechanically or chemically processing cellulose fibres derived from wood, rags, grasses or other vegetable sources in water, draining the water through fine mesh leaving the fibre evenly distribut ...
or digital format, attesting that its bearer has a degree of
immunity Immunity may refer to: Medicine * Immunity (medical), resistance of an organism to infection or disease * ''Immunity'' (journal), a scientific journal published by Cell Press Biology * Immune system Engineering * Radiofrequence immunity desc ...
to a
contagious disease A contagious disease is an infectious disease that is readily spread (that is, communicated) by transmission of a pathogen through contact (direct or indirect) with an infected person. A disease is often known to be contagious before medical s ...
. Public certification is an action that governments can take to mitigate an epidemic. When it takes into account natural immunity or very recent negative test results, an immunity passport cannot be reduced to a vaccination record or ''vaccination certificate'' that proves someone has received certain
vaccine A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified.
s verified by the
medical record The terms medical record, health record and medical chart are used somewhat interchangeably to describe the systematic documentation of a single patient's medical history and care across time within one particular health care provider's jurisdi ...
s of the clinic where the vaccines were given., such as the ''
Carte Jaune The International Certificate of Vaccination or Prophylaxis (ICVP), also known as the Carte Jaune or Yellow Card, is an official vaccination report created by the World Health Organization (WHO). As a travel document, it is a kind of ''medical ...
'' ("yellow card") issued by the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
(WHO), which works as an official vaccination record. The concept of immunity passports received much attention during the
COVID-19 pandemic The COVID-19 pandemic, also known as the coronavirus pandemic, is an ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The novel virus was first identif ...
as a potential way to contain the pandemic and permit faster economic recovery. Reliable serological testing for antibodies against SARS-CoV-2 virus is done to certify people as relatively immune to COVID-19 and issue
immunity Immunity may refer to: Medicine * Immunity (medical), resistance of an organism to infection or disease * ''Immunity'' (journal), a scientific journal published by Cell Press Biology * Immune system Engineering * Radiofrequence immunity desc ...
documentation.


History

Quarantine A quarantine is a restriction on the movement of people, animals and goods which is intended to prevent the spread of disease or pests. It is often used in connection to disease and illness, preventing the movement of those who may have bee ...
has been used since ancient times as a method of limiting the spread of infectious disease. Consequently, there has also been a need for documents attesting that a person has completed quarantine or is otherwise known not to be infectious. Since the 1600s, various Italian states issued ''fedi di sanità'' to exempt their bearers from quarantine. The International Certificate of Vaccination (''Carte Jaune'') is a certificate of vaccination and prophylaxis, not immunity. The document has remained largely unchanged since it was adopted by the International Sanitary Convention of 1944. The certificate is most commonly associated with
Yellow Fever Yellow fever is a viral disease of typically short duration. In most cases, symptoms include fever, chills, loss of appetite, nausea, muscle pains – particularly in the back – and headaches. Symptoms typically improve within five days. In ...
, but it is also used to track vaccination against other illnesses.


Modern definition

An immunity certificate is a legal document issued by a testing authority following a
serology Serology is the scientific study of serum and other body fluids. In practice, the term usually refers to the diagnostic identification of antibodies in the serum. Such antibodies are typically formed in response to an infection (against a given mi ...
test demonstrating that the bearer has
antibodies An antibody (Ab), also known as an immunoglobulin (Ig), is a large, Y-shaped protein used by the immune system to identify and neutralize foreign objects such as pathogenic bacteria and viruses. The antibody recognizes a unique molecule of the ...
making them relatively immune to a disease. These antibodies can either be produced naturally by recovering from the disease, or triggered through
vaccination Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating ...
or another medical procedure. Reliable immunity certificates can be used to exempt holders from
quarantine A quarantine is a restriction on the movement of people, animals and goods which is intended to prevent the spread of disease or pests. It is often used in connection to disease and illness, preventing the movement of those who may have bee ...
and
social distancing In public health, social distancing, also called physical distancing, (NB. Regula Venske is president of the PEN Centre Germany.) is a set of non-pharmaceutical interventions or measures intended to prevent the spread of a contagious dise ...
restrictions, permitting them to travel and work in most areas, including high-risk occupations such as medical care. In the COVID-19 context, it has been argued that such certificates are of practical use to society only if all of the following conditions can be satisfied: * Recovered or vaccinated patients have protective immunity that prevents them from being reinfected * The protective immunity is long-lasting * The pathogen mutates sufficiently slowly for immunity to work against most strains * Immunity tests have low
false-positive A false positive is an error in binary classification in which a test result incorrectly indicates the presence of a condition (such as a disease when the disease is not present), while a false negative is the opposite error, where the test result ...
rates However, some long-standing vaccines recommended by the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
, such as
Meningococcal vaccine Meningococcal vaccine refers to any vaccine used to prevent infection by ''Neisseria meningitidis''. Different versions are effective against some or all of the following types of meningococcus: A, B, C, W-135, and Y. The vaccines are between 85 ...
, are less than 100% effective and their protection is not everlasting.


COVID-19

In 2021, as COVID-19 vaccines became more publicly accessible, some governments began to authorize health credentials either as a document or in a digital form. These "vaccine passports" are used to control public access to indoor venues (like bars, restaurants, spas, and casinos) and very large gatherings (like concerts, festivals, and sporting events) and not just to facilitate travel. Depending upon the requirements of the issuing authority, an applicant would need to provide either proof of vaccination(s), a negative COVID-19 test, proof of a recovery from the virus, or some combination of these. Their usage and implementation has been controversial and has raised various scientific, medical, ethical, legal, discrimination, privacy, civil rights, and human rights concerns.


See also

*
Electronic health record An electronic health record (EHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared throu ...
*
Fast Healthcare Interoperability Resources The Fast Healthcare Interoperability Resources' (FHIR, pronounced "fire") standard is a set of rules and specifications for exchanging electronic health care data. It is designed to be flexible and adaptable, so that it can be used in a wide rang ...
* Patient record access * Vaccination requirements for international travel *
COVID-19 Vaccine Passport A vaccine passport or proof of vaccination is an immunity passport employed as a credential in countries and jurisdictions as part of efforts to control the COVID-19 pandemic via COVID-19 vaccine, vaccination. A vaccine passport is typically i ...


References

{{Portal bar, COVID-19, Medicine, Viruses Responses to the COVID-19 pandemic Passports Immunology Software associated with the COVID-19 pandemic