Is it time to end vaccine passports? Experts divided over whether they are still useful

The Vax Divide: ‘We are starting to look at our fellow citizens in a way that they are not equal citizens to us…. And I think that’s a very dangerous thing to do’

Publishing date:

Jan 14, 2022  •  22 hours ago  •  6 minute read  •  453 Comments

vaccine passports
Vaccine passports/certificates are a nuanced proposition. Photo by Getty

Psychologist and McMaster University professor emeritus David Streiner is of two minds on vaccine passports.


He’s willing to consider just about anything to convince people to get COVID shots, even charging the unvaccinated for hospital stays.

“But the passports? They may be a good stick,” he said, “but I’m not sure how effective they are for slowing transmission.” He worries, too, that passports are creating a “me-them” environment that could only grow worse if the pandemic persists. “We’ve seen it affecting families, splitting families apart.” Once vaccines became polarized, “all reason went out the window.”

The power of the vaccines always lay in the ability to prevent severe disease, hospitalization and death in vulnerable adults. The debate was, do they reduce the risk of transmission?

According to a new and not-yet peer-reviewed Canadian study, they do for a short period of time. But two doses are unlikely to protect against infection by Omicron. By six months after the second dose, “it kind of wanes down to, like, zero,” said lead author and Toronto family physician and epidemiologist Dr. Jeff Kwong.


His team’s updated data show effectiveness against infection recovers to about 60 per cent after a third dose with an mRNA vaccine. Higher, yes, “but still not great,” and not as high as with Delta.

Vaccine passports were based on two objectives: prevent transmission, and help keep people out of hospitals and alive. On the latter, the shots are holding their own. But it’s becoming clearer they do not fully stop transmission and infections, especially wildly contagious Omicron, leading some to question whether passports are still relevant, and why the issue isn’t being more fully addressed by governments.

“We haven’t separated out in our messaging what it is we’re trying to achieve,” said Dr. Martha Fulford, an infectious diseases specialist at McMaster Children’s Hospital. “And that is part of the whole confusion.”


Passports encourage vaccine uptake, by making life less convenient for those who willfully decline the shots, Kwong said. First-dose bookings quadrupled after Quebec expanded its vaccine certificate scheme to cannabis and liquor stores.

But Kwong, a senior scientist with ICES, said that, at this juncture, vaccine passports are serving to protect the unvaccinated. It can be a bit tricky to explain why, exactly. But with most of the population with two doses, a lot of people can enter places with vaccine passports. “Given the reduced/no effectiveness of two doses, depending when the last dose was, there is a risk of these people having an infection, perhaps unknowingly, and transmitting to someone else in such a setting,” Kwong said.


The vaccinated are much more likely to have mild illness, because of their shots. “So they may be more likely to be out and about, despite being infected,” he said. “By excluding all the unvaccinated people from these places, we are in essence keeping them safer from the vaccinated people, who may be asymptomatically or pre-symptomatically infected with COVID, but still able to transmit, especially when everyone is unmasked.”

“If we drop the vaccine passports, the unvaccinated are going to go into those spaces. Right now, they may be living the life of a hermit, and have managed to stay safe that way. But if we get rid of vaccine certificates, they’re like sitting ducks.”

More On This Topic

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    Federal modelling shows a surge in COVID-19 hospitalizations due to Omicron: Tam

  2. People protest the implementation of COVID-19 vaccine certificates by the Ontario government, in front of Toronto City Hall on Sept. 1, 2021.

    Opinion: Why vaccine passports won’t slow COVID spread, will hurt the poor and threaten medical ethics

  3. People protest the implementation of the QR Code COVID-19 vaccine passport by the Ontario government at Toronto City Hall. Peter J Thompson/National Post

    Randall Denley: Ontario’s vaccine passport is mostly just a comfort to the fearful

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Others believe vaccine certificates may even now be harmful, “because it makes people think that they are in a safe space — they were pre-Omicron, but no longer,” Toronto infectious diseases specialist Dr. Andrew Morris wrote in one of his COVID weekly emails.

“Vaccine certificates may prove valuable again at some point,” Morris wrote, “but the two main purposes — motivating people to get vaccinated and protecting people by keeping spaces confined to those at low likelihood of infection — are clearly no longer relevant.”

There is also a question as to how many people need to be excluded to prevent one transmission of SARS-CoV-2.

Quebec’s vaccine passport scheme will eventually require three doses to shop in government-run alcohol and cannabis stores, dine indoors or enter gyms, concerts and other venues. Israel has begun rolling out fourth doses for the 60 and older. There are talks of annual shots, like with seasonal flu. Streiner, a professor in the department of psychiatry and behavioural neurosciences at McMaster, sees risk of push back. “I think we’re in this stage of producing fatigue about it: Okay, I’ve got my two shots, my booster. Enough already. Let me go on with my life.”

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Streiner is senior author, the “eminence grise” of a pre-print study that estimated, in the pre-Omicron era, that at least 1,000 unvaccinated people likely needed to be excluded to prevent one SARS-CoV-2 transmission event in most types of settings.

“In the fall, when people were talking about implementing mandates, and some of my colleagues who were unvaccinated were facing termination, I thought to myself, what, exactly, is the risk reduction gained by terminating unvaccinated healthcare workers,” said lead author Dr. Aaron Prosser, a psychiatry resident at McMaster. “And that just led to a broader exploration for the actual numbers behind that.”

The study looked at household settings, social gatherings (meaning more intimate contacts between friends and families), casual close contacts (“the kind of transient, fleeting contacts in public areas or buildings,” Prosser said), work and study settings and travel and transportation. For comparison purposes, “Going to a restaurant is probably some mixture of a social gathering and public area risk,” he said.

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The analysis was done when infection rates in Canada and across much of the globe were quite stable. “We were in these in-between phases of the waves,” Prosser said. “Obviously now infection risks are rising. It’s a totally different situation.”

“But I think we should think very carefully about whether or not, in a pluralistic democracy, we are sure that the benefits we may extract from (vaccine mandates and passports) outweigh the harm of creating a class of citizens who are not allowed to fully participate in society,” Prosser said.

We are starting to look at our fellow citizens in a way that they are not equal citizens to us, because they have made decisions that we don’t agree with

Dr. Aaron Prosser

“We are starting to look at our fellow citizens in a way that they are not equal citizens to us, because they have made decisions that we don’t agree with. And I think that’s a very dangerous thing to do.”

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New federal modelling released Friday sees a surge in daily hospitalizations in the coming weeks. But there are also signals the Omicron wave may be peaking in Ontario and Quebec, the way it appears to be in Britain and the U.S. According to the Associated Press, the variant may be running out of people to infect. “It’s going to come down as fast as it went up,” University of Washington in Seattle scientist Ali Mokdad told AP.

The other good news: “Vaccines are protecting against severe outcomes,” Kwong said. “That’s what we need to hang our hats on.”

Canada’s unvaccinated by the numbers

Eligible Canadians 5 and over who are unvaccinated (zero doses): 12%

Eligible Canadians 5 and older in each province and territory who are unvaccinated:

Alberta: 15.8%

Saskatchewan: 14.1%

Manitoba: 12.6%

Ontario: 12.5%

B.C.: 11.6%

Nunavut: 11.6%

Quebec: 10.2%

New Brunswick: 9.7%

Yukon: 9%

Nova Scotia: 8.4%

Prince Edward Island: 7.2%

Northwest Territories: 5.6%

Newfoundland and Labrador: 2.5%

Males who are unvaccinated (as of Jan. 8): 18.3% (of total population)

Females who are unvaccinated (as of Jan. 8): 16% (of total population)

Proportion of unvaccinated by eligible age group:

5-11: 60.5%

12-17: 13%

18-29: 14.3%

30-39: 12.2%

40-49: 10%

National Post, with additional files from Tom Blackwell

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