Why vaccine passports are replacing lockdowns from Israel to Australia

Israel led the world in vaccinating its population against Covid, and was also the first country in the world to introduce a 'vaccine passport' system to curb the spread of the virus.

Its 'green pass' regime was launched in mid-February, initially giving exclusive access to gyms, hotels, cinemas, theatres, and concerts to those who could provide proof of full vaccination or "presumed immunity" from a prior Covid infection.

In March, proof of a negative Covid test no more than 48 hours old was added to the list of options that people could present to gain entry to cultural and leisure venues, with the green pass also extended to encompass bars, restaurants, cafes, hotels, museums, swimming pools and places of worship.

READ MORE: Vaccine passports 'leap into North Korea territory', says top scientist

Even children - who were initially not eligible for vaccination - were banned from entering these public spaces without a green pass.

The 'passport' took the form of a QR code which could be downloaded from the Health Ministry onto Israelis' smartphones.

The scheme remained in place for just over three months, during which time infections declined to almost zero in Israel while the country rolled out Pfizer vaccines and kept its borders largely closed.

Israel fully scrapped all restrictions in June - but soon reintroduced facemasks and its green pass as the Delta variant took hold

On June 1, the green pass system was scrapped - declared "redundant" - as victory was declared over Covid.

Requirements for indoor facemasks were also dropped soon afterwards and life in Israel (with the exception of ongoing tourism and international travel restrictions) briefly returned to normal.

Yet within weeks, facemasks were back and on July 29 the green pass system was reinstated - along with limits on indoor and outdoor event sizes - as Israel fell victim to the highly infectious Delta variant which spread rapidly in unvaccinated children and young people (27% of Israel's population is under 15, compared to around 16% in Scotland).

Israel had been offering the vaccine to all of its 12-15-year-olds (600,000 out of a population of nine million people) in early June, but by mid-June cases were rising rapidly.

The UK has now fully vaccinated slightly more of its population than Israel, but trails Denmark and is set to be overtaken by Italy and France where uptake is still climbing

In early August, all over-60s in Israel were invited to take up third doses of the Pfizer vaccine as boosters.

To date, 62.4% of Israel's total population is fully vaccinated (compared to 62.9% in the UK) but cases are still rising rapidly.

As of August 31, Israel was recording 896 Covid cases per million people, per day (compared to 492.6 in the UK).

Given that this is up from 196 when the green pass was reinstated, it is hard to say whether it has had any effect on transmission.

Would the situation be even worse without it?

READ MORE: How can Scotland increase vaccine uptake in young people? 

One of Israel's problems, as in Scotland, is uptake in younger groups.

A report from its Health Ministry in late August stated that the “main characteristics” of unvaccinated people is that they were more likely to be "economically disadvantaged", young, or from marginalised communities: only 50% of Arab Israelis and one in three ultra-Orthodox Jewish Israelis have been vaccinated.

In the 12-15 age group, uptake is around 42%, rising to 80% in 16 to 19-year-olds and 20-29-year-olds, and 84% among those in their 30s.

DENMARK

In mid-April, Denmark became the first country in Europe to launch a 'vaccine passport' system.

The coronapas scheme was aimed at helping non-essential businesses reopen safely.

Citizens were able to access it using an app or by obtaining a paper certificate as long as they had been fully vaccinated, had tested positive for the virus in the two to 12 weeks prior, or had proof of a negative Covid test within the past 72 hours.

The coronapas was initially required for access to hairdressers and beauty salons, but was gradually rolled out to pavement cafes, museums, bars, restaurants, libraries, art galleries and sports venues by the time the country's economy fully reopened on May 6.

Denmark began phasing out facemasks (except on public transport) in June, began routinely vaccinating 12-15-year-olds in mid-July, and earlier this week the Danish government announced plans to scrap the coronapas from September 10 after the country's health minister Magnus Heunicke said the epidemic was "under control".

Only border restrictions will remain.

Denmark currently has one of the highest vaccination rates in the world with 72.4% of people fully inoculated and uptake is still climbing rapidly.

Virus rates in Denmark have been stable since mid July and currently stand at 151 cases per million people, per day.

FRANCE

Since June 9, in order to access large events of 1000 people or more, over-18s in France have been required to provide proof of vaccination, a negative test no more than 48 hours old, or a positive Covid test taken between 11 days to six months earlier.

On July 21, the passe sanitaire was extended to cover leisure and cultural venues with more than 50 people, including museums, exhibitions, fairs, concerts, cinemas, festivals and nightclubs, before being rolled out again on August 9 to cover long-distance trains, restaurants, cafes and bars - including outdoor terraces.

Since August 30, the pass has also been required for 12 to 17-year-olds (children aged 12 and over have been eligible for vaccination in France since June 15).

READ MORE: Teachers' risk of Covid doubled after schools reopened in autumn

The move has been controversial in France - a nation known for its vaccine hesitancy - with mass protests in major cities and accusations that it was creating a "health dictatorship".

However, it has also been credited with boosting vaccine uptake with a record 926,000 vaccine appointments booked in the 24 hours after President Macron announced that the pass would apply to bars and restaurants.

France's coronavirus rate has also been falling since mid-August, and currently stands at 213 cases per million people, per day.

Just under 60% (59.7%) of France's population are now fully vaccinated and, with uptake still rising sharply, it is set to overtake the UK very soon.

ITALY

Northern Italy was engulfed by Covid before any other part of Europe was experiencing severe outbreaks.

Its devastating experience in February and March of 2020 led it to impose a national lockdown - the first on the continent - and was credited with surprisingly high compliance with restrictions, masking, and distancing as the pandemic wore on.

Now it has adopted one of the strictest vaccine passport systems in the EU.

Since August 6, Italians have had to provide a Certificazione Verde (Green Pass) to attend large events such as sports matches, to dine indoors in restaurants (outdoor dining is exempt) or to enter other public spaces such as museums, bars, cafes, gyms, swimming pools, concerts, theme parks and more.

Covid cases per million people, per day (Our World in Data). Despite reinstating its Green Pass, rolling out vaccines to over 12s and boosters to over-60s, Israel's epidemic has surged. However, in France, Italy and Denmark measures including passes appear to have slowed or decreased the virus

The pass can be digital - on a smartphone app - or paper, but must demonstrate that the individual is fully vaccinated, tested negative in the last 48 hours, or has recovered from a recent infection.

Since Wednesday, the pass has also been compulsory for everyone except children under-12 travelling on high-speed trains, ferries, and domestic flights.

Even school teachers and university students must now have a valid green pass before they can enter a classroom or a lecture hall, with reports on non-compliant teachers in Turin being sent home from schools this week.

Despite controversy (protesters from the No Vax movement threatened to blockade dozens of trains and some Italian politicians have received death threats) there was little disruption as the measure was implemented this week, with a heightened police presence in stations.

To date, 60.8% of Italy's total population is fully vaccinated - 70% if counted as the population aged 12 and older - and Covid cases have been levelling off during August.

Italy is currently recording 107 cases per million per day - around a fifth of the rate in the UK.

AUSTRALIA

In 2020, rapidly-closed and tightly-controlled borders were credited with insulating Australia from the pandemic, such that by mid-May this year it had recorded just 910 Covid deaths in total compared to 128,000 in the UK.

In recent weeks, that number has climbed to 1,019 after the Delta variant slipped through the net in June and local lockdowns failed to contain its spread.

The situation is serious in a population where just 27.8% of people are fully vaccinated.

There are fears hospitals in some regions could become so overwhelmed by October that non-Covid patients will have to be sent home instead to be looked after by nurses and GPs.

Currently, the case rate stands at 46 per million people per day - a tenth of the UK's - but compares to just 0.6 on June 23.

Beyond trying to persuade more people to be vaccinated (the rollout has been blighted by a combination of low supplies after leaders banked on a Queensland-made vaccine which failed, and then by the reluctance of many people to get the AstraZeneca vaccine due to blood clot fears at a time when prevalence of the virus was so tiny their risk of Covid seemed remote) the Australian government is now turning to vaccine passports in a bid to avert crisis.

Prime Minister Scott Morrison has unveiled a four-stage plan which will involve reopening the borders once 80% of people are fully vaccinated, but introducing "special rules" for vaccinated people once coverage reaches 70%.

The number of Covid deaths in the UK far exceeds Australia due to border closures which mostly kept the virus out, until now

Exactly what these exemptions will be is still being worked out, but it is expected to mirror other international examples by limiting entry into bars, restaurants, nightclubs and other leisure facilities to those with a 'pass'.

As in Scotland, however, many fully vaccinated Australians are discovering that there is no record of them on the vaccine database.

The problem appears to be that if state-employed vaccinators have not recorded the patient's details in a way that exactly matches the information held about them in federal records, they effectively disappear.

Cue hours on helplines or being passed from pillar to post in search of a person or department who can correct the error.

The Herald previously reported that hundreds of people were similarly jamming Scotland's vaccine certificate helpline with concerns about missing or incorrect records - and that was when the certificates were only required for international travel.

With Scotland set to launch downloadable QR codes from today, it remains to be seen whether the faults in the database have been ironed out ready for domestic use.