COVID Passport: An Issue of Access
Asking for proof of vaccination seems natural as people want to be assured work environments are safe. But we cannot discuss COVID passports without considering privacy and access; to do so would further increase disparities and put all at risk.
The Equal Employment Opportunity Commission (EEOC) has issued guidance for employers seeking to require employee COVID vaccinations: (1) The vaccine must be generally available to the employee population. (2) Employers must provide exceptions to a mandatory vaccine policy for
those individuals who cannot obtain a vaccine due to their own personal health or disability. (3) Employers must excuse those employees who have a sincerely held religious belief that prohibits them from getting the vaccine. (4) If the employee is a member of a bargaining unit, any mandatory vaccine policy could raise issues under the National Labor Relations Act.
Before collecting copies of vaccination cards understand HIPPA standards for the use and storage of health information. Vaccination records must be kept confidential and strictly limited to those with a business need to know. Failure to do so could lead to significant liability. Covered entities are subject to fines for reasonable cause between $100 to $50,000 and willful negligence between $10,000 to $50,000. Even non-covered entities are required to ask employees to submit a HIPAA authorization when requesting information directly from a vaccine provider.
Before making decisions know the employee protection of The Americans with Disabilities Act (ADA) and The Family and Medical Leave Act (FMLA) against discrimination in employment decisions (hiring, firing, promoting, demoting, training, and job assignments) based on certain medical conditions. Under certain circumstances, the Genetic Information Nondiscrimination Act (GINA) may also apply. Some states have enacted stronger protections against medical discrimination.
Duke Global Health Innovation Center Launch and Scale Speedometer, which monitors COVID19 vaccine purchases, estimates there will not be enough doses to cover the world's population until at least 2023. High-income countries already own more than half of global supply. According to the CDC, discrimination and inequities in income, healthcare, and education have made some groups vulnerable to the spread of COVID19.
Under & Uninsured
While the U.S. federal government has committed to purchasing initial COVID19 vaccinations, it has not committed financing future doses, which will be needed to cover variants. Unfortunately, the U.S. vaccine financing, relying on public and private insurance programs, is fragmented and leaves the under and uninsured vulnerable.
According to the Coalition for the Homeless, while the overall counts appear to be small, the deaths for sheltered homeless per 100,000 were 75% higher than the overall rate for New York City. Yet, only about half of states include people experiencing homelessness in their state vaccination plans.