| Technological considerations |
Technological requirements include a minimum data set, standards for interoperability and governance, basic digital infrastructure, and systems architecture.4,25 This necessitates widespread adoption of open interoperability standards for secure data access and exchange. The emerging government-led DVP initiative with the greatest level of trans-border standardization is the “EU Digital Covid Certificate”.26 Knowledge sharing between countries is essential for ensuring equitable technological development and interoperability.
Non-state actors possess the expertise that governments lack in digital health implementation, and several are developing DVPs independently using blockchain technology for decentralized DVP systems.2,26–29 In some cases, DVPs are being developed in public–private partnerships between governments and tech companies.2,26
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| Ethical considerations |
There is limited access to COVID-19 vaccines worldwide (particularly in lower-income countries),30 raising the risk that the introduction of DVPs may hinder global travel equity.30 Economic and social benefits should be weighed against the public health risks. While some assert that DVPs do not increase inequality,31 questions remain regarding the freedom of movement.32,33
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| Legal considerations |
The 6th meeting of the International Health Regulations Emergency Committee regarding the coronavirus disease (COVID-19) pandemic cautioned against proof of vaccination for international travel.34 Nonetheless, IHR Annex 7 and IHR Articles 12, 15, 18, and 53 do permit countries to require proof of vaccination as a condition of entry or exit. Nations are divided on the approaches to be taken. Some independently develop legal frameworks for federalized DVP systems,35 while others recommend that the IHR be revised.36 The legal implications of digitizing DVPs should also be considered,37 including (1) the regulation of collecting, storing, sharing, using, and accessing personal data and health information, and (2) the regulation of data sharing and intellectual property by private technology providers.
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| Scientific considerations |
There are persisting scientific unknowns around vaccine efficacy and their capacity to prevent disease, limit transmission, prevent asymptomatic infection, and the duration of these effects. Not all vaccines are equally effective, and deciding which vaccines are eligible for certification by a DVP system will have implications for the vaccine diplomacy efforts of the nations espousing them.
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| Public Policy & Societal Concerns |
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