Covid-19 Vaccination Cards Are the Only Proof of Shots, Soon an Essential
The U.S. lacks a central database for immunizations due to privacy concerns, leaving nonstandardized impermanent cards as the sole record of shots
Millions of adults vaccinated against Covid-19 have little to prove it beyond a paper card they received at inoculation sites.
The U.S. has no central database for immunizations. States maintain an incomplete patchwork of records. Nor is there standard proof of Covid-19 vaccinations like the yellow-fever cards that are required for travel to many countries where that disease remains prevalent.
With some countries and businesses preparing to make digital proof of vaccination a requirement for entry and travel, the paper cards may be the only ticket to access those platforms. Proof is already being requested on some first dates and at weddings.
“I’m glad we prioritized getting shots in arms,” said Ami Parekh, chief medical officer at digital healthcare company Grand Rounds Inc., which acts as a kind of medical concierge for patients. “But putting in rules about being vaccinated without giving people a way to properly track it is a little bit backwards.”
The cards themselves are a patchwork of formats. The Centers for Disease Control and Prevention has designed a version, which many locations use, but it isn’t required. State and local authorities and even individual sites are devising their own cards to hand out. With no official standard, it may be hard to say what constitutes proof.
Fake U.S. vaccination certificates are already selling for $200 a pop, according to Check Point Software Technologies, a Tel Aviv-based cybersecurity company that monitors less-accessible parts of the internet where everything from cyber weapons to drugs are sold. Users simply send their details and money, the company said, and the seller emails back fake documents.
“We’re setting ourselves up for a big problem down the road,” said Ekram Ahmed, a Check Point spokesman.
Andy Slavitt, President Biden’s senior adviser on Covid-19, acknowledged Monday that people would want documentation to show they had received the Covid-19 vaccine. But he deferred to the private sector on establishing credentials, citing concerns over privacy and security if the process was overseen by the federal government.
“There will be no centralized universal federal vaccinations database and no federal mandate requiring everyone to obtain a single vaccination credential,” White House spokeswoman Jen Psaki said Monday. “We’ll leverage our resources to ensure that all vaccination-credential systems meet key standards—whether that’s universal accessibility, affordability [or] availability, both digitally and on paper.”
Security experts are talking about everything from biomarkers to a single digital standard. But public-health researchers say a national database for storing vaccination records has been politically fraught in the U.S., with a ban in place since 1998 for any system that would create national identifiers for individual patients. The ban was spearheaded by then-Rep. Ron Paul (R., Texas), who said a national identifier system would be an unwarranted privacy intrusion.
A coalition of healthcare organizations tried to repeal the ban as recently as 2020, saying it needlessly added to costs in the healthcare system and that any widespread vaccination effort would hinge on accurate patient identification. The House removed the ban, but in November an effort in the Senate failed, leaving it in place.
States have their own vaccination databases that are maintained with varying accuracy. In November 2020, just over half of states reported having immunization registries in place that were comprehensive or reliable, according to the nonprofit Kaiser Family Foundation.
Carbon Health, a San Francisco-based health provider that operates clinics, has been distributing Covid-19 digital vaccination cards in California that can be stored in an Apple wallet and linked to a patient’s information in the state’s vaccination database.
Unlike countries with central patient registries that simplify tracking vaccination status, the U.S. has different databases and systems in different states that are largely incomplete, said Eren Bali, co-founder and chief executive of Carbon Health. Mr. Bali said when the company took over vaccinations in certain sites late January, they found no official record had been entered into the state database for 20% of patients.
“We had to chase tens of thousands of patients to understand what had happened; it took us a month to clean it up,” he said.
A coalition of insurance, technology and healthcare companies including Mayo Clinic, Cigna Corp. and Microsoft Corp. are pushing for a single, digital standard for individuals to access their vaccination records. They say that the many organizations already looking into the idea of digital cards are creating conflicting models.
In the absence of national or international standards, millions of Americans who have been vaccinated are coming up with ways to protect the piece of paper that could be their only vaccination record.
“They are making copies and laminating the copies,” said Lisa Yue, owner of Shipping & Beyond in Chicago’s Little Italy Neighborhood. She said she is recommending sheet protectors instead since they won’t permanently change the cards.
Rick Murray, the 64-year-old managing partner of SHIFT Communications, said when he took a flight to California this month, his first business trip since the pandemic began, he wasn’t sure if he would need his vaccine credentials. He decided to carry his vaccination card in his passport and take a photo of the card just in case.
“I know it’s incredibly important, but no one has asked for anything yet,” he said.
The cards may also be useful to employers seeking proof their workers are vaccinated to reduce the risk of on-the-job transmission and eventually, to relax some stringent and costly workplace-safety measures. Some companies are using other means to verify that their staff is vaccinated, like insurance claims.
At Krispy Kreme Doughnuts Inc., which is offering a free doughnut every day to anyone with proof of vaccination, the evidence varies. T.J. Pierson, general manager of a Krispy Kreme in Elk Grove Village, Ill., said the phone calls were nonstop, with many asking what they needed to bring to prove they had been vaccinated.
“I’ve had ones that are half sheets of paper. I’ve seen wallet-sized cards,” he said. “They’re all different.”
Sydney Robinson, 68, came in for his free doughnut for the second day in a row. He is folding his wallet around his CDC emblazoned card because it doesn’t fit in a credit-card slot but said the National Guardsman at his vaccination site also warned him to take a photo of it.