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California health officials have repeatedly stated that they have no plans to institute “passports” for the COVID-19 vaccine – digital or paper passes that allow vaccinated residents or those who have tested negative to participate in concerts, baseball games and other sporting arenas.

But this month, the state announced the reopening of rules for live indoor events that prompt companies to require such proof from ticket holders. Companies can organize larger events when they check one or the other of the safeguards.

“Of course, it’s a form of vaccine passport,” said Dr. John Swartzberg, an infectious disease expert at UC Berkeley.

The fact that California has not adopted the label is not surprising, he said.

“What happened to the vaccine passports is the same thing that happened with the masks,” Swartzberg said. “He has become politicized, and that’s a shame.”

As the pandemic continues, the vaccination requirements of employers, colleges and others in California are likely to increase, especially once vaccines can be readily obtained and get official approval from the federal government. Private companies and medical and educational institutions are already working on producing a pass, similar to an airline boarding pass, which could be used digitally or printed.

“The idea of ​​vaccine verification is very old,” said Dr. Christopher A. Longhurst, professor of pediatrics and chief information officer at UC San Diego Health.

Many countries require travelers to carry “yellow cards” verifying inoculation against yellow fever or other illnesses. Children in the United States have long had to be vaccinated to attend schools and camps.

“What’s new and different and what scares some people is the idea of ​​checking vaccines not for employment or school enrollment, but for day-to-day activities,” Longhurst said. . “You have to show it more frequently.”

UCLA constitutional law professor Eugene Volokh said a vaccine pass might have generated less opposition had it not been dubbed a passport, which is a government-issued document and “gives the impression that the government controls your movement”.

“Communicable diseases create a special imperative that allows things that people might be skeptical about,” said Volokh, one of many legal scholars who says these passes are constitutional. Still, he said, it was no surprise that verification systems might worry some.

“It’s just not an American thing to be told constantly, ‘Your papers, please’,” he said.

Longhurst and UC San Diego are working with a group called the Vaccination Credential Initiative, which is helping develop a system that aims to produce reliable and verifiable copies of COVID-19 vaccination records in digital or paper form.

The generalization of these passes will depend in part on public health and political tendencies. In places where most people are vaccinated and virus levels are low, that might not make sense, Longhurst said.

“It will really depend on the market,” he said. The US government “will not impose a vaccine passport. It’s very clear. But other governments will certainly need it, ”especially for international travel, he said. Israel already has a strong passport system for vaccines.

In the United States, he said, it will be at least another two to three months before a viable technical standard is developed for health passes.

Dr Robert Wachter, professor and chairman of the UC San Francisco department of medicine, said he anticipates that proof of vaccination may be required to travel or attend certain events.

“If you thought masks were a hot potato,” he says, “wait for this one.”

Wachter has been fully vaccinated but still does not dine indoors in a restaurant as vaccines are not foolproof. If a restaurant made sure all of its employees and customers were vaccinated, Wachter said, it would “absolutely” participate.

Swartzberg has said he will pay a premium to fly on an airline that requires travelers to show they are vaccinated against COVID-19.

“If I knew of a store that said people who come here need to be vaccinated, I would preferentially go to that store,” Swartzberg said.

The 2011 movie “Contagion” predictably showed vaccine passports, said Longhurst, who is also deputy medical director for quality and safety at UC San Diego Health. The film is about a deadly virus that is spreading around the world. Scenes show Americans must wear bracelets proving vaccination to enter stores.

In real life, the United States has conducted vaccine-verification campaigns to stem the smallpox epidemics. By the turn of the 20th century, proof of vaccination was required in some places to go to work and school, take the train and even go to the theater. Health officials have often demanded to see a vaccination scar rather than relying on certifications that could be forged.

Some cities have created anti-virus teams, going door-to-door to check people’s immunization status, said Michael Willrich, professor of history at Brandeis University. People who refused to be vaccinated resorted to exposing part of their skin to nitric acid. He created a scar the size of a nickel similar to the mark left by the vaccine.

In 1905, the Supreme Court upheld state laws that require vaccination against communicable diseases. In a 7-2 decision, Judge John Marshall Harlan wrote that “the rights of the individual[…]may at times, under the pressure of great dangers, be subject to such restraint, to be enforced by reasonable regulations, as the general safety the public may demand. ”

Lawyers say states have the flexibility to require vaccine passports or ban them in their jurisdictions, and political battles have already started. Conservative governors in Texas and Florida have banned them, saying vaccination cards are personal medical records that shouldn’t have to be revealed. Liberal New York has authorized an “Excelsior Pass” to prove vaccination or a negative test result for entry to Madison Square Garden, major weddings and live performances.

In California, assemblyman Kevin Kiley (R-Rocklin) drafted a bill to ban these passes “as a condition of receiving service or entering anywhere.” The legislation is unlikely to go far in the State Assembly and the Senate, both controlled by Democrats.

Dr Mark Ghaly, Secretary of State for Health and Human Services, said he did not consider California’s rules for reopening indoor sites to be a vaccine passport. A pass system should be carefully designed to protect privacy and ensure fairness, he said.

“We’re looking at whether that makes sense in the most risky places – large indoor, random-mix environments – where you might expect to have a vaccine or a test check,” Ghaly said in a commentary. interview.

The new state rules vary based on a county’s place in the state’s color-coded risk level. In the orange level, in which the spread of the virus is moderate, the capacity of indoor rooms will be capped at 15% or 200 people. But if the operator demands proof of vaccination or a negative test, the site can more than double its capacity to 35%.

Under the rules, theaters, music halls and other indoor venues will have to decide whether the limited capacity opening makes financial sense and whether they want to risk a backlash from customers who oppose the move. verification of vaccinations or tests. This may not be a problem in urban areas that support immunizations, but could pose dilemmas for businesses in “redder” areas of the state, where opposition to vaccine passports is high and relatively low. fewer people were vaccinated.

Several universities across the country are planning to require students to be vaccinated to return to campus in the fall. The University of California system, which last year required all students and staff to receive a flu shot, has yet to decide whether to impose a COVID-19 inoculation.

The California State University system won’t need vaccines, at least not until they get formal approval from the Food and Drug Administration, although some campuses may require athletes. and residents of the dorms to get vaccinated, spokesman Mike Uhlenkamp said.

San Francisco, which has handled the pandemic conservatively, allowed fans to attend Giants games this month after the team agreed to require people 12 and older to show proof of vaccination or a negative coronavirus test. About 7,300 fans attended the home opener at Oracle Park, nearly the 8,000 or so allowed by health officials.

Julie Elliott, 46, a teacher and avid Giants fan, praised the safety protocol. “It’s respectful of other fans and the players and their families,” she said.

Elliott has been vaccinated, but her 14-year-old daughter is not yet eligible and is expected to be tested to enter the site. “That wouldn’t stop me from taking him to a game,” Elliott said.

The Golden State Warriors, following San Francisco rules, will also require participants to show proof of a negative test or vaccine to enter their stadiums.

“We know that a big part of what makes San Francisco unique are the live performances and the events where people can come together for music, sports and cultural performances and diplomas,” said the Mayor of London Breed in a statement. “We are delighted with this milestone and what lies ahead, but we must all continue to do our part to put safety first.”

Times writer Luke Money contributed to this report.

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