California crossed a major threshold last week: For the first time, state officials moved to adopt a policy that that would give residents who are vaccinated access to different events and activities than those who aren’t.
New requirements for a “vaccine passport” — showing proof of vaccination to attend gatherings like weddings, conferences, concerts or theater shows — set California apart from states looking to ban such requirements and raise questions surrounding vaccine access and privilege in a region that has repeatedly failed to protect its most vulnerable populations.
Starting April 15, venues hosting concerts, theater or other events may welcome larger crowds if they require attendees to show proof either of a negative COVID-19 test or full vaccination, state health officials said Friday. Those who are vaccinated will also be allowed to sit in special sections without social distancing.
Although experts laud the decision as a reasonable way to lower the risk of transmission while the economy reopens, many worry that vaccine passports come at the expense of Californians who have already suffered most throughout the pandemic — and before the state can assure a steady stream of supplies to vaccinate them.
“It’s an automatic exclusion. You’re adding another nail in the coffin to the same population that has been denied the availability to vaccines, that is dealing with social determinants of health, that is dealing with unemployment,” said Dolores Alvarado, CEO of Community Health Partnership, which oversees clinics for underserved South Bay residents. “And now you’re going to add another layer to it that says, ‘You cannot be part of all these things we’re doing.'”
Elsewhere, the passports have sparked the same conservative backlash that consumed mask-wearing last spring. Florida’s Gov. Ron DeSantis, a Republican, banned requirements for vaccine documentation in businesses and government agencies outright Friday, saying they threaten “individual freedom” in his executive order. Pennsylvania senators are drawing up similar legislation.
But Bay Area experts are less concerned with political debate and more with how the rules could leave behind those for whom getting vaccinated remains rife with structural, technological or financial barriers.
California’s Latinx community makes up nearly 40% of the population and 50% of COVID-19 infections, but just 19% of vaccinations received so far, according to the California Department of Public Health. Meanwhile, residents in the top quartile of the California Healthy Places Index — which rates census tracts based on factors like income and health care access — make up about 30% of those who have received at least one dose, while those in the bottom quartile make up just 20%.
Requiring vaccinations at large gatherings ameliorates the chance that those events could cause a “super-spreader” surge of COVID-19 infections, said Dr. Kirsten Bibbins-Domingo, an epidemiologist with UC San Francisco. But she’s wrestling with the fact that the new rules arrived before Latinx and Black communities have been widely vaccinated.
Another red flag for community health advocates is the idea of a digital passport on one’s phone or device, as State Health Officer Dr. Tomás J. Aragón hinted could become the norm in a call with reporters Friday. Throughout the pandemic, reliance on online platforms has made it more difficult for many to sign up for first coronavirus tests and now vaccines.
“Showing proof of vaccination is very likely to be a tool we need to use to safely reopen parts of our economy,” Bibbins-Domingo said. “It’s not an inherently inequitable idea. What is inequitable is doing it at a time when we have eligible people who cannot get vaccines right now, and we have deep inequities in those who have been deeply affected by the disease.”
Santa Clara County Executive Jeff Smith, meanwhile, believes that vaccine passports are a “false reassurance” given the widespread detection of different COVID-19 variants across the state — but that the county is hamstrung when it comes to enacting tighter restrictions without regional support. Ideally, he added, the state would wait until hard-hit communities reached a certain vaccination threshold before moving ahead with the scheme.
Aragón promised that officials are closely watching how well vaccines protect against variants and that supplies are expected to open up significantly in late April. And despite a manufacturing disruption, California is expecting 572,700 doses of the Johnson & Johnson vaccine this week, 215,400 the following week, and another 215,400 the week after that.
“We anticipate that the majority of people will be able to do this, and the barriers will be removed,” he told reporters Friday. CDPH declined to respond further Saturday.
For some anxious residents, vaccine passports seem like a useful way to at least reduce some risk. Waiting outside the Aloha Skate Rink mass vaccination site in East San Jose on Saturday, Milpitas resident Minh Nguyen said he supported the idea but that it’s not carte blanche to cast off other precautions.
“Absolutely, show that card,” Nguyen said. “But I still suggest people wear their mask, just to be extra careful.”
Hardware engineer Nima Ardestani, who had just been vaccinated, said he’s in no rush to go back to concerts or travel — but that he might consider paying a little extra for a vaccinated patrons-only section at a concert or airplane.
“It would be nice, but I don’t know if it’s entirely necessary,” Ardestani said. “I can take a 5 percent risk.”
The extent to which the passports could permeate Californians’ day-to-day life — whether through restaurant reservations, priority for certain shoppers or recreational sports — remains an open discussion among experts. Aragón said that documentation will not be required for essential services.
While showing proof of inoculation makes sense for bigger, riskier gatherings, it’s unlikely that they will be needed for most everyday activities — in part because there is no real mechanism for enforcement, Bibbins-Domingo surmised.
“It’s hard to imagine we’re going to live in a state where everything we do requires showing this,” she said, “but that remains to be seen.”
