Sanitary pass: the lessons we must learn from it

The health pass came into effect in the middle of summer 2021. From August 9, we collectively had to present proof of a complete vaccination schedule or a negative SARS-CoV-2 test to access to places like bars, museums or hospitals (as a visitor, of course). In a comment published in the journal NatureMedicine, French researchers wonder: what effects have the announcement and implementation of the health pass had on:

• the rate of vaccination the population and certain sub-populations;
• feelings of hesitation and doubt about vaccination;
• overall public confidence in government.

Vaccination rates have increased…

In June 2021, 60% of the adult population was vaccinated or in the process of being vaccinated against Covid-19. After the announcement and implementation of the pass, the rate of people with a complete vaccination schedule increased from 49% to 89% in mid-December. The health pass therefore seems to have had a significant effect on the vaccination rate, even if it is not clear what effect it had on the intention to vaccinate.

1. Leaving the isolated and marginalized aside

However, the health pass did not have the expected effect on certain groups of the population such as the elderly (only 86% of people over 80 were fully vaccinated on October 12, 2021, even though this population is the one most at risk of dying from Covid-19) and people in very precarious and marginalized conditions. Indeed, the pass was necessary for activities to which these individuals do not generally have access.

2. By increasing the feeling of doubt towards vaccination

After the implementation of the pass, the share of the population with doubts about vaccination increased from 44 to 61%. France is historically a country with strong mistrust and distrust of vaccines with strong geographical disparities. This pandemic was undoubtedly an opportunity to build a relationship of trust with the population by clearly explaining the uncertainties and constraints that led the government to make this type of decision. A missed opportunity, according to the researchers.

3. By torpedoing public trust

When we are not clear and transparent concerning the uncertainties and the possible change of our decisions, a feeling of betrayal can be felt by part of the population. In their commentary, the researchers take the example of the announcements of the French government after the third confinement: “ the health pass will never concern restaurants or cinemas”. Two months later, that promise was broken. More recently, we can also take the example of the promise of the President of the Republic concerning the fact that the vaccination would never be mandatory. If it is still not, the announcement and the implementation of the vaccination pass certainly resonate as a form of obligation for a large part of the population.

Vaccination has become a political issue

With the presidential elections approaching, public health policy has become an electoral issue. Of certain far-right actors who propagate fake news about vaccination, right up to the President of the Republic who intends “fuck the unvaccinated”, the subject of vaccination is becoming more politicized than it could already be.

It therefore seems that we are assisting to the increasingly marked outbreak of a secession of the political space which draws epistemic and moral boundaries between the good, informed, vaccinated, and altruistic citizen and the bad, misinformed, unvaccinated, and selfish citizen. However, the reality is much more complex than these separations dichotomous and it is time for us to find other answers in order to preserve living together.