Vaccine passports.

Califorinia is moving towards vaccine passports. In Hawaii it was a mess

Eric Ting

California Gov. Gavin Newsom has refused to call the state's digital COVID-19 vaccination verification system a "vaccine passport," but as more and more businesses across the state require customers to show proof of vaccination for entry, several health experts believe the state is headed for a "soft" vaccine passport system.

"I do think that's where the wind seems to be blowing," said Dr. George Rutherford, an epidemiologist at UCSF. "I don’t see the state or federal government stepping into it. It'll largely be a private sector solution that's encouraged by government but not required. It'll be like, 'no shoes, no shirt, no service.'"

Even if the state does not mandate that businesses ask customers to show digital vaccine cards, simply providing the digital infrastructure and gently nudging businesses in that direction — which it is already doing for employee vaccination — could create a de facto system of vaccine passports. The state's digital IDs are not as easily forged as the Center for Disease Control and Prevention's physical vaccination cards and could become the preferred method of verifying vaccine status in the state.

Vaccine passports are controversial. Some Republican-led states have banned localities from implementing a vaccine passport system, and even in heavily Democratic California, where 61% of the population is fully vaccinated, Newsom is careful to avoid using the phrase.

The one state where a version of "vaccine passports" has been implemented on a relatively wide scale is Hawaii, a major tourism hub that sees millions of visitors per year from the mainland. It did not go well.

In early July, Hawaii launched its "Safe Travels Program," which allows incoming travelers to skip a quarantine period or get a negative test in favor of showing proof of vaccination. According to local TV reports, the program's first day at Daniel K. Inouye International Airport was a mess.

Under the program, travelers were required to submit images of their vaccination cards to the Safe Travels website ahead of time. Once travelers arrived at the airport, the wait time for screening lines was reported to last more than an hour, and finger-pointing ensued.

"They said about 90% of the cards that were submitted through Safe Travels had not been reviewed by Hawaii yet,” a traveler told KHON2.

Meanwhile, the state said that 70% of travelers did not follow instructions properly when uploading their cards. Originally, Hawaii only allowed images of the official CDC cards to be uploaded but later allowed vaccination records from any health care provider or hospital.

"Uploading the vaccine card is not easy. And unless you're tech savvy, regardless, seniors are having a hard time uploading the carry card, or the phone features don't have that feature to upload the card or vaccine card," Bob Burr, the operations manager for the agency behind the Safe Travels, told KITV4. 

California has no imminent plans to implement vaccine passports for travel, but Hawaii's challenges with the Safe Travels system raise some questions about California's digital system. Once Californians submit information associated with their vaccine record (name, date of birth, cellphone number, email), they are supposed to receive their digital card complete with a QR code.

The operative phrase there is "supposed to."

Tens of thousands of Californians are reporting delays in receiving their QR codes, and a recent report from the San Francisco Chronicle details some of the behind-the-scenes issues with the system (SFGATE and the San Francisco Chronicle are both owned by Hearst but operate independently of one another).

According to the Chronicle, many of the records from vaccine sites are incomplete, typo-filled or otherwise inaccurate, and the state has a team of 80 people working on troubleshooting and correcting records. There is no timeline for when there will be minimal delays.

Only 1.4 million people have successfully gotten their digital records, which makes up about 3.5% of California's population. If restaurants, bars, sports venues and other businesses considering vaccine passports opt to use the state's digital system, it seems highly unlikely the state will be able to quickly and efficiently process the influx of vaccinated individuals seeking their digital cards, thus creating another Hawaii airport situation.

The other major lesson for California relates to how unvaccinated individuals may react to businesses requiring proof of vaccination for entry.

Oahu bars and restaurants operating at full capacity were ordered to ask customers to show proof of vaccination or a negative COVID-19 test result within the prior 48 hours for entry, and Hawaii News Now reported that establishments were subsequently "eaten alive" by customers unhappy with the policy.

"It would be hard to manage and I didn’t want to put my staff in a position where a situation would arise," said a restaurant owner who is not complying with the order.

Reports of unruly restaurant patrons are on the rise in California, and the Hawaii Restaurant Association said it cannot name a single eatery still abiding by the order after widespread backlash.

From a practical standpoint, it seems unlikely businesses can rely on the state's slow digital system as the primary mode of vaccination verification. In its place, businesses will have to use physical vaccination cards, which are easily forged or lost. However, with physical cards, the issues of compliance and putting employees in a situation where they can be confronted and harassed by customers still linger.

The one development that could possibly make California's vaccine passport foray different from Hawaii's is full FDA approval of the COVID-19 vaccines, which would theoretically remove remaining excuses for not being vaccinated. Rutherford expects full approval sometime in the fall.

"Once it's not only an emergency use approval, certain people who have been hesitant can then move forward, and the vaccine is more easily mandated," Rutherford said. "The reason places like the United States military haven’t mandated the vaccine is because it's not fully approved. Once it is, people can start pushing buttons and making it happen."