From UPSC perspective, the following things are important :
Prelims level : Immunity certificates/ passports
Mains level : Ethical/Health concerns involved in issuing immunity passports
There is a growing debate for a rethink on “immunity passport” to be handed out to those who have recovered from COVID-19 for the purpose of travel or work without restrictions of quarantine.
Try this question form mains:
Q.Discuss various ethical issues evolved during the outbreaks of pandemics (of the scale of COVID-19).
- They are the recovery or release certificate or a document attesting that its bearer is immune to a contagious disease.
- The concept has drawn much attention during the COVID-19 pandemic as a potential way to contain the pandemic and permit faster economic recovery.
- The can be used as a legal document granted by a testing authority following a serology test demonstrating that the bearer has antibodies making them immune to a disease.
What is the ongoing debate?
- Experts argue that if reinfections were a significant problem, by now, there would have been hundreds or at least thousands of cases of reinfections at the global level.
- Till such time effective vaccines become available people who have recovered from COVID-19 should be permitted to travel without restrictions.
A case for consideration
- Immune protection after infection/disease is always much more robust than most vaccines, and definitely than most COVID-19 vaccines in development.
- Some of the vaccines undergoing clinical trials are mostly directed at a single or a couple of proteins (spike) of the virus.
- But vaccines under trial that use the inactivated coronaviruses would expose the immune system to a whole range of viral proteins, much like natural infection and can produce immune responses.
- However, it is not known if people who have experienced asymptomatic infection would show robust immune responses like those who have recovered from moderate or severe disease.
Ethical issues involved
- Issuing ‘immunity certificates’ to people who have recovered can be an ethical minefield.
- Doctors do not generally prefer immunity to be induced by natural infection compared with vaccines. It seems logical, but there are multiple challenges.
- There might be long-term health complications in those who had COVID-19, whereas the vaccine will have minimal or no adverse health consequences.
- There is a danger that similar arguments will be made for other vaccine-preventable diseases for which we have a universal immunisation programme.
There is also a public health risk of issuing immunity certificates:
- People whose livelihood has have been affected would be encouraged to adopt risky behaviour so as to get infected rather than taking precautions to stay protected from the virus.
- This would lead to a sharp increase in cases across the country with huge numbers requiring hospitalization.
- Such a situation would lead to testing capabilities getting overwhelmed, crumbling of the health-care systems and increased deaths.
Threats over malpractices:
- Immunity certification will include a system for identification and monitoring, thus compromising privacy.
- Other contentious issues would be profiteering by private labs performing tests, and the menace of fake certificates which we have already seen in some Indian states.
- In the end, an immunity passport will further divide the society with different ‘haves’ and ‘have-nots’.
- We need to look at COVID-19 with a sense of balance and not hysteria.
- Terms such as immunity passports may not have relevance as we do not know anything about specific kinds of immune responses and the duration of protection in people.
- There is currently not enough evidence about the effectiveness of antibody-mediated immunity to guarantee the accuracy of an ‘immunity passport’ or ‘risk-free certificate’.
- The permission to travel or work should be decided on a case by case basis, according to the principles of ethics while dealing with a pandemic.