Covid-19 status certification - UK Parliament
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By Bukky Balogun,
Daniel Ferguson,
Roger Tyers
Covid-19 status certification
28 July 2021
Summary
1 What is Covid-19 status certification?
2 Policy background
3 The NHS Covid Pass
4 Scientific evidence
5 Business and vaccine policies
6 Considerations for implementation and use
7 International Travel
commonslibrary.parliament.ukNumber CBP 9288 Covid-19 status certification
Image credit
Attribution: texting image 1490691 image by Dean Moriarty – terimakasih0
from Pixabay. / image cropped. Free for commercial use. No attribution
required. Wednesday 28 July 2021.
Contributing authors
Georgina Hutton, Industry response;
Joanna Dawson, Data protection and privacy
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2 Commons Library Research Briefing, 28 July 2021Covid-19 status certification Contents Summary 6 1 What is Covid-19 status certification? 9 2 Policy background 11 2.1 Government review on certification 12 2.2 Public Administration and Constitutional Affairs Committee inquiry 15 2.3 Government report on certification 17 2.4 Certification requirements for nightclubs and large capacity venues 18 2.5 Exemptions 19 2.6 Response to proposals 20 3 The NHS Covid Pass 24 3.1 Using the NHS Covid Pass in England 24 3.2 Obtaining an NHS Covid Pass in England 25 3.3 Obtaining proof of Covid-19 status for clinical trial participants 26 3.4 Obtaining proof of Covid-19 status in devolved nations 27 4 Scientific evidence 28 4.1 Immunity 29 4.2 Vaccine effectiveness 32 4.3 Accuracy and availability of Covid-19 testing 37 4.4 Variants of concern 39 5 Business and vaccine policies 41 5.1 Overview of the legal framework 41 5.2 Employment law 43 5.3 Equality law 45 5.4 Data and privacy concerns 47 5.5 Human rights law 49 6 Considerations for implementation and use 52 3 Commons Library Research Briefing, 28 July 2021
Covid-19 status certification 6.1 Standards for a certification system 52 6.2 Impact on other Covid-19 measures 53 6.3 Threshold for introduction and removal 55 6.4 Cost 57 6.5 Forms of certification and accessibility 58 7 International Travel 59 7.1 Current rules for inbound travel 59 7.2 Outbound Travel 62 4 Commons Library Research Briefing, 28 July 2021
Covid-19 status certification 5 Commons Library Research Briefing, 28 July 2021
Covid-19 status certification
Summary
Covid-19 status certification involves the use of testing, infection or
vaccination information to demonstrate, in different settings, that a person
has a lower risk of transmitting the Covid-19 virus to others. 1
Certification would evidence that a person has acquired some degree of
immunity to the Covid-19 virus through prior infection or vaccination.
Certification could also be provided when a person uses a recent negative
test result to show that they do not have active infection.
This paper discusses a range of issues relating to the implementation and use
of certification in England.
Domestic use
In its Spring 2021 roadmap, the Government committed to reviewing “whether
Covid-status certification could play a role in reopening our economy,
reducing restrictions on social contact and improving safety”.
As part of the review, led by the Cabinet Office, the Government considered
evidence from academics, industry representatives and civil liberties groups.
In July 2021 the Government published the Covid-status certification review
report. This set out that the Government would not mandate the domestic
use of certification as a condition of entry for visitors to any setting at the
present time. However, the report raised the possibility of “keeping events
going and businesses open if the country is facing a difficult situation in
autumn or winter”. The report said that the Government would keep “the
wider application of certification under consideration”.
The Government said that it would make the NHS Covid Pass available as a
means for individuals to demonstrate their Covid status, and for
organisations from Step 4 of England’s Covid-19 roadmap.
On the 19 July 2021 England entered Step 4 of the Covid-19 roadmap, at which
point the majority of Covid-19 restrictions ended. Speaking at a press
conference on the same day, Prime Minister Boris Johnson expressed concern
about the continuing risk of transmission and announced that from
September, full vaccination would be a condition of entry to nightclubs and
other large capacity venues. 2
1
Cabinet Office, Covid-19 Response- Spring 2021 (Roadmap), 22 Feb 2021
2
BBC News, Covid: Two jabs needed to enter nightclubs from September, 20 Jul 2021
6 Commons Library Research Briefing, 28 July 2021Covid-19 status certification As with other aspects of Covid-19, the scientific evidence with regard to certification is far from complete. Uncertainty remains about the extent and duration of immunity provided by natural infection or vaccination, and the extent to which these reduce the rate of transmission. It therefore remains unclear whether certification, as presently proposed, would be a reliable and consistent indicator of a person’s Covid-19 status or (in)ability to transmit the Covid-19 virus to others. Additionally, uncertainty remains about whether the proposed methods of certification can be delivered from an operational perspective. These issues been considered in reports published by scientific institutions, such as the Ada Lovelace Institute and the Royal Society. Similarly, the Public Administration and Constitutional Affairs Committee has set out its own standards for a certification system in a June 2021 report. The response to the proposed introduction of certification requirements for domestic purposes has been varied. The Royal College of General Practitioners has said that it has no objection in principle to the use of certification but stressed the importance of detail on implementation. Some music and events industry stakeholders have supported the introduction of a temporary industry-wide certification scheme as a route to lifting capacity restrictions on venues. Civil liberties groups have raised concerns about what they consider to be unwarranted infringement of people’s privacy, whilst equality campaigners have highlighted the potential for discrimination against those unable, or unwilling, to provide certification. Business and industry stakeholders, particularly in the hospitality sector, have raised concerns about the need for a Covid-19 certification scheme and the costs and practicalities involved in implementing such a scheme. Employment and equality At present, there is no legal obligation for a business to require its staff or customers to show an NHS Covid Pass before entering their premises. The guidance on working safely during Covid-19 only recommends the use of the Pass for nightclubs and other large crowded settings where people will be in close proximity. The Government has indicated that it might legislate to make this a legal requirement towards the end of September 2021. Businesses may decide to require staff or customers to show their vaccination status using the NHS Covid Pass. If they decide to do so, businesses will need to ensure they are complying with employment and equality legislation. If an employer dismisses an employee who is not or cannot be vaccinated, it could face a claim for unfair dismissal or unlawful discrimination. The Government has legislated to make vaccination a condition for working in a care home, with limited exceptions for people under the age of 18 and those 7 Commons Library Research Briefing, 28 July 2021
Covid-19 status certification who cannot be vaccinated for clinical reasons. These rules come into effect on 11 November 2021. Travel The NHS Covid Pass can be used during outbound and inbound travel. A number of countries exempt fully vaccinated travellers from a requirement to quarantine on arrival. Some of these countries accept the NHS Covid Pass as evidence that a person is fully vaccinated. From 19 July 2021, people arriving in the UK from amber list countries (except France) are no longer required to quarantine or test on Day 8 if they are fully vaccinated in the UK. The guidance on entering England says people can use the NHS Covid Pass to show their vaccination status. 8 Commons Library Research Briefing, 28 July 2021
Covid-19 status certification
1 What is Covid-19 status certification?
In simple terms, Covid-19 status certification is a means through which an
individual can demonstrate that they are lower risk of transmitting the Covid-
19 virus to others.
Covid-19 terminology: the virus and the disease
Covid-19 disease is an infectious disease caused by the Covid-19 virus. The
symptoms of Covid-19 disease include a high temperature, a continuous cough
and a loss or change to sense of smell or taste.
The scientific name of the virus that causes Covid-19 disease is severe acute
respiratory syndrome coronavirus 2, abbreviated to SARS-CoV-2.
SARS-CoV-2 is one type of coronavirus- a specific family of viruses with similar
features.
The Royal Society captured this succinctly by recommending that a
certification scheme be able to confirm that:
• A person is not infectious or,
• A person is immune to Covid-19 illness and will not become infectious 3
In practical terms, certification would evidence at least one of the following:
• A person has acquired immunity through a full course of a Covid-19
vaccine
• A person has acquired natural immunity through infection
• A person has recently produced a negative test result
Certification through the NHS Covid Pass will be enabled by:
a. Full vaccination: 14 days after completing a full course of
vaccination, whether that requires two doses or one dose (according
to the MHRA authorised schedule);
3
The Royal Society, Twelve criteria for the development and use of Covid-19 vaccine passports, 14 Feb
2021
9 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
b. Testing: evidence of a negative polymerase chain reaction (PCR)
or lateral flow test taken with 48 hours of entry to a venue, with both
on-site (where available) and at-home tests being accepted; and
c. Natural immunity: proof of a positive PCR, lasting for 180 days
from the date of the positive test and following completion of the
self-isolation period. 4
Certification has been described using other terms, such as “immunity
passport”.
Another term, “vaccine passport”, which evidences that a person has
received a full course of a Covid-19 vaccination, should be considered
separately as it does not make use of testing data or naturally acquired
immunity in characterising a person’s status.
4
Cabinet Office, Covid-Status Certification Review: Report, Jul 2021
10 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
2 Policy background
The Government’s position on the potential use of certification has developed
across the course of the pandemic.
In January 2021, the Minister for Covid-19 vaccine deployment, Nadhim
Zahawi, said that the Government had ‘no plans to introduce Covid-19 vaccine
passports’. 5 Mr Zahawi indicated that vaccine record cards would be issued
to patients with details of vaccination on receipt of a Covid-19 vaccine, as
with other vaccination programmes. Mr Zahawi said that this would “not
constitute an immunity passport and [would] not be used as a form of
identification”.
In the February 2021 Covid-19 roadmap, the Government said that it would
review the role that certification might play in reopening the economy,
reducing restrictions on social contact and improving safety. 6
In an April 2021 update to the review, the Government indicated that
certification might be introduced for domestic use and to facilitate
international travel. 7
Providing evidence to the Public Administration and Constitutional Affairs
Committee (PACAC) in May 2021, the Minister for the Cabinet Office, Michael
Gove set out the potential value that certification might have in terms of risk
reduction:
Certification can be a tool that means we reduce the risk of
transmission and make venues and activities safer, but both
Professor Wolff and David Davis are right to stress that there is a
balance here. You can never make any venue or activity completely
safe and quite rightly, as has been pointed out, even two doses of
vaccination does not automatically inoculate someone completely
against the risk of infection, transmission or indeed ill health. What it
does do is dramatically reduce the risk. If one can have confidence
that people in a venue have been vaccinated, or have immunity in
another way or have recently received a valid test that confirms their
negative status, you know that that venue will be safer. Set against
that of course must be the question about the cost and the hassle
factor that certification will involve. There always must be a balance
5
PQ 133629, 25 Jan 2021
6
Cabinet Office, Covid-19 Response- Spring 2021 (Roadmap), 22 Feb 2021
7
Cabinet Office, Roadmap Reviews: Update, 5 Apr 2021
11 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
between the two and, in that sense, I think both previous witnesses
were right to stress that. 8
In July 2021, the Government published a report of its findings from the review
on certification, announcing that it would not mandate the use of certification
in domestic settings at the present time, but did raise the possibility of it
providing a means of “keeping events going and businesses open if the
country is facing a difficult situation in autumn or winter”. 9
On the 19 July 2021 England entered Step 4 of the Covid-19 roadmap, at which
point the majority of Covid-19 restrictions ended. Speaking at a press
conference on the same day, Prime Minister Boris Johnson expressed concern
about the continuing risk of transmission and announced that from
September, full vaccination would be a condition of entry to nightclubs and
other large capacity venues. 10
The proposed introduction and use of domestic certification has been highly
controversial. Some have supported the proposals for its potential benefit in
enabling a wider reopening of the economy and supporting the public health
response to Covid-19. Others have considered it to be an infringement on
personal liberty. Business and industry leaders have also expressed concern
about logistical and financial barriers to use whilst equalities groups have
highlighted the potential for discrimination against those who are unable or
unwilling to make use of certification.
2.1 Government review on certification
In February 2021, the Government published the Spring 2021 roadmap (the
roadmap) in which it set out plans to lift Covid-19 restrictions. 11 Within this,
the Government committed to reviewing the potential role of certification:
The Government will review whether COVID-status certification could
play a role in reopening our economy, reducing restrictions on social
contact and improving safety. This will include assessing to what
extent certification would be effective in reducing risk, and the
potential uses to enable access to settings or a relaxation of COVID-
Secure mitigations. 12
Acknowledging the potential wider implications of Covid status certification,
the Government said that it would:
8
Public Administration and Constitutional Affairs Committee, Oral evidence: Covid 19 vaccine
certification, 27 May 2021, HC 42- II, 2021-22, para 72
9
Cabinet Office, Covid-Status Certification Review: Report, Jul 2021
10
BBC News, Covid: Two jabs needed to enter nightclubs from September, 20 Jul 2021
11
Cabinet Office, Covid-19 Response- Spring 2021 (Roadmap), 22 Feb 2021
12
Cabinet Office, Covid-19 Response- Spring 2021 (Roadmap), 22 Feb 2021
12 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
… also consider the ethical, equalities, privacy, legal and
operational aspects of this approach and what limits, if any, should
be placed on organisations using certification. It will draw on
external advice to develop recommendations that take into account
any social and economic impacts, and implications for
disproportionately impacted groups and individuals’ privacy and
security. 13
The review’s Terms of Reference set out its scope:
• Whether there is a case for introducing COVID-status certification,
including:
– the extent to which certification would be effective in
reducing risk, including evidence on the likely clinical and
behavioural impacts in different settings taking
consideration of emerging evidence on vaccine efficacy,
effectiveness, and effect on transmission;
– the extent to which certification would be effective in
reopening parts of the economy and society more quickly
and more safely than otherwise;
– the ethical, equalities, privacy, legal and operational
aspects of COVID-status certification;
– the implications of certification for those unable or
unwilling to get vaccinated or tested, including the
equalities implications; and
– the impacts of certification on those groups
disproportionately affected by the pandemic.
• The mechanics of how COVID-status certification would work,
including:
– how COVID status would be conferred, including through
vaccination and the use of different testing technologies;
– the mechanisms through which COVID-status could be
demonstrated, including technological and non-
technological options.
– what limits, if any, should be placed on which
organisations could use certification for which purposes;
and
– for how long the use of COVID-status certification may be
relevant. 14
13
Cabinet Office, Covid-19 Response- Spring 2021 (Roadmap), 22 Feb 2021
14
Cabinet Office, Terms of Reference: COVID-status Certification Review, last updated 5 Apr 2021
13 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
As part of the review, the Government held a consultation between 15 and 29
March 2021 and invited stakeholders to submit evidence. Over 50,000
responses were submitted. 15
On 5 April 2021, the Government published an update to the review and said
that “Covid-status certification could have an important role to play both
domestically and internationally, as a temporary measure”. 16 The
Government set out the rights of establishments to request proof of Covid
status:
Likewise, in the UK, businesses and other organisations are able to
ask customers for proof of COVID-status in order to access their
premises, as long as they are compliant with equalities legislation.
The Government believes that introducing a ban on this would in
most cases be an unjustified intrusion on how businesses choose to
make their premises safe - although, as set out below, there may be
exceptions where the Government needs to intervene to ensure
equitable access to essential services. It is therefore right that the
Government provides a means of easily demonstrating COVID-status,
in order to ensure UK citizens and residents are not denied
opportunities to travel or attend certain venues or events. 17
The Government identified certification as potentially having a role in settings
such as theatres, nightclubs and mass events to help manage risks where
large number of people are brought together in close proximity. 18 In addition,
it clarified that it had identified certain settings, “such as essential public
services, public transport and essential shops” where, it said, Covid-status
certification “should never be required” so as to ensure universal access. 19
The Government also indicated that certification was likely to play a role in
international travel during the pandemic:
Even without Government intervention, COVID-status certification is
likely to become a feature of our lives until the threat from the
pandemic recedes. Other countries are already developing their own
certification systems, such as the “Green Pass” in Israel and the
“digital green certificate” in the European Union. Negative tests are
already required to enter the UK and many other countries and, as
vaccination programmes roll out worldwide, countries have made
clear they will soon require proof of vaccination in order to cross the
border. 20
15
Cabinet Office, Roadmap Reviews: Update, 6 Jul 2021
16
Cabinet Office, Roadmap Reviews: Update, 5 Apr 2021
17
Cabinet Office, Roadmap Reviews: Update, 5 Apr 2021
18
Cabinet Office, Roadmap Reviews: Update, 5 Apr 2021
19
Cabinet Office, Roadmap Reviews: Update, 5 Apr 2021
20
Cabinet Office, Roadmap Reviews: Update, 5 Apr 2021
14 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
The Government said that it would begin to trial certification in certain
settings, including large events, through the Events Research Programme.
2.2 Public Administration and Constitutional
Affairs Committee inquiry
Following the announcement of the Government’s review on certification, the
Public Administration and Constitutional Affairs Committee (PACAC) launched
an inquiry to “consider potential ethical, legal and operational issues and the
efficacy and appropriateness of a certificate system”. 21 The inquiry primarily
focused on the domestic use of certification.
In a May 2021 oral evidence session, the Committee took evidence from:
• Michael Gove, the Minister for the Cabinet Office
• Kathy Hall, Director General, Delivery, Covid-19 Task Force, Cabinet
Office, and
• Dr Sue Hopkins, Epidemiological Consultant at Public Health England
The Committee asked a wide range of questions about scientific evidence
underpinning the Government’s proposals and the policy implications on the
public, organisations and businesses.
Other witnesses providing oral evidence to the Committee include academics,
industry representatives for sports, hospitality and events and civil liberties
group Big Brother Watch.
Public Administration and Constitutional Affairs
Committee report
PACAC published its report on Covid status certification on 12 June 2021. 22
The Committee set out it’s serious concerns about the extent of consideration
the Government had given to the potential gains and limitations of a
certification scheme:
Given the significance and seriousness of introducing such a Covid-
status certification system, the Committee was surprised at the lack
of consideration by the Government of a number of issues and
concerns with their suggested approach, in particular the scientific
case for that system. It is imperative that if the Government seeks to
bring forward any proposals for a Covid-status certification system,
21
Public Administration and Constitutional Affairs Committee, Covid 19 Vaccine Certification, accessed
16 Jul 2021
22
Public Administration and Constitutional Affairs Committee, Covid 19 Vaccine Certification, 12 Jun
2021, HC 42-II 2021-22
15 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
the criteria against which the efficacy of that system has been
assessed, together with a cost-benefit analysis of the system, and
full financial costings, are published in advance of those proposals.
We would also expect detailed modelling of the potential impacts of
the introduction or non-introduction of such a system in the context
of the different scenarios for unlocking to be published alongside any
such announcement. The Committee was struck by the fact that the
best assessment the Minister could make in favour of certificates was
to say that it was a “finely balanced judgement”. 23
PACAC were highly critical of the Government’s account of what extent of
consideration had been given to proposals to introduce certification:
It is clear that the idea of certificates has been under consideration
within government for at least six months. Ministers and officials
have given conflicting statements on the possibility of certification
being introduced as a measure, and on the extent to which proposals
were actively under review. At times, these statements have been
directly contradictory. At the very least, this demonstrates a lack of
coordination and effective interworking between different
departments and teams in the Government’s response to Covid. On
at least two occasions, a Minister has said that certificates were
actively being considered, only for the suggestion to be immediately
denied by another Minister. Given that the review into the potential
use of Covid-status certification was subsequently launched, this
indicates either that several senior members of the Government were
unaware of the Government’s policy direction in this area, or there
was an effort to downplay to the public the seriousness with which
the introduction of a Covid-status certification system was being
considered. Either way, the Government’s approach to certification
has risked damaging trust in government and in the measures put in
place to tackle the pandemic. 24
The Committee considered that the Government had not provided sufficient
information in a number of key areas:
Given the large number of areas where the Government was unable
to provide the Committee with information and answers in regards
to: criteria against which the efficacy of that system is to be
assessed; the cost-benefit analysis proposals; modelling of different
scenarios with and without a certificate system, combined with the
Minister’s own assessment that the case of a Covid-status certificate
system is “finely balanced”, the Committee does not think the
23
Public Administration and Constitutional Affairs Committee, Covid 19 Vaccine Certification, 12 Jun
2021, HC 42-II 2021-22, summary
24
Public Administration and Constitutional Affairs Committee, Covid 19 Vaccine Certification, 12 Jun
2021, HC 42-II 2021-22, para 7
16 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
Government has made a case for any form of domestic Covid-status
certification system. 25
The Committee concluded:
Overall, we found that the Government has not established a clear
scientific case, nor a good overriding public interest case for the
introduction of a Covid-status certification system. There remain a
large number of uncertainties about the rationale for an operation of
such a system, as well as serious ethical concerns in regards to
discrimination and infringement of individual rights and significant
data protection concerns. When we consider that the Government’s
own assessment that the case for introduction is “finely balanced”, it
is our clear recommendation that the Government abandon the idea
of using a Covid-status certification system domestically. 26
Prior to the introduction of a certification system, PACAC recommended that
the Government:
• Publish the criteria against which the efficacy of that system is to be
assessed, with a statement and explanation of whether or not the
Government believes that the system is able to satisfy those criteria
• Carry out and publish a cost-benefit analysis including financial, social
and societal costs and benefits
• Publish detailed modelling, or if this has not been carried out, explain
why they have opted not to use modelling and what account they have
taken of different scenarios 27
2.3 Government report on certification
On 6 July 2021, the Cabinet Office published the Covid-Status Certification
Review report, where the Government announced that it would not introduce
certification as a condition of entry on a mandatory basis:
Having considered a wide range of evidence as part of the review,
the Government has concluded that it will not mandate the use of
25
Public Administration and Constitutional Affairs Committee, Covid 19 Vaccine Certification, 12 Jun
2021, HC 42-II 2021-22, para 28
26
Public Administration and Constitutional Affairs Committee, Covid 19 Vaccine Certification, 12 Jun
2021, HC 42-II 2021-22, summary
27
Public Administration and Constitutional Affairs Committee, Covid 19 Vaccine Certification, 12 Jun
2021, HC 42-II 2021-22, paras 24 & 25
17 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
COVID-status certification as a condition of entry for visitors to any
setting at the present time. 28
The report acknowledged a public health benefit but judged that “the burden-
particularly on those who have not yet been offered a full course of
vaccination and would therefore require repeated testing, and possibly on
organisations – would be disproportionate to the public health benefit at this
stage of the pandemic”.
Notably, the Government said that organisations could choose whether or not
to make use of certification:
The Government believes that to ban certification in domestic
settings would, in most cases, be an unjustified intrusion on how
organisations choose to make their premises safe. Essential settings
should not use certification, but others can decide to use it at their
own discretion in compliance with legal obligations.
Additionally, the Government did not rule out the use of certification at a later
point:
The review recognises the concerns expressed over certification.
However, it is possible that certification could provide a means of
keeping events going and businesses open if the country is facing a
difficult situation in autumn or winter. Therefore, the Government will
keep the wider application of certification under consideration. The
Events Research Programme is trialling the use of certification in
large events, and the Government will continue to assess the findings
from the programme.
2.4 Certification requirements for nightclubs and
large capacity venues
On the 19 July 2021 England entered Step 4 of the Covid-19 roadmap, at which
point the majority of Covid-19 restrictions ended. Speaking at a press
conference on the same day, Prime Minister Boris Johnson expressed concern
about the continuing risk of transmission and announced that from
September, full vaccination would be a condition of entry to nightclubs and
other large capacity venues. 29 Mr Johnson set out plans to restrict entry to
certain venues to those who have had a full course of vaccination from
September:
I should serve notice now that by the end of September, when all
over-18s will have had their chance to be double-jabbed, we are
28
Cabinet Office, Covid-Status Certification Review: Report, 6 Jul 2021
29
BBC News, Covid: Two jabs needed to enter nightclubs from September, 20 Jul 2021
18 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
planning to make full vaccination the condition of entry to nightclubs
and other venues where large crowds gather. 30
It has also been reported that the Government is considering other settings
where vaccination may become be a requirement of entry. 31
2.5 Exemptions
In the July review report on certification, the Government set out
arrangements for exemptions from certification requirements:
There are a small number of exemptions, where if individuals meet
one of the following criteria, they will be able to demonstrate their
exempt status:
a. Those who have received a trial vaccine, including those
who are blinded 32 or may have a placebo, as part of a
formally-approved COVID-19 vaccine trial in the UK; and
b. Exceptional circumstances for individuals where a clinician
recommends vaccine deferral or that vaccination is not
appropriate and where testing is also not recommended on
clinical grounds. 33
The Government also set out exemptions for children and young people under
the age of 18:
Given that vaccination is not recommended for those below 18, the
Government recommends that children under 18 are exempt from
having to demonstrate their COVID status. The Government believes
that repeat testing of this group would be disproportionate for the
purposes of gaining COVID status to visit settings. 34
30
The Guardian, No 10 refuses to rule out Covid passports for entry into pubs, 20 Jul 2021
31
The Guardian, No 10 refuses to rule out Covid passports for entry into pubs, 20 Jul 2021
32
In clinical trials, “blinding” refers to an arrangement in which trial participants are unaware of which
treatment group they have been assigned to. This is done to prevent participants from being
influenced by that knowledge in a way that might compromise the validity of the findings. For further
explanation see: Cancer Research UK, Randomised trials, accessed 27 Jul 2021
33
Cabinet Office, Covid-Status Certification Review: Report, 6 Jul 2021
34
Cabinet Office, Covid-Status Certification Review: Report, 6 Jul 2021
19 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
2.6 Response to proposals
Opposition view
Leader of the Opposition, Sir Keir Starmer is reported to have said that he
would scrutinise government proposals on certification before deciding
whether to oppose them. 35 Sir Keir also said that the use of domestic
certification for everyday social activities would be “against the British
instinct”. Speaking about their use in pubs, Sir Keir advised the Government
not to leave the decision to pub landlords.
Shadow Health Secretary Jonathan Ashworth indicated that he would support
the use of certification for larger events but not for uses such as everyday
retail. 36
Professional bodies and academics
The Royal College of General Practitioners set out that it had no objection in
principle to the use of certification but stressed the importance of detail on
implementation. 37 The College recommended that certification be used
primarily for international travel purposes and not for domestic use, due to
the “risk of unintended consequences in terms of the diversion of healthcare
resources from patient care and in terms of equalities”. The College also
highlighted workload pressures on general practice and said that the use of a
certification system should have no impact on GP workload.
Referring to the association of antibody presence with negative PCR test
results, some academics consider that there is now a scientific premise for
certification. 38 Other academics have expressed caution, calling for detailed
understanding about the protection offered by Covid-19 vaccines before
knowing if certification is viable. 39 Some have also considered the
behavioural implications, suggesting that telling a person that they may be
‘immune’ to infection may reduce adherence to precautionary measures such
as social distancing. 40
35
The Telegraph, Exclusive: Covid vaccine passports would be un-British, says Sir Keir Starmer, 31 Mar
2021
36
The Guardian, Labour opposed to ‘discriminatory’ and ‘confusing’ Covid status certificates, 6 Apr 2021
37
Royal College of General Practitioners, Covid-status Certification Review, accessed 16 Jul 2021
38
Professor Richard Tedder, Senior Research Investigator in Medical Virology, Imperial College London,
Science Media Centre, Expert comments about immunity passports, 1 Dec 2020
39
Professor Deborah Dunn-Walters, Chair of the British Society for Immunology COVID-19 and
Immunology taskforce and Professor of Immunology at the University of Surrey, Science Media Centre,
Expert comments about immunity passports, 1 Dec 2020
40
Prof Richard Tedder, Senior Research Investigator in Medical Virology, Imperial College London,
Science Media Centre, Expert comments about immunity passports, 1 Dec 2020
20 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
Industry
Business and industry stakeholders, particularly in the hospitality sector,
have raised concerns about the need for a Covid-19 certification scheme and
the costs and practicalities involved in implementing such a scheme.
The Confederation of British Industry (CBI) in April 2021 set out
recommendations for any Covid-19 certification scheme to have the
confidence of businesses. These included that any certification scheme should
be aligned with existing Covid-19 policies already in place, be simple and
accessible to use and be applied consistently across the UK. 41
Hospitality trade bodies have strongly opposed the introduction of a Covid-
certification scheme. Kate Nicholls, Chief Executive of trade body
UKHospitality said in March 2021 that a vaccination certification scheme
would be “simply unworkable” and could cause confusion and conflict among
businesses, customers and staff. 42 The industry has highlighted the costs and
burden that a certification scheme would bring to businesses in the sector,
which have already had significant restrictions on their trade. 43 For example,
representatives of beer and pub said on 1 April:
Pubs will already be trading at a loss when they reopen with all the
existing restrictions and covid-secure measures in place. Adding
further disproportionate and discriminatory measures threatens the
very survival of thousands of businesses. It’s unfair to single out our
sector again with these added impractical burdens that will have
economic consequences and risk our recovery. 44
Retail industry stakeholders have also said that while they can see the
potential for a certification scheme to support the re-opening of international
travel, it would not be appropriate for a domestic retail setting. 45
Some music and events industry stakeholders have supported the
introduction of a temporary industry-wide certification scheme as a route to
lifting capacity restrictions on venues. 46 Bill Bush (Director of Policy at the
Premier League) and Richard Jordan (a theatre producer) told the PACAC
committee that for their sectors, removing social distancing limitations was
the priority. 47 Bill Bush said that although the Premier League would like to
avoid certification if possible, if such a scheme were the only way to avoid
41
CBI, COVID-status certification: How to introduce vaccine and testing passports, 1 April 2021.
42
UKHospitality, Vaccine passport scheme unworkable, says UKHospitality, 25 March 2020.
43
Public Administration and Constitutional Affairs Committee, Covid 19 Vaccine Certification, 12 Jun
2021, HC 42-II 2021-22, paras 52 & 53
44
British Beer and Pub Association, Pub trade dismayed at Government backsliding on reopening
restrictions, 1 April 2021
45
Covid vaccine passports could be needed in high street shops, Retail Gazette, 7 April 2021.
46
British music and events industry backs COVID-19 certification scheme, Reuters 23 April 2021.
47
Public Administration and Constitutional Affairs Committee, Covid 19 Vaccine Certification, 12 Jun
2021, HC 42-II 2021-22, paras 50 & 51
21 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
social distancing rules, then it would be the “lesser of evils”. 48 The UK Cinema
Association has argued against the introduction of a Covid-certification
scheme. 49
Civil liberties groups
In an April 2021 report, civil liberties group Big Brother Watch, set out strong
objections against a “two-tier society” and the potential disproportionate
impact on marginalised groups:
COVID-status certificates would create a two-tier society and a
subclass of citizenry, in which minority ethnic groups, migrants,
poorer people and people with lower education would be
disproportionately represented. The policy would likely result in
unlawful discrimination against pregnant women, disabled
people, young people and, potentially, religious groups. The best
way to ensure marginalised groups are included in public health
measures is to create an enabling, not a punitive, environment. 50
The report also raised concerns about the scientific basis for certification,
pointing to “insufficient evidence” that vaccinations or natural immunity
prevents transmission.
The report’s concluding recommendation was that the Government “should
legislate to prohibit Covid-status certification being used to segregate or
exclude individuals from general businesses, events, services or jobs”.
Similar concerns have been shared across the political spectrum, with a
cross-party group of 79 Members and 14 peers joining a wider campaign
pledge organised by Big Brother Watch to “oppose the divisive and
discriminatory use of Covid status certification to deny individuals access to
general services, businesses or jobs”. 51
Another civil liberties group, Liberty, commented on the wider implications of
introducing certification, which it considered “could pave the way for a full ID
system- an idea which has repeatedly been rejected as incompatible with
building a rights-respecting society”. 52
A petition hosted on the Parliament website calling on the Government to
commit to “not rolling out any e-vaccination status/immunity passports to
the British public” has gained over 375,000 signatures. 53 The opposition is
48
Public Administration and Constitutional Affairs Committee, Covid 19 Vaccine Certification, 12 Jun
2021, HC 42-II 2021-22, paras 50 & 51
49
UK Cinema Association, UK Cinema Association reiterates opposition to use of COVID-status
certificates, 1 April 2021
50
Big Brother Watch, The case against a two-tier Britain under Covid certification, 2 Apr 2021
51
Big Brother Watch, MPs launch cross-party campaign against Covid passes, accessed 16 Jul 2021
52
Liberty, Liberty responds to “vaccine passport” plans, 13 Jan 2021
53
UK Government and Parliament petitions, Do not rollout Covid-19 vaccine passports, accessed 28 Jul
2021
22 Commons Library Research Briefing, 28 July 2021Covid-19 status certification based on concerns that “such passports could be used to restrict the rights of people who have refused a Covid-19 vaccine, which would be unacceptable”. 23 Commons Library Research Briefing, 28 July 2021
Covid-19 status certification
3 The NHS Covid Pass
The NHS Covid Pass is available in England and Wales and shows details of a
person’s Covid-19 vaccination details or test results- their ‘Covid-19 status’.
The Pass is available to those over the age of 16 who are registered with a GP
and have an NHS number. The Pass displays the type of vaccine received,
date and batch number, with an accompanying QR code.
3.1 Using the NHS Covid Pass in England
The Cabinet Office commissioned NHSX 54 to develop the NHS Covid. Following
this, the Westminster Government set out that certification through the NHS
Covid Pass would be acquired by:
a. Full vaccination: 14 days after completing a full course of
vaccination, whether that requires two doses or one dose (according
to the MHRA authorised schedule);
b. Testing: evidence of a negative PCR or lateral flow test taken with
48 hours of entry to a venue, with both on-site (where available) and
at-home tests being accepted; and
c. Natural immunity: proof of a positive PCR, lasting for 180 days
from the date of the positive test and following completion of the
self-isolation period. 55
The NHS Covid Pass website explains that the pass can be used for travel
abroad, or at events and venues in England asking for proof of Covid-19
status.
People aged 16 or over can get an NHS Covid Pass for travel abroad. People
aged 18 or over can get an NHS Covid Pass for domestic events.
54
NHSX Covid Pass
55
Cabinet Office, Covid-Status Certification Review: Report, 6 Jul 2021
24 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
The website sets out the requirements for international travel and domestic
events which are reproduced below:
Covid Pass- travel abroad
What you need to get a pass When you can get a pass
1 or 2 doses of a Covid-19 vaccine used in the UK Usually within 24 hours of having your vaccination –
however it can take up to 5 days for your records to
be updated
Source: NHS, NHS Covid Pass, last reviewed 25 Jul 2021
Covid Pass- domestic events
What you need to get a pass When you can get a pass
To be fully vaccinated with a Covid-19 vaccine 2 weeks after your 2nd dose, or 2 weeks after 1
used in the UK dose of the Janssen vaccine
As soon as you get your result
Negative PCR test or rapid lateral flow test
If you did a rapid lateral flow test at home, report
within the past 48 hours
your lateral flow test result on GOV.UK first
After you've finished self-isolating and up to 180
Positive PCR test within the past 6 months
days after taking the test
Source: Source: NHS, NHS Covid Pass, last reviewed 25 Jul 2021
3.2 Obtaining an NHS Covid Pass in England
People can obtain a Covid Pass digitally, either through the NHS App or the
online NHS Covid Pass service. Digital versions of the Covid Pass are valid for
specified time periods:
How long digital versions are valid for
If you've had:
• a vaccine used in the UK – your pass lasts for 30 days, but the 30
day period refreshes every time you log in
• a negative PCR test or rapid lateral flow test – your pass is valid
for 48 hours after a negative result
• a positive PCR test – your pass lasts 30 days, but the 30 day period
refreshes every time you log in (for up to 180 days after you took
the test)
25 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
If you download your COVID Pass as a PDF, always check the expiry
date before using it.
If you're fully vaccinated or had a positive test result, the barcode on
a PDF is valid for 30 days. 56
Paper versions of the Covid Pass, showing vaccination status only, are also
available and do not have an expiry date.
The Government has published guidance for demonstrating Covid-19
vaccination status. 57
The Government has also published guidance explaining how the Pass may be
used in businesses and venues:
We encourage organisations in certain settings to use the NHS
COVID Pass as a condition of entry, in order to reduce the risk of
COVID-19. This will especially be the case in large, crowded settings
(such as nightclubs) where people are likely to be in close proximity
to others outside their household.
To support organisations and individuals in these settings, the NHS
COVID Pass will be made available through the NHS App, NHS.UK, or
as a letter that can be requested by ringing NHS 119. Visitors will also
be able to show text or email confirmation of test results.
Organisations should ensure they are in compliance with all legal
obligations, including on equalities.
There are some settings where the NHS COVID Pass should not be
used as a condition of entry, in order to ensure access for all. This
includes essential services and essential retailers which have been
able to stay open throughout the pandemic. 58
3.3 Obtaining proof of Covid-19 status for clinical
trial participants
The NHS Covid Pass website explains that people who have received a Covid-
19 vaccine as part of an official clinical in trial in England do not need to use
the NHS Covid Pass. 59 It advises that these individuals should have received a
letter identifying their Covid-19 status as “fully vaccinated.
The Be Part of Research website, operated by the National Institute for Health
Research, provides several responses to FAQs on certification requirements
56
NHS, NHS Covid Pass, accessed 26 Jul 2021
57
DHSC, Demonstrating your Covid-19 vaccination status, last updated 16 Jul 2021
58
Cabinet Office, Coronavirus: how to stay safe and help prevent the spread, last updated 22 Jul 2021
59
NHS, Get your NHS Covid Pass letter, accessed 28 Jul 2021
26 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
for clinical trial participants and advises on how they can demonstrate their
vaccination status. 60
3.4 Obtaining proof of Covid-19 status in devolved
nations
The Welsh Government has published information about how the NHS Covid
Pass is being used in Wales.
The NHS Covid Pass is not available in Scotland and Northern Ireland.
Vaccinated people in Scotland can receive an NHS coronavirus vaccination
status letter. 61
Vaccinated people in Northern Ireland can obtain Covid-19 certificates via the
COVIDCert NI mobile app, a digital certificate or a paper certificate. 62
60
Be Part of Research, Vaccine passports/ certification and travel, 28 Jul 2021
61
NHS Inform Get a record of your coronavirus (COVID-19) vaccination status Last updated 20 Jun 2021
62
NI Direct, Coronavirus (Covid-19): Covid certificate for NI residents, 26 Jul 2021
27 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
4 Scientific evidence
Consideration must be given to a range of scientific factors in order to
determine the feasibility, practicality and ultimately success of any
certification scheme.
Decisions on the use of certification systems are likely to be underpinned by
the scientific understanding of Covid-19 and its transmission, and any
potential gains on reducing the impact of the pandemic on everyday life.
Covid-19 terminology: the virus and the disease
Covid-19 disease is an infectious disease caused by the Covid-19 virus. The
symptoms of Covid-19 disease include a high temperature, a continuous cough
and a loss or change to sense of smell or taste.
The scientific name of the virus that causes Covid-19 disease is severe acute
respiratory syndrome coronavirus 2, abbreviated to SARS-CoV-2.
SARS-CoV-2 is one type of coronavirus- a specific family of viruses with similar
features.
When asked about the scientific case for introducing certification certificates,
Minister for the Cabinet Office Michael Gove said:
The scientific case would be that, if you have a group of people in a
venue and the people in that venue you are confident have either had
the disease or are vaccinated or have recently tested negative, the
risk of a super-spreader event, the risk of transmission, diminishes. 63
Dr Sue Hopkins provided estimates of the reduction in transmission risk
through the requirement of certification and testing for event attendance:
Most events that people go to are smaller events, meeting indoors.
That is where most of the transmission occurs. Clearly the risk of a
large event, both travelling to the event, the socialising around the
event and the event itself, can potentially be reduced by the use of
testing, vaccination or, alternatively, knowing people’s prior
infection status. All those things together are likely to reduce the risk
63
Public Administration and Constitutional Affairs Committee, Oral evidence: Covid 19 vaccine
certification, 27 May 2021, HC 42- II, 2021-22, para 119
28 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
of transmission by 30% to 50%, not eliminating it as we have
mentioned earlier but maybe even higher.
[…]
A negative lateral flow test shortly before entering the event reduces
the risk of transmission by about 30% to 50%. 64
In its June 2021 report, PACAC identified four factors that need to be
considered in order to demonstrate a clear scientific case for introduction of a
certification system:
• Transmission of the virus
• The effectiveness of vaccines on symptomatic disease, hospitalisation,
mortality, infection and transmission
• The implications of new variants
• The accuracy of testing
Similarly, in its May 2021 report, Checkpoints for vaccine passports, the Ada
Lovelace Institute questioned the impact of vaccination, transmission and
testing on certification:
[…] the first question to ask of a COVID vaccine passport system is
whether an individual’s status, for example that they have been
vaccinated, conveys meaningful information about the risk they pose
to others? Does the scientific evidence base we have on COVID-19
vaccines, antibodies and viral testing, support making that link, and
if so, how certain should we be about an individual’s risk based on
those proxies? 65
Below, we provide an overview of the current scientific evidence that
examines these factors within the context of certification.
It is clear that a great deal is still unknown with respect to the science of
SARS-CoV-2. As data from long-term studies continue to become available it
is likely that these uncertainties will be addressed.
4.1 Immunity
By way of vaccination, recent infection or a negative test result, an inferred
principle of certification is that it demonstrates that a person is unable to
transmit SARS-CoV-2, or, at least, much less likely to transmit the virus, than
a person without certification.
64
Public Administration and Constitutional Affairs Committee, Oral evidence: Covid 19 vaccine
certification, 27 May 2021, HC 42- II, 2021-22, para 93
65
Ada Lovelace Institute, Checkpoints for vaccine passports. 10 May 2021
29 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
This approach is based on our understanding of how immunity to the SARS-
CoV-2 virus is conferred.
The Scientific Advisory Group for Emergencies (SAGE) provides scientific and
technical advice to support government decision makers during emergencies.
The advice provided by SAGE does not represent official government policy.
SAGE also relies on external scientific advice from expert groups, which for
Covid-19 includes the New and Emerging Respiratory Virus Threats Advisory
Group (NERVTAG).
NERVTAG explains that there are two types of immunity to consider with
respect to Covid-19:
Sterilizing immunity means that a person is protected against both
infection and illness. Therefore, as well as being themselves
protected from illness they cannot be a source of infection for others.
Non-sterilizing immunity means that a person can still get infected
but not become ill. Therefore, although themselves protected from
illness, they may still be able to become infected, shed virus and be a
source of infection for others. 66
In November 2020, NERVTAG said 67 that the level of sterilising immunity
provided by Covid-19 natural infection or immunisation is not yet fully
understood and, consequently the risk of reinfection remains.
NERVTAG also reported that that whilst reinfection upon re-exposure to SARS-
CoV-2 is rare, it does occur, and that most reinfections are mild, but some are
severe. 68
Public Health England’s (PHE) Sarscov2 Immunity & REinfection EvaluatioN
(SIREN) study examined reinfection rates in healthcare workers. Researchers
were able to quantify the risk of reinfection, reporting that a previous history
of SARS-CoV-2 infection was associated with an 84% lower risk of
reinfection. 69
When considering immunity, it is also important to recognise that the immune
response may differ between individuals, as explained by the British Society
for Immunology (BSI):
Does everyone make the same immune response to SARS-CoV-2?
No. Immune responses can vary hugely between different
individuals. Some people seem to make a very effective immune
response such that they cannot be infected again and therefore will
not get sick again from SARS-CoV-2 and will not pass the virus to
66
NERVTAG, Update note on immunity certification, 3 Feb 2021, published 5 Jul 2021
67
NERVTAG, Certifying COVID-19 immunity - 19 November 2020, published 4 Dec 2020
68
NERVTAG, Certifying COVID-19 immunity - 19 November 2020, published 4 Dec 2020
69
PHE, SIREN, accessed 26 Jul 2021
30 Commons Library Research Briefing, 28 July 2021Covid-19 status certification
anyone else (so called ‘sterilising’ immunity). Other people make
antibodies and are protected from disease, but not from future
infection by the virus. In theory these people could still pass the virus
to other people. People vary in the number of antibodies they make
after infection, in the quality of those antibodies (how good they are
at preventing infection) and in the number and quality of the T cell
response they make. We don’t yet know exactly how important these
variations in antibodies and T cells are in terms of levels of protective
immunity but ongoing research (by the UK Coronavirus Immunology
Consortium) is designed to answer this question. 70
Duration of immunity
One of the crucial unanswered questions about Covid-19 is how long immunity
lasts in individuals, following either vaccination or natural exposure to the
virus. Scientists have placed a range of estimates on immunity duration.
NERVTAG, drawing on knowledge of Covid-19 and other respiratory viruses,
initially placed a conservative estimate of immunity duration of 90 days:
The length of immunity conferred by natural infection or vaccination
is currently not known. Waning immunity is believed to partly
underlie the propensity for other coronaviruses to reinfect after 1-2
years. Studies on MERS-CoV [Middle East respiratory syndrome
coronavirus] and SARS-CoV [severe acute respiratory syndrome]
found waning antibody levels over this time period. Reinfections with
seasonal coronaviruses occurs frequently at 12 months, sometimes
as early as 6 months but not within three months. Therefore, based
on the variability in the data and differential responses in the
population we conservatively estimate that a protective immune
response after SARS-CoV-2 infection or vaccination may last for 90
days (moderate confidence). 71
In February 2021, NERVTAG said that the duration of immunity beyond 6
months (following natural infection) and 3 months (following vaccination) is
not well understood. 72 In February 2021, the BSI suggested that immunity
might last for a year. 73 The SIREN study reported that previous SARS-CoV-2
infection protects most individuals against reinfection for an average of 7
months. 74
70
V. Hall et.al., SARS-CoV-2 infection rates of an antibody-positive compared with antibody-negative
health-care workers in England: a large, multicentre, prospective cohort study (SIREN), The Lancet,
Vol 397, p.1459-1469, 9 Apr 2021
71
NERVTAG, Certifying COVID-19 immunity - 19 November 2020, published 4 Dec 2020
72
NERVTAG, Update note on immunity certification, 3 Feb 2021, published 5 Jul 2021
73
British Society for Immunology, Immunity & Covid-19, 3 Feb 2021
74
V. Hall et.al., SARS-CoV-2 infection rates of an antibody-positive compared with antibody-negative
health-care workers in England: a large, multicentre, prospective cohort study (SIREN), The Lancet,
Vol 397, p.1459-1469, 17 Apr 2021
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