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Public Health in Practice: Letter To The Editor
Public Health in Practice: Letter To The Editor
A R T I C L E I N F O
Keywords
Emerging technologies
COVID-19
Electronic vaccination certificates
Passports
Immunization
https://doi.org/10.1016/j.puhip.2021.100136
Received 9 March 2021; Received in revised form 19 April 2021; Accepted 3 May 2021
Available online 7 May 2021
2666-5352/© 2021 The Author(s). Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC
BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Letter to the Editor Public Health in Practice 2 (2021) 100136
vaccination programmes and facilitates cross-border vaccination acti [3] E. Mbunge, S.G. Fashoto, B. Akinnuwesi, C. Gurajena, A. Metfula, Challenges of
social distancing and self-isolation during COVID-19 pandemic in Africa: a critical
vation guided with International Health Regulations [17]. Greece [20]
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and Israel have also implemented COVID-19 vaccination certificates. In [4] M. Black, A. Lee, J. Ford, Vaccination against COVID-19 and inequalities – avoiding
Africa, the Africa Centres for Disease Control and Prevention launched making a bad situation worse, Public Heal Pract (2021) 100101, https://doi.org/
Trusted Travel, a tool to simplify verification of public health docu 10.1016/j.puhip.2021.100101.
[5] E. Mbunge, M.N. Sibiya, R.C. Millham, S. Takavarasha, m-Health Framework for
mentation for travellers during exit and entry across borders. Various Improving Malaria Information Dissemination in Buhera Rural District amid
other digital tools and apps are being employed in different parts of the COVID-19 and beyond. 2021 Conf. Inf. Commun, Technol. Soc., IEEE, 2021,
world help travellers to store and manage their verified certifications for pp. 59–66, https://doi.org/10.1109/ICTAS50802.2021.9395020.
[6] C. Gurajena, E. Mbunge, S.G. Fashoto, Teaching and learning in the new normal:
COVID-19 tests or vaccination. opportunities and challenges of distance learning amid COVID-19 pandemic, SSRN
Digital tools and apps that generate COVID-19 electronic vaccination Electron J (2021), https://doi.org/10.2139/ssrn.3765509.
certificates may encounter several impediments such as heterogeneous [7] K.M. Douglas, COVID-19 conspiracy theories, Group Process. Intergr. Relat. 24
(2021) 270–275, https://doi.org/10.1177/1368430220982068.
communication protocols, lack of certificates (data) standardization and [8] E. Mahase, Covid-19: what new variants are emerging and how are they being
interoperability issues with other apps, privacy and security issues [18], investigated? BMJ 372 (2021) n158, https://doi.org/10.1136/bmj.n158.
lack of clear international regulations and policies guiding the use of [9] M. Eisenstadt, M. Ramachandran, N. Chowdhury, A. Third, J. Domingue, Covid-19
Antibody Test/vaccination Certification There’s an App for that, ArXiv 2020, htt
electronic vaccination certificates amid COVID-19, data sharing without ps://doi.org/10.1109/ojemb.2020.2999214, 2020.
user-consent violates ethical issues. Also, there is no clear framework [10] A.L. Wagner, The use and significance of vaccination cards, Hum. Vaccines
guiding the integration of blockchain technology in health systems and Immunother. 15 (12) (2019), https://doi.org/10.1080/21645515.2019.1625647.
[11] K. Marhold, J. Fell, Electronic vaccination certificates: avoiding a repeat of the
the issuance of electronic vaccination certificates [4]. Further,
contact-tracing ‘format wars, Nat. Med. (2021) 1–2, https://doi.org/10.1038/
COVID-19 vaccination certificates pose considerable scientific, prac s41591-021-01286-w.
tical, equitable, and legal challenges [19]. [12] S. Whitelaw, M.A. Mamas, E. Topol, H.G.C. Van Spall, Applications of digital
The issuance of COVID-19 vaccination certificates raises some technology in COVID-19 pandemic planning and response, Lancet Digit Heal
(2020), https://doi.org/10.1016/S2589-7500(20)30142-4.
ethical concerns that need to be fully understood and addressed. For [13] E. Mbunge, Integrating emerging technologies into COVID-19 contact tracing:
instance, the Nuffield Council on Bioethics raised concerns on the pro opportunities, challenges and pitfalls, Diabetes Metab Syndr Clin Res Rev 14 (6)
posed introduction of immunity or vaccination passports in the UK citing (2020), https://doi.org/10.1016/j.dsx.2020.08.029.
[14] E. Mbunge, B. Akinnuwesi, S.G. Fashoto, A.S. Metfula, P. Mashwama, A critical
that this could enable coercive and stigmatising workplaces, thereby review of emerging technologies for tackling COVID-19 pandemic, Hum Behav
compounding current structural disadvantages in that country. Addi Emerg Technol 3 (1) (2020), https://doi.org/10.1002/hbe2.237.
tional concerns on whether privacy protections of people will be guar [15] D. Kamerow, Immunized? There’s an app for that, BMJ (2021) 372, https://doi.
org/10.1136/bmj.n85.
anteed and that the health data will only be used for the intended [16] China Launches COVID-19 Vaccination Certificates for Cross-Border Travel |
purpose must also be addressed. In the context of limited-resource set Reuters n.D. https://www.reuters.com/article/us-health-coronavirus-china-certifi
tings, COVID-19 vaccines are scarce and access remains unequal within cates-idUSKBN2B10LO (accessed March 10, 2021).
[17] World Health Organization Open Call for Nomination of Experts to Contribute to
the countries. People with serious health conditions and allergies have the Smart Vaccination Certificate Technical Specifications and Standards n.d. htt
been advised not to take the vaccines. This means people facing vacci ps://www.who.int/news-room/articles-detail/world-health-organization-open-
nation access problems will be unable to obtain vaccine passports and call-for-nomination-of-experts-to-contribute-to-the-smart-vaccination-certificate-t
echnical-specifications-and-standards-application-deadline-14-december-2020
therefore deprived of their civil rights. While vaccine passports are
(accessed March 9, 2021).
permissible under international health regulations, the implementation [18] E. Mbunge, S.G. Fashoto, J. Batani, COVID-19 digital vaccination certificates and
of COVID-19 vaccine passports should be tailored to address these digital technologies: lessons from digital contact tracing apps, SSRN Electron J
ethical concerns and digital tools and apps used should offer means for (2021), https://doi.org/10.2139/ssrn.3805803.
[19] A.L. Phelan, COVID-19 immunity passports and vaccination certificates: scientific,
enhanced security and privacy protection. equitable, and legal challenges, Lancet 395 (10237) (2020), https://doi.org/
In conclusion, there is a need to homogenize digital solutions and 10.1016/S0140-6736(20)31034-5.
standardization of regional and international electronic platform to [20] COVID-19: WHO Races to Develop Vaccination Card | Science| In-Depth Reporting
on Science and Technology | DW | 27.01.2021 n.d. https://www.dw.com/en/co
document and validate COVID-19 electronic vaccination certificates vid-19-who-races-to-develop-vaccination-card/a-56352930 (accessed March 10,
[20]. The outbreak of pandemics in the future is imminent; therefore, it 2021).
is imperative to develop a framework and policies guiding the integra
tion and synchronization of digital solutions especially digital vaccina Elliot Mbunge*
tion certificates in case of international public health emergencies. Department of Information Technology, Faculty of Accounting and
However, such technological interventions should be guided by ethical Informatics, Durban University of Technology, P O Box 1334, Durban,
guidelines. 4000, South Africa
Department of Computer Science, Faculty of Science and Engineering,
Funding University of Eswatini (formerly Swaziland), Kingdom of Eswatini
Tafadzwa Dzinamarira
None.
Department of Public Health Medicine, School of Nursing and Public Health,
University of KwaZulu-Natal, Durban, 4001, South Africa
Declaration of competing interest
Stephen G. Fashoto
Authors declares no competing interests. Department of Information Technology, Faculty of Accounting and
Informatics, Durban University of Technology, P O Box 1334, Durban,
Acknowledgements 4000, South Africa
John Batani
Not applicable.
Faculty of Engineering and Technology, Botho University, P. Bag A7156,
Maseru, 100, Lesotho
References
*
[1] COVID-19 vaccines n.d. https://www.who.int/emergencies/diseases/novel-coron Corresponding author. Department of Information Technology,
avirus-2019/covid-19-vaccines (accessed March 9, 2021). Faculty of Accounting and Informatics, Durban University of
[2] E. Mbunge, Effects of COVID-19 in South African health system and society: an
explanatory study, Diabetes Metab Syndr Clin Res Rev 14 (6) (2020), https://doi.
Technology, P O Box 1334, Durban, 4000, South Africa.
org/10.1016/j.dsx.2020.09.016. E-mail address: [email protected] (E. Mbunge).