The imminent vaccination campaign against the spread of the COVID-19 disease that is about to begin in the countries of the European Union poses two major challenges for public administrations. The first is none other than the need to solve the logistical challenges associated with its distribution, especially if we bear in mind that the vaccine from Pfizer and BioNTech, which is the first to have obtained conditional marketing authorization from the European Medicines Agency , must be kept at a temperature in no case higher than -70 ºC.
The Spanish Government plans to begin the vaccination campaign on December 27, first serving the population groups that are most exposed and those whose health may be more severely compromised. This category includes residents and staff working in nursing homes and centers for highly dependent persons, as well as healthcare personnel. But this is only the first link in the chain.
Andalusia plans to implement a "COVID card"
Little by little, the vaccine should reach other population groups to help us achieve the long-awaited group immunity , which according to experts requires that between 50 and 70% of the population be immunized, which places us in front of the second great challenge that this strategy entails: convincing citizens who do not want to be vaccinated, or who at least do not want to do it when they are due and prefer to wait longer, that it is essential that they do so to contribute to the group immunity that we aspire to achieve soon as possible.
According to the experts, we will achieve group immunity against the COVID-19 disease when between 50 and 70% of the population is vaccinated as long as the reproduction rate (R0) remains below 6
Currently the European Administration and the Spanish Government do not oblige citizens to be vaccinated against COVID-19, and today there are no solid indications that support the possibility that this strategy will change in the short term. However, in Spain some territorial administrations have raised their voices to put on the table the possibility that this is not the appropriate strategy .
No regional government has hinted that it is going to force its citizens to be vaccinated, at least for the moment, but the president of the Junta de Andalucía has made public his intention to launch a COVID card when the vaccination campaign begins next 27 from December.
Juan Manuel Moreno, the president of the Junta de Andalucía, has anticipated that the Government he directs is preparing a vaccination certificate that will be delivered to Andalusian citizens who are vaccinated to protect themselves from the coronavirus. What this strategy pursues is that they can prove that they have been vaccinated in order to travel and participate in those events that involve the concentration of a large number of people in a limited space.
Moreno has also assured that getting vaccinated will not be mandatory in any case, but has stressed that doing so represents "a moral obligation towards ourselves and towards others." From his words it is quite clear the possibility that citizens will end up demanding the presentation of the COVID card in order to participate in mass events, such as football matches or concerts, and also to be able to travel.
Doubts are inevitable: the ethical and legal dilemma is on the table
Juan Manuel Moreno is not the first Spanish politician to speak of a COVID card, but he has been the first to materialize it in a tangible way. At the end of last July Isabel Díaz Ayuso, the president of the Community of Madrid, raised the possibility of launching a serological passport that would certify which people had overcome the disease, and whose body, therefore, had generated antibodies. Its purpose was that they could travel freely and participate in activities with other people without the possibility of contagion.
Other autonomous communities, such as Catalonia or Castilla León , also tried its implementation, but it did not materialize. The hypothetical passport that Isabel Díaz Ayuso told us about and the card that Juan Manuel Moreno is now defending do not prove exactly the same information. The first was intended to identify the people who had overcome the disease, and the second those who will be vaccinated, but its ultimate purpose is the same, and, for this reason, its legal and ethical implications are on the table.
Citizens are free to decide if we want to be vaccinated, but this decision would be conditioned by the obligation to prove that we are vaccinated in order to carry out certain activities
The contradiction that we could face if the COVID card finally prospers in Andalusia or any other autonomous community is that citizens are free to decide whether or not we want to be vaccinated, but this decision would be seriously conditioned by the obligation to prove that we are vaccinated to be able to carry out certain activities. Hence, it is reasonable to use the term "conditional obligation". But this is only the tip of the iceberg.
The Spanish Society of Preventive Medicine, Public Health and Hygiene ensures that passports and serological cards inevitably lead us to :
[...] the stratified limitation of fundamental freedoms and rights on the grounds of health and discrimination and stigma based on serological status [...] Measures aimed at making the HIV status public can dissuade the population from seeking healthcare.
In addition, this institution ensures that the implementation of this type of document would violate the constitutional principles of non-discrimination, equality, relevance and proportionality, as well as the confidentiality of the clinical information of any person. It is also interesting what Josefa Cantero, professor of Administrative Law at the University of Castilla-La Mancha, and Ildefonso Hernández, professor of Preventive Medicine and Public Health at the Miguel Hernández University, published in The Conversation when the possibility of launch the first COVID primers :
The mere requirement of a serological passport affects the fundamental right to privacy. To which is added that the fundamental right of freedom could be affected if the document were required to circulate [...] If we try to use the legal categories existing in our Law we would not find any that would allow us to frame this figure exactly.
It is evident that the need to have a document that proves that a person has been vaccinated, or that they have overcome this disease, in order to travel or participate in some activities raises very deep legal and ethical conflicts that society as a whole will have to calibrate . Especially while defending a voluntariness that could be called into question. Let us trust that politicians rise to the occasion and that citizens behave according to what the situation we are all facing requires of us.