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Will you need a COVID-19 vaccine to fly?

‘Immunity passports’ might be coming to air travel—but should they?

Will you need a COVID-19 vaccine to fly?
[Photo: travelview/iStock]
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Airlines have adapted to the COVID-19 pandemic with policies on face masks, keeping middle seats empty, and requiring evidence of a negative coronavirus test before heading to some destinations. So when the first doses of a COVID-19 vaccine are rolled out in the coming months, will you have to prove your immunization to board a plane?

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For most airlines, it’s too soon to tell. While Australian airline Qantas announced on November 23 that it would require proof of vaccination to fly, other airlines are still deciding. When asked if American Airlines would implement such a policy, a company spokesperson said that while the airline is pleased that vaccine development is moving forward, it’s too early to comment on policies related to a COVID-19 vaccine. A spokesperson from Delta couldn’t share specifics either, and noted that the entire pandemic has been unpredictable.

A spokesperson for Southwest said that the airline “will continue monitoring public health information from the CDC, the latest scientific research, and insights from our internal and external experts to guide our operational policies as we work to support the well-being of our customers and employees during the COVID-19 pandemic.” Jet Blue and United did not respond to a request for comment.

As for whether airlines should require passengers to be vaccinated for COVID-19 in order to fly, that’s even more complicated, says Jeffrey Kahn, director of the Johns Hopkins Berman Institute of Bioethics and a professor of bioethics and public policy. “The question is whether airlines should be the arbiters of public health policy,” he says. “I’m sure they would do it if they were required to as part of public health, but that would require a federal approach to the pandemic. . . . We haven’t had that.”

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Without federal mandates, states have borne the brunt of the coronavirus pandemic response. When it comes to travel, that means states and regions have made their own rules about who can come in from other areas, though their enforcement has been spotty. New York state, for example, has a travel advisory list requiring people traveling from states with high COVID-19 spread to quarantine for 14 days. Similarly, airlines follow the regulations of their destinations, rather than having their own rules across the board. Beginning November 24, anyone flying to Hawaii will have to show a negative COVID-19 test before their departure, no matter the airline they fly in on.

“It will depend on the destination,” Kahn says of COVID-19 vaccine requirements on airplanes. Just like how we have to show a passport to board a plane before flying to another country, Kahn guesses we might have “immunity passports” to prove our COVID-19 immunization before boarding a plane to go abroad. American citizens are still banned from traveling to Canada and most of Europe because of the high rates of COVID-19 infection here, based on rules that are imposed by those countries’ governments, not the airlines that serve those regions.

There was talk of immunity passports at the beginning of the pandemic, too—the idea, Kahn says, “that if people could show they had been infected and recovered and were therefore immune, they could travel more freely.” The problem became that we don’t have a way to test for that: There’s growing evidence that the coronavirus antibodies last only a few months, even if the protections they afford last longer. It’s also not clear yet either if the COVID-19 vaccines in development actually prevent someone from getting SARS-CoV-2, the virus that causes COVID-19, or if they only prevent people from getting really sick.

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While some countries do require proof of vaccination to get a visa, there’s no real precedent for what airlines should do in the face of a global pandemic. The 1918 Spanish flu preceded the age of commercial air travel, and there were no (and still aren’t) licensed vaccines for SARS or MERS during those outbreaks. “Like a lot of things in this [COVID-19] outbreak, it’s unprecedented,” Kahn says. “We don’t have a playbook to follow.”

In an example of an immunity passport, the International Air Transport Association, a global airline lobby and trade association, did announce on November 23 that it’s working on an IATA “travel pass,” a digital health pass to allow for the safe reopening of global borders. That pass would include a global registry of health requirements, showing testing and “eventually vaccine” needs for different journeys, along with a global registry of testing and vaccination centers. It also will allow labs to share test and vaccine certificates with passengers, and will include a “digital passport” so passengers can share those certificates with airlines and local authorities.

Though some countries may require a negative COVID-19 test or proof of a vaccine to travel there, Kahn doesn’t anticipate that happening for domestic flights in the U.S. There aren’t going to be enough vaccines for everyone to be immunized right away, he notes, and there are people who are hesitant to get a COVID-19 vaccine because of the speed at which it was developed and the novelty of the science. And there’s little economic incentive for the airlines right now: Without a COVID-19 vaccine yet available, people are flying anyway—on the Sunday before Thanksgiving, more than 1 million travelers passed through TSA checkpoints.

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As for the federal government’s involvement in a vaccine policy for flying, it comes down to the difference between what the federal government can require versus what it can recommend. The Centers for Disease Control and Prevention recommended people not travel for Thanksgiving, but it couldn’t require a travel ban. It’s similar to the idea of a national mask mandate: “Who could impose such a thing?” Kahn asks. “If the feds buy a bunch of vaccines then they can allocate them, or if they buy a lot of ventilators and share them, they get to allocate that. But when it comes to ‘everybody should wear a mask,’ it’s not clear that the federal government could do more than just say ‘everybody should.'” A COVID-19 vaccine might similarly be a suggestion for domestic travel.