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The History Of Vaccine Passports In The U.S. And What's New

STEVE INSKEEP, HOST:

Next, we report on the backstory of vaccine passports. The idea here is that you'd be required to show proof of immunization against COVID-19. The airline industry and universities and retailers are all considering ways to do that. But the effort has prompted accusations that some people would lose some of their freedom or medical privacy. The idea of a vaccine passport, though, is not new. Here's NPR's Yuki Noguchi.

YUKI NOGUCHI, BYLINE: The smallpox vaccine was first developed in 1770, but historian Jordan Taylor says small outbreaks continued to crop up across the U.S. for nearly two centuries after that. Factory workers, for example, infected each other by the dozen, developing sores that quickly spread over their bodies.

JORDAN TAYLOR: Pustules usually around your arms or your lymph nodes. And it's quite repellent, actually. It's extremely painful, very contagious. It's a gnarly disease.

NOGUCHI: And one that killed about a third of those infected. The country's first vaccine passport system was developed in response in the 1800s. Taylor, who teaches at Smith College, says local health officials or state governments started requiring proof of immunity when traveling or applying for a job. Train conductors and employers asked people to show either a scar left by a vaccine, a face pockmarked by smallpox or a doctor's certificate showing they'd been inoculated. Schools began requiring proof of smallpox vaccination to enroll, a practice that continues to today for myriad other diseases. Such measures proved highly effective at controlling infection. It enabled the economy to keep moving. And for the most part, the public accepted it as part of the public health bargain.

TAYLOR: For people in the 19th and 20th centuries, it really wasn't a question. It was obviously the case that this sort of vaccine passport system was preferable.

NOGUCHI: That's not to say there weren't vaccine skeptics. Taylor says a black market developed a century ago for forged certificates for those avoiding vaccination.

TAYLOR: Or to even create and sell fake scars made of plaster and things like that so that they can bypass and get around these restrictions.

NOGUCHI: But for the most part, he says, vaccine passport systems were seen as a ticket to greater freedom.

TAYLOR: There was a different understanding of what it meant to be free.

NOGUCHI: A century ago, the public measured freedom in terms of their ability to gather publicly or participate in community activity.

TAYLOR: There's actually, as far as I can see, relatively little talk about violation of their liberties or their rights, the sorts of discourse that we're seeing now in response to the proposals for vaccine passports.

NOGUCHI: Today, those opposed to vaccine passports also express concern for the security and privacy of medical information. James Colgrove, a public health professor at Columbia, says that wasn't an issue 100 years ago because both smallpox and the vaccine left physical scars.

JAMES COLGROVE: It was much easier to check immunity back then. You just asked people to roll up their sleeves. Privacy was not really so much an issue.

NOGUCHI: Today, by contrast, people worry that a digital vaccine passport system could link to other databases that in turn could compromise other private information. And, says Colgrove, compared to a century ago, mistrust of government today runs very high.

COLGROVE: We're at one of those times when anti-government sentiment is particularly vehement. And so you throw that into the mix along with the mass spread of disinformation over the Internet, and it's a very toxic combination.

NOGUCHI: What's important, he says, is to not allow politics to derail public health measures like vaccine passports, which helped eradicate smallpox in the U.S. by 1950.

Yuki Noguchi, NPR News.

(SOUNDBITE OF NORTHCAPE'S "CAPILLARY ACTION") Transcript provided by NPR, Copyright NPR.

Yuki Noguchi is a correspondent on the Science Desk based out of NPR's headquarters in Washington, D.C. She started covering consumer health in the midst of the pandemic, reporting on everything from vaccination and racial inequities in access to health, to cancer care, obesity and mental health.