March 5, 2021

There, now, seems to be light at the end of the tunnel that is the pandemic with global pharmaceutical companies having developed vaccines for COVID-19. Many countries across the globe have begun rolling out vaccination programs. Businesses, events, airlines, and schools are considering how, and what it will take, to safely resume in-person operations. However, we need to look at evidence-based solutions that can be preserved as a record separating those that have been inoculated against the virus from those that haven’t. For instance, a tick or alert on a person’s phone that could tell us whether they’ve been vaccinated.

A solution of this nature allows individuals access to a secure, digital record of their COVID-19 shot – a sort of vaccine passport – that can be stored on smartphones. This record could be used for everything from international travel to entering concert venues to participating in marathons. Once children have access to vaccination, they may need to get immunized before returning to classrooms. And some experts expect that nations currently requiring negative COVID-19 test results for incoming travelers, may eventually accept vaccination records.

Among the biggest tech-firms, Microsoft, Salesforce and Oracle, and healthcare organizations Cerner, Cigna, and so on, have already joined to help facilitate that state of “return to normal” with the vaccine credential initiative AKA the digital vaccine passport.

Challenges, and overcoming these

The solution, however, needs to work locally as well as internationally. Furthermore, not all residents may have an international-ID, and internationally acceptable systems might not have locally acceptable data copies. The vaccine digital record needs to be interlinked within country-level IDs such as Aadhaar (India), Social Security numbers (USA), driving licenses, voter id cards, and with internationally acceptable IDs such as passports and international driving licenses.

What the digital vaccination passport should be:

  • An open-source, standard model to make digital records

  • Easily usable

  • Interoperable

  • Verifiable and secure in a way that it is distinct to the vaccine for the pandemic, to prevent faking having received the vaccine by using someone else’s record

  • An encrypted, digital copy of the vaccination record like a QR code

  • Paper printed with a QR containing the record for those that don’t have smartphone but need to maintain evidence of having been vaccinated

To further indicate levels of vaccination, a color-coded status can be assigned. For instance,

green, indicating all mandatory shots have been administered; amber, if only the first dose has been taken; red, for those not vaccinated at all.

Leverage existing digital identity systems

India is considering using its existing Aadhaar digital identity system to create a massive vaccination program – administering and tracking 3-5 million COVID-19 vaccinations per day. The Kenyan government can use its Huduma Namba national IDs in a similar fashion, as can other countries with national digital identity systems. China has proposed using QR codes to identify those with COVID-19 immunity based on nucleic acid test results. These systems could be linked to government-issued passports to allow international travel.

Authentication using the blockchain approach

Once vaccine records are gathered, it will become important to establish a foolproof and secure authentication of the vaccination record, considering the PII data amassed. A blockchain technology-based approach would therefore be useful to consider. Tracking activities via a public, immutable record is the one real use case for distributed ledger technology and is depicted in the figure below.

The user journey can be explained thus:

  1. Citizen visits the healthcare facility to get the vaccine shot

  2. Healthcare worker creates an eCard for the vaccine and administers the shot to the citizen. The corresponding node in the blockchain will be leveraged for this.

  3. The eCard is linked to the patient various IDs – driver’s license, passport and other government IDs

  4. When the citizen visits a public event, he/she produces a personal ID and the event authority looks through the vaccine database to trace the eCard for the said person. This is feasible through restricted views from API’s in the blockchain

Key principles to adhere to in the blockchain approach:

  • Follow the decentralized approach

  • Do not store medical records in the blockchain (off-chain storage of records)

  • Store the reference to where the data is, what type of info does the data comprise, and for when the visit is made in the blockchain

  • Use standard messaging protocols and share the data with citizen consent. Each user has an updated copy of the blockchain so hackers cannot obtain control over the ledger.

  • The department of health can be recommended as the blockchain governing body and can confirm whether the citizen has been vaccinated or not, in a Boolean format.

There are, however, advantages and limitations as well to this approach. The positive outcomes are that there may be multi-level permissioned access to digital vaccine passport; secure sharing of citizen information with consent; and that the citizen stays custodian of their records. On the flip side are the following concerns or limitations: a lack of universally defined standards; the presence of unknowns as the technology keeps evolving; a shortage of skilled IT specialists who understand both industry domain and blockchain.

It, however, may be inarguable that a digital vaccine passport solution when accepted widely and when it reaches critical mass, will accelerate the smooth return to normal life and living, and a world where we can finally put the pandemic behind us. The role that governments and technology leaders play in this journey is going to be undeniable.

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Ramalingeswara Rao Balla (Ram) works in the International Public Services unit of TCS as an Enterprise Architect in the Public Health practice. He has an overall IT experience of 21.5 years and industry recognized certifications in the Enterprise Architecture space. Ram seeks to understand trends across healthcare, digital technologies and enterprise architecture. His area of expertise includes Innovation and Enterprise Architecture. The views expressed in this blog are his own.