Dalhousie professor wants Canada to consider sending any excess vaccine to Caribbean

A bioethicist from Dalhousie University wants the federal government to explore sending any excess vaccine supply to places like the Caribbean and Mexico, which are struggling due to a Canadian flight ban.

There have been reports the federal government could donate shots to lower-income countries if Canada received more doses than it needs. 

Research professor Françoise Baylis thinks any excess supply should go to countries that would usually benefit economically from a large number of Canadian tourists. Earlier this year Canada cancelled all flights to the Caribbean and Mexico until at least April 30.

"Why don't we protect both parties? Protect the traveller, the Canadian, by offering them access to vaccines and protect the receiving country, the locals, by making sure that they've had an opportunity to reach population immunity?" she told CBC Radio's Information Morning.

Baylis joined host Portia Clark for a conversation earlier this week about the ethics of vaccine passports, which would show proof that someone has been vaccinated and allow them to travel and socialize more freely.

On Friday, Prime Minister Justin Trudeau said he was reluctant to introduce such a system, pointing to concerns about inequities, although he also said these passports might be necessary for international travel.

The World Health Organization is working on international standards for what they call "a digital vaccination certificate" but has said it shouldn't be used for international travel at this time. 

Baylis's interview has been edited for clarity and length.  

What are the reasons for the WHO's hesitance or caution? 

I think the main reason is a commitment to evidence-informed policy. What it means is you shouldn't introduce rules and regulations that will govern our behaviour if you don't have the science to back up what you think you're trying to accomplish. So the goal in terms of thinking about having something that people would call a vaccination passport is the idea that you've been vaccinated, you therefore have a certain level of protection for yourself, and it's also believed that you then won't be transmitting the virus to other people. 

The problem in terms of the science right now is that we actually don't have very good data about the level or duration of this transmissibility function, because the clinical trials we've done so far have been about protecting people from not ending up dead or in the hospital. We don't actually have the kind of data we need to know for sure that the vaccine would prevent transmission. If it doesn't prevent transmission, then you're actually not achieving the goal.

Now, having said that, we do have some preliminary data that suggests it will prevent transmission, but we don't know for how long, and we don't know with respect to which vaccine or which variant so we still have a lot of unknowns in this space. 

So if someone has a so-called vaccine passport, they might actually still be a risk to others around them and to people in countries also that have lesser vaccination rates or haven't vaccinated as many people?

I think that's exactly right. I am particularly concerned about that when we think about low and middle income countries, which for some people in terms of tourism is the destination. And what you need to think about here is that if you're traveling to a country that will have most of its population vaccinated, we talk about that as having population immunity. And what that means is you have enough people within the country who have been vaccinated that you actually have protection for those who can't or choose not to be vaccinated. 

If we imagine going to a place like Israel, which has right now the highest level of vaccination and is continuing toward that goal of population immunity, it's very different from going into a low-income country where they may have no people who are vaccinated.

And to me, that brings us back to what we really should be working on is making sure that we have enough vaccine for everyone. And that really is our biggest challenge, and we're experiencing that here in Canada, never mind other countries who are worse off than we are. 

And you're suggesting perhaps Canada should identify countries where Canadians like to go and vacation and help them out with their vaccination? 

Yes, I'm trying to float this idea in the context of my commitment to the common good ... Very recently the federal government made a decision such that Canadians could not travel to a number of sunny destinations. And in that context, we know that we have both protected those countries, insofar as we haven't sent Canadians or allowed Canadians to go, who might put their population at risk, but we have also hurt their economies, which are completely dependent upon tourism.

Our government has said that if we had excess vaccine that we would make a contribution, we would gift this to other countries. I'm saying, well, why don't we start talking about that? Why don't we talk about an equitable plan for the distribution of excess vaccines? 

Do you also have concerns about how this will actually work? 

I think there are going to be a number of challenges in terms of things like fraud and forgery. I think there will be a number of challenges in terms of hacking and privacy issues, and I say that because most people are looking to try to develop some kind of a digital certification. 

Now, you'll appreciate there are a lot of equity challenges with that, not everybody has a smartphone, et cetera, so we're probably going to have both paper documentation and digital documentation and there are going to be all of those kinds of challenges. 

But I think, you know, one of the things we need to be aware of is that it's not just the black market we have to worry about, it's all of the assumptions that will surround practices where we think we can go in and demand that people provide us with a certain kind of documentation. I'm worried about who's going to be demanding what documentation of whom, and we have already seen at home in Canada how sometimes that has some very serious racist overtones.