COVID-19 Immunity Testing: A Passport to Inequity

As COVID-19 case numbers start to plateau in various places, some governments are now focusing on how best to ease restrictions and reopen the economy. In the absence of herd immunity for the population—for which the threshold may be as high as 82%—next steps are not obvious.

Recently, some have touted “immunity passports” for people who have survived infection with SARS-CoV-2 (the novel coronavirus that causes COVID-19) and tested positive for SARS-CoV-2 antibodies. Under this proposal, citizens deemed immune to the virus through serological testing (a type of blood test) could be freed from current restrictions and allowed to return to work. According to media reports, Chile is poised to become the first country to issue some kind of immunity cards. Others considering this option include Australia, Germany, Italy, the United Kingdom, and the United States.

In an already heavily stratified society, the introduction of immunity passports is ethically problematic. They would not only exacerbate current inequities but also create a novel layer of biological inequity—one based on a potentially ineffective measure of immunity.

Infection with...