The United States’ first “vaccine passport” app is launched: $2.5 million invested in development, using blockchain to protect privacy

As the global COVID-19 vaccination coverage continues to expand, and in order to achieve safe cross-border movement of people and restart the international economy, many countries are planning to launch "COVID-19 vaccine passports". "Vaccine passports" are not real passports, but certificates that record COVID-19 vaccination information to prove the vaccination status of people traveling across borders.

Starting last Friday, New Yorkers can use the U.S.'s first "vaccine passport" app, "Excelsior Pass," to prove they have been vaccinated against COVID-19 or tested negative for nucleic acid. The app will first be used in large venues such as Madison Square Garden, and will gradually cover dozens of events, arts and entertainment venues in New York State starting next week. With the help of this app, people will be able to expand the scale of weddings or banquets.

New York Governor Andrew Cuomo said he hopes to take this opportunity to promote a quick recovery in the industries most affected by the epidemic.

The Excelsior Pass system is based on blockchain technology provided by the IBM Digital Health Check Platform, which ensures that no non-essential parties, including IBM, can access private medical information.

Users only need to download the Excelsior Pass app, enter their name, date of birth and zip code, and answer a series of personal questions to confirm their true identity. The epidemic prevention data is provided by the state's vaccine registration center, and the results are linked to pre-approved test data. When users go to entertainment venues, they only need to scan the QR code to get a green check mark representing health and a red cross representing health risks.

The development of this app is funded by the state government and will be provided free of charge to businesses and people in New York State who have vaccination records or nucleic acid test results.

Eric Piscini, vice president of IBM's emerging business network, who has been deeply involved in the industry for many years, said that IBM intends to use the same technology platform to release more health data in the future.

Piscini explained that the ultimate goal is to allow everyone on the planet to collect information on their phones and disclose it to the right people after explicit consent. Users don't have to worry about privacy issues, all data will be controlled by healthcare providers, and IBM or any other partner will not be able to view the data content.

Behlendorf, who has been researching this technology for a long time, also mentioned that such a system will ensure that the data "is always centered on the patient, rather than on the healthcare provider or insurance company."

The first large-scale test of this type of system is currently underway in New York. It is reported that the development cost of the Excelsior Pass system in New York State is $2.5 million, and the results will be provided free of charge to companies and individuals.

Initial tests have shown that the system works well and can be used by all groups. Those without smartphones can still simply present a copy of their health code. People can store multiple Excelsior passes on one phone, for example, so that parents can keep health information on behalf of their children.

Businesses are not required to use the app, but if they do they will receive additional benefits - including the ability to expand the size of their events and allow more people in.

In addition, this app does not require full internet access, which greatly increases its usability. Excelsior Pass is currently available for Android and iOS systems, and companies can use the Android and iOS versions of the scan and verify app.

Several New York State officials involved in the program said they will continue to improve the Excelsior Pass system over time to provide strong support for the state's economy and public health.

In addition to IBM, retailers such as Walmart are also developing similar systems, including providing digital proof for people who have been vaccinated. In addition, several open source computer experts are also working on developing free solutions.

The biggest challenge for such applications is how to connect different systems to ensure that people can use one application to prove their health status in different occasions and with different needs.

In response, advocates of open source projects have begun to work together to "step through the pieces of the puzzle." Brian Behlendorf, executive director of the Linux Foundation's Public Health Foundation, an industry-driven open source software development organization, said, "Technical people are equivalent to setting up their own 'United Nations' to bring together the relevant parties."

At present, New York State has not released detailed details about the connection system, but the project hopes to link paper certificates with Excelsior Pass so that users can present their health code and tickets at one time, eliminating the hassle of using multiple applications.

Another major obstacle to application is how to establish a unified set of standards so that people who have completed nucleic acid testing or vaccination in one state or country can also be recognized for epidemic prevention in other states or countries.

Currently, there are at least two competing sets of vaccination safety information standards around the world when it comes to international travel.

New York State uses its own solution built by the state health department, but it is still unknown how other states in the United States will coordinate and unify their own certification systems. Amy Fairchild, dean, historian and ethicist at Ohio State University, said the biggest challenge facing such certification is cultural, not technical.

Fairchild explained, “Both IBM and Abbott could develop real applications, but the question was what would their results look like? Would people actually want to use them?”

International travel is of course the most important application scenario for the epidemic prevention pass. Many countries, including the United States, refuse entry to people who cannot prove that they are not infected with COVID-19. But she said that whether American consumers and companies are willing to accept this technical attempt to prove their own epidemic prevention before entering the country. In addition, many Americans have refused to wear masks during the epidemic, and it is hard to imagine that they are willing to use the health code to prove that they are eligible to watch baseball games or go clubbing.

In Fairchild's view, vaccination work "has long been limited to the school and hospital systems in the United States and rarely covers the entire population." But the importance of vaccination itself is unquestionable. If it can be recognized by the public, this application can also cover a wider range of areas such as influenza and measles vaccines in the future.

“These kinds of apps may even help us build a new public health infrastructure, which is really exciting.” Fairchild mentioned that previous efforts have failed due to cultural resistance and opposition. “Except for children, the American people are ideologically very resistant to this kind of mandatory directive.”

It is for this reason that developers decided to use blockchain technology to protect personal privacy. In addition, the White House also made a special statement, emphasizing that such health certification procedures must comply with the principles of freedom, fairness, security and privacy.

Furthermore, how to prevent counterfeiting is also very important. According to Chad Anderson, a senior security researcher at Domaintools, fake CDC vaccine ID cards have appeared on websites such as OfferUp, some of which are sold for as much as $200.

Other possible vaccination certification methods include marking on driver's licenses. Cimarron Buser, president and CEO of the Appointment Scheduling & Booking Industry Association, said that driver's licenses are the only universal ID that we can actually use. Each state immunization registry needs to send the information to the state vehicle registration office, and then issue a new driver's license to the relevant person. Although the process is not simple, at least it saves the trouble of presenting a separate document.

Many companies are also working hard to build their own authentication systems. Buser mentioned that all parties hope to have a say in system construction.

Standardization is a harder problem to solve. Since September, big-name companies such as Microsoft, Mayo Clinic, Oracle, Walmart, CVS, and Salesforce, as well as a number of relatively low-profile nonprofits, have been working together to ensure that people can access health information safely and for free. The good news is that all parties have at least reached a consensus on the development goal of developing a set of rules that companies or nonprofits can use to create digital vaccine passports.

But who sets those standards? Fairchild said the problem is unlikely to be solved without federal intervention.