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What Happens After Receiving A COVID-19 Vaccine?


There have been tears of happiness and relief. And standing outside a Pfizer plant in Portage, Mich., a reporter from the Detroit Free Press recorded these first moments of vaccine distribution trucks leaving the facility to this reaction.


KRISTEN SHAMUS: The FedEx driver is waving to the crowd as the truck pulls out. It's headed to the arms of American people.

GARCIA-NAVARRO: But questions do remain about how those who've received the vaccine will be tracked and monitored here in the United States and all around the world. The U.S. government said last week that American employers could require workers to get the vaccine and keep them from the workplace if they don't comply. Some others have proposed the idea of an immunity passport or some sort of documentation that shows a person is up to date on their COVID-19 vaccines before they can enter big festivals, concerts or even traveling to another country. To help us sort through some of the proposals is Thomas Bollyky. He's a senior fellow for global health, economics and development and the director of the Global Health Program at the Council on Foreign Relations. Welcome back to the program.

THOMAS BOLLYKY: Thanks so much for having me.

GARCIA-NAVARRO: All right. Immunity or vaccine passports - explain to us how this could work.

BOLLYKY: So vaccine passports are an old idea. They are documents that were developed around yellow fever to indicate that travelers had been immunized and therefore would be safer to enter into other nations. These documents are still required. They're legal under international law, and most airline carriers will enforce the requirement to have them before you get on a plane.

GARCIA-NAVARRO: So this is, like, the passport that's normally yellow, and it has written inside of it the different vaccinations that you may have had. Is that what you're referring to?

BOLLYKY: That's exactly right.

GARCIA-NAVARRO: But there's already been some pushback even to the idea of having some sort of proof. The British minister for vaccine deployment suggested that, quote, "proof of vaccination would be required at restaurants, bars, sporting events." But then there was a huge outcry, and he had to walk back the statement.

BOLLYKY: Yeah. So the issue is going to be for some period of time - well there are going to be a couple. First is that access is going to be limited. So internationally, really, just a handful of countries are going to have access to vaccines. And that may be true, really, all the way into 2022 and perhaps even later. But then there's also the issue of privileging people's immune status as an ability to be able to participate in economic life.

GARCIA-NAVARRO: So do you think there needs to be a unified system? Or should it be sort of the pharmacy or the doctor that gives you your vaccination can simply certify that it was done?

BOLLYKY: I think there needs to be a unified system. So first and foremost, we need to encourage access. So we need to have enough access, both domestically and internationally, to justify this system. Second, we need to do the scientific research that can make these certifications valid. So it's not entirely clear yet how long immunity from these vaccines will last, whether or not those who are vaccinated can still spread infection - all those are research that still needs to be done. The last is on the technical issues. We do need to make sure that privacy is maintained and that we can authenticate the validity of these certificates, so you don't see fraud and unscrupulous behaviour spur up around all this.

GARCIA-NAVARRO: And how far along is the United States, for example, in that process - or elsewhere?

BOLLYKY: We're so early in these days. The World Health Organization just this week announced that it's beginning to explore smart vaccination certificates for global use. So they formed a commission. It's going to be based on a digital version of those yellow cards. The United States and the United Kingdom are issuing personal record cards as part from medical providers for vaccinations, but these are not meant yet to be used as either passports to restaurants or broader society, let alone internationally. What is filling the void are companies. So airline carriers, which are absolutely desperate for travelers, are starting to invest in apps that might be able to link to immunization status. And that really calls for some oversight to make sure that these protect privacy and are scientifically justifiable in what they purport to verify.

GARCIA-NAVARRO: All this really points to this larger issue of exactly who is going to get the vaccine when, which countries are going to be more privileged than others. What are you seeing on that front? I mean, there does seem to be already quite a bit of inequity.

BOLLYKY: So for the first vaccine that has been authorized, the Pfizer vaccine, the U.S. is making moves this week to exercise its option to buy 500 million more doses, potentially jumping the queue. If they do, that will be 94% of the supply of that vaccine through to the end of 2021 that has been purchased by a handful of countries. It's not just the U.S., though. Japan, Australia, Canada have less than 1% of the world's coronavirus cases, but they have locked up more doses of potential vaccines than all of Latin America and the Caribbean combined, which has close to 20% of the cases. It may be until years before we start to see access being widespread in low- and middle-income countries. And just this week, internal documents leaked from the multilateral initiative meant to share access to vaccines said it has a high risk of failure because it has been starved of resources and been left to compete with these large purchases by wealthy nations.

GARCIA-NAVARRO: That's Tom Bollyky of the Council on Foreign Relations and a vaccine expert. Thank you very much.

BOLLYKY: My great pleasure. Thanks for having me.

(SOUNDBITE OF BASSTI'S "ORANGES IN WINTER") Transcript provided by NPR, Copyright NPR.

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