Apps to Let Travelers, Others Show
COVID-19 Status

Christine Lehmann, MA

January 14, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Americans who get vaccinated against COVID-19, and use a digital health "passport" to prove it, may have an easier time traveling this year and being admitted to things like concerts, sporting events, and museums.

With tourism and other economic sectors largely shuttered by the pandemic, countries are eagerly looking at alternatives to travel restrictions and quarantine to safely reopen their borders.

Cyprus last month became the first European Union member state to announce it would open its borders in March to vaccinated travelers. Those travelers would not need to show proof of a negative COVID-19 test. The announcement is part of a plan by Cyprus to resume flights to the country, which relies heavily on tourism.

In Israel, which is vaccinating its residents quickly against the virus, the health ministry has unveiled a "green passport" that will allow people who are vaccinated or recovered from COVID-19 to attend large things like conferences, cultural events, and sporting events. Health officials say those who test negative for the virus could receive a temporary green passport for 72 hours, while passports granted to those who have been vaccinated or recovered from COVID-19 will be valid for 6 months, according to The Times of Israel.

The passport is available on a smartphone application, interactive voice recognition, or it can be printed out, according to TheTimes.

Australia's Qantas Airways announced in November that once a coronavirus vaccine was available, passengers hoping to fly on the airline would need to prove they had taken it. "I think that's going to be a common thing, talking to my colleagues in other airlines around the globe," Alan Joyce, the airline's chief executive, said in an interview with Australia's Nine Network.

But the World Travel and Tourism Council, which represents the global travel and tourism private sector, together with Airports Council International, the World Economic Forum, and International Chamber of Commerce, want international travel to be restored without waiting for vaccinations.

"They must not be a requirement to travel, as this will further delay the revival of the already ailing travel and tourism sector, which needs to restart now to save itself, millions of jobs in the sector and beyond, and the global economy," the council said in a December news release.

Public health experts say it's premature to abolish travel requirements such as testing with so many unknowns about the COVID-19 vaccine.

"I do think we have a lot to learn about vaccination and immunity passports before they can be used. I don't think it will be long before we know the truth about transmission or at least about whether the vaccinated are carriers for the virus," says Julie Parsonnet, MD, a professor of epidemiology and population health at Stanford University in Palo Alto, CA.

"There is modest evidence about some of the vaccines that they have some impact on transmission and infection, but how much is unclear. They are certainly not completely protective. Testing would be more meaningful than the vaccine at this point," says Marc Lipsitch, DPhil, a professor of epidemiology and director of the Center for Communicable Disease Dynamics at the Harvard T.H. Chan School of Public Health in Boston.

Digital Health Passport Apps

Requiring travelers to show proof of vaccination is not new. The first International Certificate of Inoculation and Vaccination was established by the International Sanitary Convention for Aerial Navigation in 1933 in The Hague, Netherlands, and then later adopted by the World Health Organization. Known as the "yellow card," in part because many countries require vaccination against yellow fever, travelers still use the paper document to meet government requirements for vaccination against contagious diseases, including typhus and smallpox.

The COVID-19 pandemic has spurred nonprofits and tech companies to create secure and verifiable digital versions of the paper "yellow card" that are "contactless," much like mobile boarding passes.

Research from a September survey by the International Air Transport Association (IATA) shows that 70% of passengers had concerns about handing over their passport, phone, or boarding pass to airline agents, security staff, or government officials at the airport, and 85% of travelers said that touchless processing throughout the airport would make them feel safer.

Residents of Los Angeles County who are vaccinated against COVID-19 can ask for a digital record. The county partnered with Healthvana to allow users to download the record to their Apple Wallet or a similar Google platform for airline travel or other purposes.

Residents of several countries, including the United States, will soon be able to download health "passport" apps on their Android and Apple cellphones. Users will verify their identity, retrieve their COVID-19 test results or vaccination records, and allow airlines to know their COVID-19 status. They can even display their status as a QR code on their cellphones when they board planes or enter venues.

Several airlines have been involved in testing these apps. United Airlines passengers on a flight from London to Newark, NJ, took part in the first U.S. trial of CommonPass, a digital health "passport" created by the World Economic Forum and Commons Project, a nonprofit focusing on public digital services, based in Geneva, Switzerland.

"We're done with testing and are now in the deployment phase to our initial partners — JetBlue, United, Lufthansa, Swiss International Airlines, and Virgin Atlantic," says Paul Meyer, CEO of the Commons Project Foundation in New York City.

In addition, Airport Council International, a group representing almost 2,000 airports around the world, has signed on to use CommonPass. Three major airline alliances — oneworld, Star Alliance, and SkyTeam — that represent most of the world's airlines have expressed support for its approach and use.

CommonPass, like the CommonHealth personal health record app, allows users to electronically link to more than 350 health systems in the U.S. to access their health records, says Meyer. The nonprofit is now focusing on making COVID-19 vaccination records available in standard digital formats.

"We expect some airlines, countries, workplaces, and venues will require COVID-19 vaccination certificates, while others will require testing results, and some may require a combination," says Meyer.

Singapore was the first country to test the AOKPass by the International Chamber of Commerce, which represents more than 45 million companies in over 100 countries.

In late December, a Singapore Airlines passenger returning from Japan successfully presented his digital health certificate using the AOKPass to immigration officials at a Singapore airport. The International Chamber of Commerce plans to make the AOKPass available to residents of Indonesia and Malaysia next, according to a news release.

The Travel Pass, from the International Air Transport Association, is expected to be released by the end of March and will also be available on Apple and Android devices. The app was tested on Singapore Airlines last month, and trials on U.S. airlines are expected soon, according to an email from Perry Flint, a spokesperson for the association. The open-source app will connect with labs, health registries, and airlines that can provide the latest information on border entry requirements. "We expect that many airlines will choose to incorporate some or all of the IATA Travel Pass modules in their own apps," says Flint.

Security and Privacy

The airlines are eager to prevent forged or doctored documents of negative COVID-19 test results that have been reported in the media. These apps offer protection against that.

VeriFLY is a digital platform that verifies the user's identity and allows passes to be added from a variety of destinations, including airports. "Our design ensures the privacy of the individual and keeps the credentials and biometric data of the person on the device," VeriFLY says on its website.

VeriFLY and IATA Travel Pass use biometric data to verify an individual's identity. For example, users of the IATA Travel Pass take a selfie that is matched with a digital biometric photo on their passport. "This verifies that the passport belongs to the person in front of the phone and that the passport is genuine and has not been tampered with," says Flint.

The World Health Organization is developing digital standards that will make these vaccine records or test results "vastly more secure and will dramatically reduce fraud. When ready, the IATA Travel Pass will be able to accommodate such new global standards," the IATA said in a statement.

The CommonHealth system uses its network of public and private partners to assess whether the information comes from a certified lab or medical system, and then whether it satisfies the health screening requirements of the country that travelers want to enter. Validation is provided through a simple digital code, but the underlying health information stays private, says Meyer, the Commons Project Foundation CEO.

The mobile app developers emphasize that travelers remain in control of their data, there is no centralized database, and their privacy is protected. "The IATA Travel Pass does not store any data centrally. It simply links entities that need verification (airlines and governments) with the test or vaccination data when travelers permit. This last point is key. No verification will go to an airline or a government without the authorization of the traveler," says Flint.


Julie Parsonnet, MD, professor of epidemiology and population health, Stanford University, Palo Alto, CA.

Marc Lipsitch, DPhil, professor of epidemiology and director, Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston.

Paul Meyer, CEO, Commons Project Foundation, New York City.

Perry Flint, spokesperson, International Air Transport Association.

Schengen Visa Info News: "Cyprus Plans to Open Borders in March for Travelers Vaccinated for COVID-19."

World Travel and Tourism Council: "International travel can safely restart, without waiting for vaccines, says WTTC and industry bodies."

The Times of Israel: "Health Ministry says vaccinated, recovered to get ‘green passport' for 6 months."

GlobeTrender: "Immunity Passports: Qantas Will Demand ‘Proof of Vaccination' to Fly."

Bloomberg News: "Los Angeles Vaccine Recipients Can Put the Proof in Apple Wallet."

The New York Times: "9 Ways the Pandemic Will Change Travel in 2021."

Axios: "Even with vaccine, COVID tests will be the passport to travel in 2021."

Afar magazine: "When will we be able to travel to Europe?" "A New COVID ‘Passport' Being Tested at Newark and Heathrow Could Help Reopen Global Travel."

The Washington Post: "Tourists are buying fake covid-19 test results on the black market to travel."

International Air Transport Association: "IATA Unveils Key Design Elements of IATA Travel Pass," "IATA Travel Pass Key to Reopening Borders Safely."

The Commons Project: "World's Airports And Leading Airlines Join CommonTrust Network And Begin Roll-out Of CommonPass In December In Support Of Safer Border Reopening."

International SOS: "First Use of a Digital COVID-19 Health Certificate to Cross an International Border Completed by Traveller to Singapore."

World Health Organization: "International Certificate of Vaccination or Prophylaxis, International Health Regulations (2005)."

Wikipedia: "International Certificate of Vaccination or Prophylaxis."

International Chamber of Commerce.