Employers that want foolproof verification of an employee's COVID-19 vaccination status could face problems. The only proof an employee may have is the paper card issued at vaccine sites. Paper records may not be good enough for many employers or for the purposes of travel.
An alternative is a digital vaccine certificate similar to the QR code on a smartphone used to validate airline boarding passes. But a large part of the nation's 160 million workers may get vaccinated -- and may be ready to return to the office -- well before digital credentials are deployed.
The good news is that once digital vaccine certificates are in operation, HR departments may have little trouble supporting them. Some vendors are already laying the groundwork.
For instance, SAP SuccessFactors said its visa and permit management system already manages uploaded vaccine certificates and can handle COVID-19 vaccination reporting as well. Still, it needs support for QR code scanning. "We are in active discussions about how to handle digital vaccination certificates using a QR code," an SAP spokeswoman said.
Salesforce also said last month that it is integrating IBM's Digital Health Pass, a digital credential verification tool. Salesforce said its platform will enable integration of any digital health credential.
While technology vendors are building or integrating point solutions into their platforms, questions about vaccine credentialing remain, which could make getting digital records into HR's hands problematic.
There is no agreed-upon data format standard for vaccination data, and vaccination reports have to get from state databases to electronic vaccine verification systems, said Lucy Yang, co-lead at the COVID-19 Credentials Initiative (CCI).
"Every state has its own immunization record system," Yang said. "The sheer market fragmentation is going to make this challenging." CCI is part of Linux Foundation Public Health and is building an open standard, interoperable vaccine verification system on the Verifiable Credentials W3C standard.
Employers can require vaccination
Employers can require a COVID-19 vaccination under federal law, according to a recent decision by the Equal Employment Opportunity Commission (EEOC). But still unresolved is how employees verify the COVID-19 vaccination with something other than the government-issued paper card.
No employer wants to go back to paper verification, just like no employer wants to go back to using faxes to communicate.
Nadina RosierChief product officer and general manager, Health Transformation Alliance
"No employer wants to go back to paper verification, just like no employer wants to go back to using faxes to communicate," said Nadina Rosier, chief product officer and general manager of pharmaceutical solutions at Health Transformation Alliance, a cooperative of more than 60 of America's major employers, including Verizon, American Express, Coca-Cola and Shell.
Employers will generally want to know the vaccination status of their employees, Rosier said. But even then, knowing an employee vaccine status isn't a failsafe. "No vaccine, including the flu vaccine, works 100% of the time," she said.
Rosier is optimistic about technology's potential in vaccine verification. "There is going to be technology that's going to be leveraged -- it's not starting from scratch," she said.
Indeed, electronic verification is already being used in COVID-19 testing.
Bizagi Ltd., a process automation firm in the UK, developed the CoronaPass, an electronic COVID-19 test verification system used by some hospitality providers in Greece.
An employee gets tested for COVID-19 at a designated third-party medical provider. The employee receives an electronic QR code certificate that can be uploaded to the CoronaPass app and can be validated by the participating employer. The testing certificate has a specific time limit set by the employer. The same system will work with COVID-19 vaccination verification, which may also require renewal, said Gustavo Gomez, CEO at Bizagi.
"We created the CoronaPass just to help," Gomez said, "because the social impact of not doing something quickly enough is just growing by the day."
Problems ahead
There are obstacles and unresolved issues for a broader deployment of digital vaccine certificates to employers and workers. Neither President Donald Trump's administration nor President-elect Joe Biden's incoming administration have outlined a plan for electronic vaccine verification credentials. It remains unclear if such a program is a priority for Biden.
The decision as to who would issue digital vaccine certificates will come from top leadership and public authorities, CCI's Yang said. Once that decision is cleared, the Linux Foundation Public Health's "open standards allow anyone to build without having to worry about not being interoperable with each other," she said.
There is also a need for a common universal data format for reporting vaccination results that is universally recognized by any firm or nation, Yang said. She compared it to standards adopted for email.
A separate effort to develop a digital vaccine credential system is the Common Trust Network, a Geneva-based initiative that includes the World Economic Forum. It's a framework for enabling access to personal lab results and vaccination records. It aims to integrate with digital health records stored on apps such as Apple's Health or Android's CommonHealth.
There are efforts large and small to address vaccine verification and it will take data aggregation to address it, said Justin Beck, founder and CEO of Contakt World, a startup that is building a CRM-like tool to help health agencies manage their caseloads, including cases of COVID-19.
It's going to take a while for the efforts to sort themselves out, Beck said, but he believes it will happen by the fall or year-end. Government funding may be forthcoming.
Based on what Biden has said generally about public health, Beck believes the new administration plans to make "a big commitment to health equity and improving public health systems broadly," he said.
