The Evidence Base

Informing Policy in Health, Economics & Well-Being
A collaboration with
USC Dornsife Center for economic and social research

It is Time for the U.S. to Create a National COVID-19 Vaccination Registry

The United States is dealing with the latest COVID-19 wave that is now resulting in more than 1,000 daily deaths for the first time since March 2021. More than 100,000 people are hospitalized, which is the highest hospitalization rate since January 2021. Despite these predictable and heartbreaking statistics, the Biden Administration has opposed a national registry for COVID-19 vaccines that leaves Americans with a hodgepodge of state-level certificates- including many places that have a paper record-only. The U.S. is ultimately hurting itself by not having a single vaccination registry, which would enable faster reopening of key economic sectors as well as international travel.

Vaccination Registry as a Faster Way to Reopen

While Americans have long relied on state-level vaccination recordkeeping, the COVID-19 pandemic has emphasized the cost of not having a national record. More and more vaccine mandates are emerging everyday with the recent full approval of the Pfizer/BioNTech vaccine. Yet for many, proving their vaccination status may be a challenge – some of them may have received shots in different states or by different providers, and the only document they have is their CDC paper record. Reports of fake cards being offered on eBay (a federal crime), and through other means, have highlighted the need for verifiable digital vaccination records such as the centralized system in California.

As concert venues, restaurants, state agencies and others implement vaccine mandates, having a trustworthy and accessible national COVID-19 vaccination record will be of even greater importance. From an economic perspective, asking local businesses and event organizers to validate a number of different vaccination records is already resulting in inevitable shirking and rule-bending, which undermines the mandates’ public health benefits, and imposes unnecessary and avoidable costs on individuals and firms. Having a national registry, even on an opt-in basis that does not require personal information beyond one’s vaccination status, simplifies the process and would make reopening all sectors of the economy safer and faster.

Safely Restarting International Travel with a Registry

Some of the most difficult-to-understand, unscientific policies of the Biden Administration have been the long-lasting travel bans on most non-citizens/residents entering the U.S. from Europe, Brazil, China, and other locations. Many of these travelers end up ‘isolating’ in a third country, such as Mexico, where their infection risk is much higher. We wrote about better ways to manage international travel earlier this year, which may include obtaining and verifying the vaccination status of traveling individuals.

The European Union has been a global leader on this front with the EU Digital COVID Certificate, which became effective on July 1, 2021. It is used by millions of Europeans to prove their vaccination status both during travel, at restaurants, and at other venues. Both EU and UK COVID certificates are accepted by the International Air Transport Association (IATA) and can be used as a proof of vaccination for travel where accepted.

While the U.S. has long resisted this approach, it may find itself in a more difficult position as the EU reimposes travel restrictions on unvaccinated Americans. While most of the traveling public is likely to be vaccinated, and few infections are linked to travel (given the enormous community spread underway, travel is likely responsible for less than 0.1% of daily cases), vaccine mandates for travelers are still beneficial from a public health perspective. They encourage vaccination and result in a lower probability that an infectious individual boards a plane and spreads COVID to their fellow passengers. Other precautions, such as testing and face coverings – could be required as long as needed, too.

A mutually recognized and verifiable vaccination record would allow for a safer reopening of international travel to and from the U.S.  Millions of families could reconnect and provide caregiving support after nearly two years of restrictions. Many employers and employees could conduct job interviews and trade visits, and entrepreneurs could start new companies. It’s hard to overstate the missed opportunity by not having such a tool available, especially with the knowledge that COVID-19 will not go away anytime soon, and most U.S. states have a long way before the current COVID-19 wave is suppressed.

Opting-In: A National COVID-19 Vaccination Record

Luckily, solutions are available and have been successfully implemented elsewhere. A national COVID-19 vaccination record would not require that all Americans submit their vaccination records to a centralized register or require that personal data be shared with international partners. An initial solution based on an opt-in registry may allow those who need to travel, or otherwise prove their vaccination status, to present a trusted digital record to international and domestic partners without the need to access personal information. Other countries outside the U.S. and EU may follow suit by reopening their borders to such individuals. Restrictions on travel in Canada, Australia, New Zealand and other partners comes to mind. As vaccines become more available all around the world, mutual recognition of vaccination records will be crucial – with the caveat that all vaccines recommended by the World Health Organization should receive recognition by the U.S. when it comes to international travel, and not just those with an FDA approval.

If the Biden Administration changes course, implementing a technical solution will not be complicated at all – especially if it involves talented programmers drawing on public-private partnerships. In Europe it was a matter of weeks before such a tool was developed. A National COVID-19 Vaccination Record could become one of the key tools needed to safely reopen and minimize further economic and human losses due to the COVID-19 pandemic.