A public health ethic should inform policies on COVID-19 immunity passports.

In their Personal View, Rebecca Brown and colleagues argue for the implementation of so-called COVID-19 immunity passports to allow individuals presumed immune to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to move through society under reduced social distancing and other restrictions. Brown and colleagues contend that constraining these individuals’ freedom of movement is a serious breach of personal liberty. We vehemently reject the political philosophy of liberal individualism that undergirds this argument and thus the conclusion in support of immunity passports.

An ethic of liberal individualism prioritises the autonomy of independent individuals over the wellbeing of the community. By stark contrast, a communitarian ethic prioritises the health of the community and, by extension, the individuals who make up that community, with special attention to those at greater risk of harm. More specifically, a public health ethics grounded in communitarian values tolerates restrictions on individual freedoms in pursuit of the common good. Mask mandates for everyone (including ill and otherwise healthy individuals) is an example of life-saving public health ethics in action.

This important philosophical divide is well illustrated when comparing the Personal View by Brown and colleagues with two commentaries we have written on immunity passports.2, 3 Brown and colleagues agree with us on many of the shortcomings of immunity passports. They acknowledge that there are “considerable challenges in measuring and inferring immunity to SARS-CoV-2”, that “the production of fraudulent passports” is a risk to public health, and that because “race and socioeconomic status influence the health care that people access and the treatment they receive” these factors would also limit access to an immunity passport programme.

What differs is our ethical reasoning. We reject immunity passports because they threaten the wellbeing of the community, increasing risks for discrimination, instigating perverse incentives to seek out infection, and further stratifying society across a novel biological divide.

Employing a philosophy of liberal individualism to steer policy decisions can have lethal consequences during a global pandemic. One only needs to compare COVID-19 deaths between a country that prioritises the individual, such as the UK (as of Dec 2, 58 448 deaths in a population of nearly 68 million), and a country that prioritises the community, such as South Korea (526 deaths in a population of just over 51 million). Readers should reflect carefully on the philosophies that undergird different perspectives on the ethical acceptability of COVID-19 immunity passports. Not doing so puts individuals and the communities they are part of at risk.