Vaccine passports are a big topic of discussion at the moment, but do you ever wonder how one might look? New U of T Scarborough research gives us a glimpse of the earliest evidence of such certification.
Two of the possible hundreds of immunity passes printed in 19th century Gibraltar are housed at the Gibraltar Museum. The cards state the person's name, age and confirmation of immunity, which was certified by a physician.
In 1828, health officials administered immunity passes during a fourth yellow fever epidemic that hit Gibraltar, a British Overseas Territory located on Spain’s southern coast. With knowledge that an individual was immune once they survived the mosquito-transmitted disease, the passes were one of many public health measures implemented to control case counts.
We’re in a period where we are in a prolonged crisis and should face it with concern for the well-being of the global community as a whole.
“Back in 1828, a vaccine passport was given if you got the disease and survived. This pass allowed you free movement to be an active participant in a community,” says Larry Sawchuk, a professor in the department of anthropology at U of T Scarborough.
“To the best of our knowledge, this is the first living example of a vaccine passport or means by which you can identify who was susceptible and who was not.”
The research, published in BMJ Global Health, explores parallels to the strategies and precautions placed in 19th century Gibraltar to today’s large-scale response in the fight against COVID-19. The paper is co-authored by Lianne Tripp, a former grad student at U of T Scarborough and current assistant professor teaching anthropology at the University of Northern British Columbia.
“There are remarkable differences in terms of the transferability of COVID-19 compared to yellow fever, but there are commonalities in how we can look at the past to treat epidemics,” says Sawchuk, whose research focuses on historic epidemics in Gibraltar and Malta.
Gibraltar was struck by yellow fever in September 1804, where approximately 2,200 people died within four months. Although the disease is spread by the bite of an infected mosquito, yellow fever was (falsely) believed to be contagious until 1828. In the 1810 yellow fever epidemic, those infected were forcibly placed to quarantine at an encampment called Neutral Ground.
By the end of the 1828 epidemic, 4,000 civilians, who never had yellow fever, were allocated to Neutral Ground for approximately four months. The death rate at its hospital was 19.75 per 1000 people, largely because of the lack of mosquitos due to its location away from water. In comparison, the mortality rate for those living in town was five times higher.
Sawchuk explains that the coordination of resources to control the disease – like printing immunity passes, contact-tracing, reporting lack of cleanliness, and quarantine for thousands of citizens – shows Gibraltar was ahead of its time.
“It took a phenomenal amount of resources, thoughtfulness and management to put thousands of people in quarantine. That’s pretty novel for 200 years ago,” Sawchuk says.
So, what are some fundamental lessons from the past when it comes to navigating a pandemic? Aside from health and safety measures, Sawchuk says that one takeaway is trust in the experts, like epidemiologists, to explain how a disease works in populations – including the best way to respond to it.
“I think one of the lessons we can learn is that we have to have more faith in science and health care providers,” Sawchuk says.
While there are questions about the complexity of COVID-19, tackling misinformation, the importance of building trust and overall care for our community is another lesson we can learn from 19th century Gibraltar.
“We’re in a pandemic now that has lasted two years. The last pandemic was the 1918/19 influenza, which lasted about nine months,” Sawchuk says.
“We’re in a period where we are in a prolonged crisis and should face it with concern for the well-being of the global community as a whole.”