COVID-19 immunity licenses can be ethical in principle but in practice depend on 4 important questions related to both the actual evidence and effective implementation… First, serology tests used to determine whether someone has had COVID-19 for licensing purposes must be valid and reliable, with high specificity and sensitivity.
…
Second, immunity-based licensing requires evidence that a positive serology test result indicates immunity. Otherwise, licenses could cause more harm than good by creating a false sense of immunity and facilitating spread.
…
Third, in the absence of a vaccine, the benefits of licenses might encourage uninfected people to relax protective measures or actively seek infection.
Fourth, the benefits of immunity licenses could encourage forgery, illegal markets, or fraud by unethical physicians or testing facilities. These problems underscore the need for careful implementation through strategies like anticounterfeiting designs, cryptographic or biometric features, and reliable chains of verification for tests.
…
Immunity-based licenses have the potential to help realize important values, including enhancing the liberty of individuals who have been infected with COVID-19 without worsening the situation of those who have not been infected, maximizing benefits to individuals and society by allowing immune people to engage in economic activity, and protecting the least advantaged by allowing safer care for vulnerable populations.
