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Published online by Cambridge University Press: 05 July 2021
Socioeconomic disadvantages are amplified by the COVID-19 pandemic all over the world. Public actions and omissions severely affect the poor, alongside their precarious living, health and working conditions. As we slowly prepare for the aftermath of the pandemic, thanks to the progression of vaccination, especially in developed countries, certain measures taken in this context, more specifically the “vaccination certificates”, are likely particularly to affect the poor, who usually also belong to other vulnerable groups such as ethnic minorities or single parents, and could eventually constitute for them a state of permanent quarantine. In this contribution, I argue that COVID-19 vaccination certificates are a slippery slope towards exclusion and stigmatisation of the poor through a bureaucratic system based on privileges that raises important questions in light of the fundamental rights of the people who reside at society’s margins, struggling to conform to the “phantom of normalcy”.
Many thanks to Harry Panagopulos and Professor Alberto Alemanno for their great input on a previous version of this paper. The usual disclaimers apply.
1 See, eg, Art 3(a) “Proposal on a framework for the issuance, verification and acceptance of interoperable certificates on vaccination, testing and recovery to facilitate free movement during the COVID-19 pandemic (Digital Green Certificate)” COM(2021)130 final, Brussels, 17 March 2021.
2 See the official website about the Green Pass: <https://corona.health.gov.il/en/directives/green-pass-info/> (last accessed 12 April 2021).
3 See the official website about the Excelsior Pass: <https://covid19vaccine.health.ny.gov/excelsior-pass> (last accessed 12 April 2021).
4 Euronews, “Denmark among first in Europe to introduce COVID pass scheme” (6 April 2021).
5 Proposal for a Digital Green Certificate regulation, supra, note 1. On this proposal, see the contribution of DV Kochenov and JD Veraldi, “The Commission against the Internal Market and European Union Citizens: Trying to Shoot Down Sputnik with the ‘Digital Green Certificate’?”, in this issue.
6 MA Hall and DM Studdert, “‘Vaccine Passport’ certification – policy and ethical considerations” (2021) New England Journal of Medicine 10.1056/NEJMp2104289.
7 E Albin et al, “The Israeli ‘Green Pass’: promoting vaccination from a human rights and equity perspective”, in this issue.
8 M Tazzioli and J Häkli, in this issue.
9 B Burström and W Tao, “Social determinants of health and inequalities in COVID-19” (2020) 30(4) European Journal of Public Health 617–18; J Patel, “Poverty, inequality and COVID-19: the forgotten vulnerable” (2020) 183 Public Health 110–11; R Blundell, “COVID-19 and inequalities” (2020) 41(2) Fiscal Sudies 311–13; C Bambra et al, “The COVID-19 pandemic and health inequalities” (2020) 74 Journal of Epidemiology and Community Health 964–68.
10 Bambra et al, supra, note 9, 964–68; E Sydenstricker, “The incidence of influenza among persons of different economic status during the epidemic of 1918: commentary” (1931) 36(4) Public Health Reports 154–70.
11 Bambra et al, supra, note 9, 964–68.
12 ibid; Burström and Tao, supra, note 9, 617–18.
13 Bambra et al, supra, note 9; M Buheji et al, “The extent of COVID-19 pandemic socioeconomic impact on global poverty. A global integrative multidisciplinary review” (2020) 10(4) American Journal of Economics 220.
14 K Pouliakas and J Branka, “EU jobs at highest risk of Covid-19 social distancing: is the pandemic exacerbating the labour market divide?” (2020) Cedefop working paper; L Gamio, “The workers who face the greatest coronavirus risk”, NYTimes (15 March 2020).
15 V Hernanz et al, “Take-up of Welfare Benefits in OECD countries: a review of the evidence” (2004) OECD Social, Employment and Migration Working papers no. 17; B Baumberg, “The stigma of claiming benefits: a quantitative study” (2016) 45(2) Journal of Social Policy 181–99; M Fuchs et al, “Falling through the social safety net? Analysing non-take-up of minimum income benefit and monetary social assistance in Austria” (2020) 54 Social Policy Administration 827–43; S Chareyron and P Domingues, “Take-up of social assistance benefits: the case of the French homeless” (2018) 64(1) Review of Income and Wealth 170–91.
16 E Beaunoyer et al, “COVID-19 and digital inequalities: reciprocal impacts and mitigation strategies” (2020) 111 Computers in Human Behavior 106424; MM Jæger and EH Blaabæk, “Inequality in learning opportunities during Covid-19: evidence from library takeout” (2020) 68 Research in Social Stratification and Mobility 100524; Special Rapporteur on Extreme Poverty and Human Rights, Looking Back to Look Ahead: A Rights-based Approach to Social Protection in the Post-COVID-19 Economic Recovery (2020) United Nations, para 44.
17 R Armitage and L Nellums, “The COVID-19 response must be disability inclusive” (2020) 5 The Lancet e257; S Hennette-Vauchez, “L’urgence (pas) pour tou(te)s” (2020) La Revue des Droits de l’Homme 10.4000/revdh.8986.
18 S Body-Gendrot, “Police marginality, racial logics and discrimination in the banlieues of France” (2010) 33(4) Ethnic and Racial Studies 656–74; F Jobard et al, “Mesurer les discriminations selon l’apparence: une analyse des contrôles d’identité à Paris” (2012) 67(3) Population 423–51; Amnesty International, Policing the Pandemic Human Rights Violations in the Enforcement of COVID-19 Measures in Europe (2020) 5.
19 T Helm et al, “£10,000 fines warning for failing to self-isolate as England Covid infections soar”, The Guardian (20 September 2020).
20 Art 12(2)c) International Covenant for Economic, Social and Cultural Rights and General Comment n°14 of the Committee on Economic, Social and Cultural Rights, The right to the highest attainable standard of health (Twenty-second session, 2000), U.N. Doc. E/C.12/2000/4 (2000), para 16. See also see Art 11(3)d) European Social Charter and European Committee for Social Rights.
21 European Social Charter and European Committee for Social Rights, Conclusions XV-2, Belgium, Art 11-3, 31 December 2001.
22 Vavricka and Others v. the Czech Republic, app no. 47621/13 and five other applications (ECHR, 8 April 2021), para 277.
23 WHO, “COVID-19 and mandatory vaccination: Ethical considerations and caveats”, Policy brief, 13 April 2021.
24 P Peretti-Watel, “Attitudes toward vaccination and the H1N1 vaccine: poor people’s unfounded fears or legitimate concerns of the elite?” (2014) 109 Social Science and Medicine 10–18.
25 D Gruener, “Immunity certificates: if we must have them, we must do it right” (2020) COVID-19 Rapid Response Impact Initiative – White Paper 12, Edmond J. Safra Centre for Ethics – Harvard University; Le défenseur des droits, Les refus de soins opposés aux bénéficiaires de la CMU-C, de l’ACS et de l’AME (2014) 14.
26 V Gamble, “Under the shadow of Tuskegee: African Americans and health care” (1997) 87 American Journal of Public Health 1773–78.
27 M Dunai, “‘Falling like flies’: Hungary’s Roma community pleads for COVID help”, Reuters (31 March 2021).
28 M Razai et al, “Covid-19 vaccine hesitancy among ethnic minority groups” (2021) 372 BMJ 513.
29 L Bogart et al, “COVID-19 related medical mistrust, health impacts, and potential vaccine hesitancy among Black Americans living with HIV” (2021) 86(2) Journal of Acquired Immune Deficience Syndrome 200–07.
30 Albin et al, supra, note 7.
31 E Paul et al, “Attitudes towards vaccines and intention to vaccinate against COVID-19: implications for public health communications” (2021) 1 The Lancet Regional Health – Europe 100012; M Schwarzinger et al, “COVID-19 vaccine hesitancy in a representative working-age population in France: a survey experiment based on vaccine characteristics” (2021) 6 Lancet Public Health 210–21; AS Walker, “Pandemic’s racial disparities persist in vaccine rollout” NYTimes (5 March 2021).
32 PICUM, The COVID-19 Vaccines and Undocumented Migrants: What Are European Countries Doing? (2021).
33 JAGM Van Dijk, “Digital divide: impact of access” in P Rössler, CA Hoffner and L Zoonen (eds), The International Encyclopedia of Media Effects (Hoboken, NJ, Wiley-Blackwell 2017). It overlaps with a urban/rural divide and a age gap (Eurostat, “Digital economy and digital economy statistics at regional level” (2021)), as well as gender gap (ITUpublications, “Measuring digital development, facts and figures” (2019)).
34 Gruener, supra, note 25; A Perrin and E Turner, “Smartphones help blacks, Hispanics bridge some – but not all – digital gaps with whites” (2019) Pew Research Center.
35 J James, “Confronting the scarcity of digital skills among the poor in developing countries” (2021) 39 Developmental Policy Review 327–30 (concerning the question of smartphones in developing countries). As an example of how the digital divide is likely to affect poverty, see: I Mingo and R Bracciale, “The Matthew Effect in the Italian digital context: the progressive marginalisation of the ‘poor’” (2018) 135 Social Indicators Research 629–59.
36 WHO, supra, note 23, 2.
37 Eurostats, “EU citizens living in another Member States – Statistical Overview” (2021).
38 ibid.
39 Albin et al, supra, note 7.
40 See supra, note 15.
41 Special Rapporteur on Extreme Poverty and Human Rights, supra, note 16, para 20.
42 Administrative costs involving long periods spent queuing, filling in forms and obligations to report detailed information and provide extensive documentation to the welfare agencies appear to play an important role in non-take-up.
43 While stigma plays a role, the literature seems divided on the magnitude of its impact. See Fuchs et al, supra, note note 15. See also H Kayser and J Frick, “Take it or leave it: (non-)take-up behavior of social assistance in Germany” (2000) 121(1) Journal of Applied Social Science 27–58; J Stube and K Kronebusch, “Stigma and other determinants of participation in TANF and Medicaid” (2004) 23(3) Journal of Policy Analysis and Management 509–30; Baumberg, supra, note 15; O Hümbelin, “Non-take-up of social assistance: regional differences and the role of social norms” (2019) 45(1) Swiss Journal of Sociology 7–33 (claiming that stigma plays an important role) and see also K Bruckmeier and JüJ Wiemers, “A new targeting: a new take-up?” (2012) 43 Empirical Economics 565–80; J Currie, “The take-up of social benefits” (2004) IZA Discussion Papers, No. 1103, Institute for the Study of Labor (claiming that stigma plays a role, but a more limited role).
44 M Nagrecha, “The limits of fairer fines: lessons from Germany” (Criminal Justice Policy Program, Harvard Law School, 2020). See also: Lăcătuş v. Switzerland, app no. 14065/15 (ECHR, 19 January 2021). This question has been much more documented and researched in the USA: NL Sobol, “Charging the poor: criminal justice debt & modern-day debtors’ prisons” (2016) 75 Maryland Law Review 486; T Atkinson, “A fine scheme: how municipal fines become crushing debt in the shadow of the new debtors’ prisons” (2016) 51 Harvard Civil Rights- Civil Liberties Law Review 189; Note, “Fining the indigent” (1971) 71 Columbia Law Review 1281; TB Harvey, “Jailing the poor” (2017) 42 Human Rights 16.
45 S Hannett, “Equality at the intersections: the legislative and judicial failure to tackle multiple discrimination” (2003) 23 Oxford Journal of Legal Studies 65; K Crenshaw, “Demarginalizing the intersection of race and sex: a Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics” (1989) 8(1) University of Chicago Legal Forum 139–67; S Atrey, “The intersectional case of poverty in discrimination law” (2018) 18 Human Rights Law Review 411.
46 L Platt and R Warwick, “Are some ethnic groups more vulnerable to COVID-19 than others?” (2020) The IFS Deaton Review.
47 Hennette-Vauchez, supra, note 17.
48 S Fredman, “Redistribution and recognition: reconciling inequalities” (2007) 23 South African Journal on Human Rights, 214–15.
49 S Fredman, “The potential and limits of an equal rights paradigm in addressing poverty” (2011) 3 Stellenbosch Law Review 567.
50 S Ganty, “Poverty as misrecognition: what role for anti-discrimination law in Europe?” (2021) Human Rights Law Review (forthcoming).
51 MA Fineman, “The vulnerable subject: anchoring equality in the human condition” (2008) 20(1) Yale Journal of Law and Feminism 21. As for the proportionality question, see Section IV.
52 A Timmer, “Toward an anti-stereotyping approach for the European Court of Human Rights” (2011) 11(4) Human Rights Law Review 714.
53 ibid., 715. See also: Human Rights Council United-Nations General Assembly, Final Draft of the Guiding Principles on Extreme Poverty and Human Rights, Submitted by the Special Rapporteur on Extreme Poverty and Human Rights, Magdalena Sepúlveda Carmona (2012) A/HRC/21/39, 4–8.
54 V Earnshaw, “Don’t let fear of Covid-19 turn into stigma” (2020) Harvard Business Review; L Manderson and S Levine, “COVID-19, risk, fear, and fall-out” (2020) 39(5) Medical Anthropology 367–70.
55 Amnesty International, “Mesures prises face à la COVID-19 et obligations des états en matière de droits humains : observations préliminaires” (2020).
56 UNAIDS, “Addressing stigma and discrimination in the COVID-19 response” (2020); R Creţan and D Light, “COVID-19 in Romania: transnational labour, geopolitics, and the Roma ‘outsiders’” (2020) 61(4–5) Eurasian Geography and Economics 559–72.
57 J Mokaya et al, “A blind spot? Confronting the stigma of hepatitis B virus (HBV) infection – a systematic review” (2018) 21(3) Wellcome Open Research 29.
58 Earnshaw, supra, note 54.
59 The fine imposed amounts to EUR 330.
60 A Barak, Proportionality, Constitutional Rights and Their Limitations (Cambridge, Cambridge University Press 2012) p 131; V Jackson, “Proportionality and equality” in V Jackson and M Tushnet (eds), Proportionality and Equality in Proportionality, New Frontiers, New Challenges (Cambridge, Cambridge University Press 2017) p 175.
61 WHO, supra, note 23, 2.
62 WHO, “Interim position paper: considerations regarding proof of COVID-19 vaccination for international travellers”, 5 February 2021. In the same vein, the organization has opposed the immunity certification: TC Voo et al, “Immunity certification for COVID-19: ethical considerations” (2020) 99(2) Bulletin of the World Health Organization 155–61.
63 Vavřička and Others v. the Czech Republic, supra, note 22.
64 The margin of appreciation of the state is also wide when it comes to a direct compulsory vaccination, although see: Solomakhin v. Ukraine, app no. 24429/03 (ECHR, 15 March 2012); Boffa and others v. San-Marino, app no. 26536/95 (ECHR, 15 January 1998).
65 Vavřička and Others v. the Czech Republic, supra, note 22.
66 Dissenting opinion of Judge Wojtyczek in Vavřička and Others v. the Czech Republic, supra, note 22, para 18.
67 Z Vikarská, “Is compulsary vaccination compulsary?”, VerfBlog (12 April 2021).
68 Vavřička and Others v. the Czech Republic, supra, note 22, para 162.
69 H Hershkoff and AS Cohen, “Begging to differ: the First Amendment and the right to beg” (1991) 104(4) Harvard Law Review 912.
70 See references in note 40, supra.
71 Comment n°14 of the Committee on Economic, Social and Cultural Rights, supra, note 20, para 3.
72 A Roy, “The pandemic is a portal”, Financial Times (3 April 2020).
