The International Certificate of Vaccination or Prophylaxis (ICVP), also known as the Carte Jaune or Yellow Card, is an official vaccination report created by the World Health Organization (WHO). [1] As a travel document, it is a kind of medical passport that is recognised internationally and may be required for entry to certain countries where there are increased health risks for travellers. [1]
The ICVP is not an immunity passport; the primary difference is that vaccination certificates such as the ICVP incentivise individuals to obtain vaccination against a disease, while immunity passports incentivise individuals to get infected with and recover from a disease. [2]
Various schemes for health passports or vaccination certificates have been proposed for people who have been vaccinated against COVID-19.
The ICVP's nickname Yellow Card or its French equivalent Carte Jaune derives from the yellow colour of the document. The fact that yellow fever is a commonly required vaccination for travel has contributed to the document's association with the colour yellow, even though the ICVP can cover a wide range of vaccinations and booster shots, not just yellow fever. [1]
The International Certificate of Inoculation and Vaccination was established by the International Sanitary Convention for Aerial Navigation (1933) in The Hague, which came into force on 1 August 1935 and was amended in 1944. [3] After the 1944 amendment, in addition to Personal, Aircraft and Maritime Declarations of Health, the Convention covered five certificates: [4] [5]
The World Health Organization (WHO) was formed by its constitution on 22 July 1946, effective on 7 April 1948. The WHO Constitution included stipulations to stimulate and advance work to eradicate epidemic, endemic and other diseases (Article 2.g) and that the World Health Assembly would have authority to adopt regulations concerning sanitary and quarantine requirements and other procedures designed to prevent the international spread of disease (Article 21.a). [6] The Fourth World Health Assembly adopted the International Sanitary Regulations (alias WHO Regulations No. 2) on 25 May 1951, replacing and completing the earlier International Sanitary Conventions. It confirmed the validity and use of international certificates of vaccination (Article 115), and updated the old model with a new version (Appendices 2, 3, 4). [7] The certificates mentioned were used for proof of vaccination against diseases such as cholera, yellow fever and smallpox; the term inoculation was no longer used. [7] [8] The old International Certificates of Inoculation and Vaccination remained valid until they expired, after which they were replaced by the new ICV. [8] On 23 May 1956, the Ninth World Health Assembly amended the form of the International Certificate of Vaccination or Revaccination against Smallpox per 1 October 1956. [9]
The WHO's World Health Assembly adopted the International Health Regulations (IHR) in 1969, succeeding the previous International Sanitary Conventions/Regulations. [10] IHR Article 79 introduced a model International Certificate of Vaccination, and Appendix 2 and Annex VI stipulated a number of conditions that had to be fulfilled in order for it to be considered valid, such as being printed and filled out in English and French (a third language, relevant to the territory in which it is issued, could be added). [10] The 1969 IHR focused on four diseases: cholera, plague, smallpox, and yellow fever; however, Article 51 specified that vaccination against plague would not be required as a condition of admission of any person to a territory. [10] The World Health Assembly determined in 1973 that vaccination against cholera was unable to prevent the introduction of cholera from one country to another, [11] and removed this requirement from the 1973 revision of the IHR; [10] [11] it was also removed from the ICV. [11]
The ICV was most successful in the case of smallpox. The mandatory possession of vaccination certificates significantly increased the number of travellers who were vaccinated, and thus contributed to preventing the spread of smallpox, especially when the rapid expansion of air travel in the 1960s and 1970s reduced the travelling time from endemic countries to all other countries to just a few hours. [12] After smallpox was successfully eradicated in 1980, the International Certificate of Vaccination against Smallpox was cancelled in 1981, and the new 1983 form lacked any provision for smallpox vaccination. [10] [12] Thus, only yellow fever remained as vaccination requirement for international travel for which the ICV was used.[ citation needed ]
By 1994, Saudi Arabia legally required pilgrims going to Mecca for the annual Hajj to vaccinate against meningococcal meningitis, while the Center for Disease Control also advised Americans travelling to the African meningitis belt or Kenya, Tanzania and Burundi to take the vaccine, especially when visiting during the dry season (November–April). [11]
The 2002–2004 SARS outbreak was the driving force behind the 23 May 2005 revision of the International Health Regulations, which entered into force on 15 June 2007. [13] : 1 On that day, the model International Certificate of Vaccination or Prophylaxis contained in Annex 6 of the International Health Regulations (as amended in 2005) replaced the International Certificate of Vaccination or Revaccination against Yellow Fever contained in appendix 2 of the International Health Regulations (1969). [14]
The main portion of the ICVP is a form for physicians to fill out when administering a vaccine. This section is mandated by the WHO's 2005 International Health Regulations, in which they provide a model of the document. It includes places for the traveller's name, date of birth, sex, nationality, national identification document, and signature. Below that is a row for each vaccine administered, in which the physician must include the prophylaxis or vaccine administered, date, signature, manufacturer and batch number, dates valid, and an official stamp from the administering centre. [15] [13] [16]
Below this, the document outlines requirements for validity. The ICVP is only valid for vaccines approved by the WHO.[ citation needed ] The form must be fully completed in English or French by a medical practitioner or authorized health worker and must include the official stamp of the administering centre. The certificate is valid for as long as the vaccines included are valid. [15] [13]
The form may include additional information. In 2007, the WHO prepared a booklet that included the following additional sections. [17]
The notes section includes information about yellow fever, since it is the only disease included in the International Health Regulations. It also specifies that the same certificate can be used if any future regulations require vaccination for another disease. [15]
The information for travellers section recommends that travellers consult their physicians to determine appropriate vaccinations before international travel and inform their physician of international travel if they fall ill after their trip. [15]
Malaria is a serious disease with no vaccine available. The ICVP recommends that travellers protect against mosquitos through mosquito nets or repellent, as mosquitos can transmit malaria. Travellers can also consult their physician for antimalarial medication, which must be taken regularly for the full duration of the prescription. [15]
The ICVP gives instructions for filling out the certificate. It also gives physicians guidelines for documenting contraindications in cases where a traveller has a medical reason that prevents them from getting a particular vaccine. This section also reminds physicians to consider travel-associated illnesses when treating a patient who has fallen ill after traveling. [15]
Yellow fever is the most common vaccine required for international travel. Many countries require the vaccine for all travellers or only for travellers coming from countries with risk of yellow fever transmission. [19] Exceptions are typically made for newborns until 9 months or one year of age, depending on the country. [20] The ICVP form is valid for yellow fever starting 10 days after vaccination. As of 2016, the vaccine is valid for the life of the traveller. No changes need to be made for those who received their vaccine or ICVP prior to 2016. [21]
In the event that a traveller cannot be vaccinated for a particular disease for medical reasons, their physician can provide them with documentation indicating their condition. They may be subject to additional requirements, such as isolation, quarantine, or observation. A traveller who refuses a vaccine or prophylaxis that is required may be subject to similar requirements or denied entry. In some cases, equivalent military-issued forms are accepted in place of the ICVP, provided the forms include the same information. [13]
Due to the prevalence of counterfeit certificates in some places, several countries, including Zimbabwe, Zambia, and Nigeria, are developing digital certificates that can authenticate an ICVP. [22] [23] As of July 2019, Nigeria requires its citizens to have its digital "e-Yellow Card" for travel outside the country. The card has a QR code that can be scanned to verify its validity. This requirement does not affect travellers from other countries with valid ICVPs, but those arriving in Nigeria who haven't been vaccinated for yellow fever may receive the vaccine and the e-Yellow Card upon arrival. [24] [25] [26] As of September 2023, Ecuador started handing out digital certificates too and is no longer going to issue yellow booklets after they are out of stock. [27]
Similar schemes have been proposed for travellers who have been vaccinated against COVID-19.[ citation needed ]
Multiple agencies and countries were creating different forms of documentation for people who have been vaccinated against COVID-19. [28] Agencies attempting this include non-profit organisations such as World Economic Forum and the Commons Project Foundation, technology companies such as IBM, travel companies such as VeriFly, and the International Air Transport Association. [28] As of March 2021 [update] , standards for digital documentation, such as an app on a smartphone, had not been established. [28] On 12 March 2021, Ecma International announced its intention to create international standards which guard against counterfeiting and protects private data as much as possible in a "Call for Participation on Vaccine Passports International Standardization". [29]
With COVID-19 vaccines showing promising results, several industry organizations including global airline lobby IATA and the World Economic Forum have announced pilots. [30] IATA's solution, "Travel Pass", is a mobile app that can display test results, proof of inoculation and will be integrated with the existing TIMATIC system. [31]
Israel employed a digital "green pass" to allow individuals fully vaccinated against COVID-19 to dine out, attend concerts, and travel to other nations. [32] It has been the subject of several privacy and data security concerns. Shortly after the scheme was rolled out, the Knesset passed a law allowing local authorities to compile data on citizens who have refused to get vaccinated. [33]
Work has been started to established and standardize at Ecma International, allow for an open interoperability ecosystem so that multiple COVID-19 immunity verification systems can work together and effectively across borders. [34]
Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating the body's adaptive immunity, they help prevent sickness from an infectious disease. When a sufficiently large percentage of a population has been vaccinated, herd immunity results. Herd immunity protects those who may be immunocompromised and cannot get a vaccine because even a weakened version would harm them. The effectiveness of vaccination has been widely studied and verified. Vaccination is the most effective method of preventing infectious diseases; widespread immunity due to vaccination is largely responsible for the worldwide eradication of smallpox and the elimination of diseases such as polio and tetanus from much of the world. However, some diseases, such as measles outbreaks in America, have seen rising cases due to relatively low vaccination rates in the 2010s – attributed, in part, to vaccine hesitancy. According to the World Health Organization, vaccination prevents 3.5–5 million deaths per year.
A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as a threat, destroy it, and recognize further and destroy any of the microorganisms associated with that agent that it may encounter in the future.
The smallpox vaccine is the first vaccine to have been developed against a contagious disease. In 1796, British physician Edward Jenner demonstrated that an infection with the relatively mild cowpox virus conferred immunity against the deadly smallpox virus. Cowpox served as a natural vaccine until the modern smallpox vaccine emerged in the 20th century. From 1958 to 1977, the World Health Organization (WHO) conducted a global vaccination campaign that eradicated smallpox, making it the only human disease to be eradicated. Although routine smallpox vaccination is no longer performed on the general public, the vaccine is still being produced to guard against bioterrorism, biological warfare, and mpox.
Travel medicine or emporiatrics is the branch of medicine that deals with the prevention and management of health problems of international travelers.
The International Sanitary Conferences were a series of 14 international meetings held in response to growing concerns about human disease epidemics. The first of the Sanitary Conferences was organized by the French Government in 1851 to standardize international quarantine regulations against the spread of cholera, plague, and yellow fever. In total 14 conferences took place from 1851 to 1938; the conferences played a major role in the formation of the Office international d'hygiène publique before World War II, and the World Health Organization in 1948.
A travel document is an identity document issued by a government or international entity pursuant to international agreements to enable individuals to clear border control measures. Travel documents usually assure other governments that the bearer may return to the issuing country, and are often issued in booklet form to allow other governments to place visas as well as entry and exit stamps into them.
Travel requirements for Polish citizens are public health and administrative entry restrictions by the authorities of other states placed on citizens of Poland.
Smallpox was an infectious disease caused by variola virus, which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) certified the global eradication of the disease in 1980, making smallpox the only human disease to have been eradicated to date.
Yellow fever vaccine is a vaccine that protects against yellow fever. Yellow fever is a viral infection that occurs in Africa and South America. Most people begin to develop immunity within ten days of vaccination and 99% are protected within one month, and this appears to be lifelong. The vaccine can be used to control outbreaks of disease. It is given either by injection into a muscle or just under the skin.
The visa policy of Singapore deals with the requirements a traveller must meet to enter Singapore. A foreign national, depending on their country of origin, must meet certain requirements to obtain a visa, which is a permit to travel, to enter and remain in the country. A visa may also entitle the visa holder to other privileges, such as a right to work, study, etc. and may be subject to conditions.
The history of smallpox in Mexico spans approximately 430 years from the arrival of the Spanish to the official eradication in 1951. It was brought to what is now Mexico by the Spanish, then spread to the center of Mexico, where it became a significant factor in the fall of Tenochtitlan. During the colonial period, there were major epidemic outbreaks which led to the implementation of sanitary and preventive policy. The introduction of smallpox vaccination in New Spain by Francisco Javier de Balmis and the work of Ignacio Bartolache reduced the mortality and morbidity of the disease.
On 20 January 2016, the health minister of Angola reported 23 cases of yellow fever with 7 deaths among Eritrean and Congolese citizens living in Angola in Viana municipality, a suburb of the capital of Luanda. The first cases were reported in Eritrean visitors beginning on 5 December 2015 and confirmed by the Pasteur WHO reference laboratory in Dakar, Senegal in January. The outbreak was classified as an urban cycle of yellow fever transmission, which can spread rapidly. A preliminary finding that the strain of the yellow fever virus was closely related to a strain identified in a 1971 outbreak in Angola was confirmed in August 2016. Moderators from ProMED-mail stressed the importance of initiating a vaccination campaign immediately to prevent further spread. The CDC classified the outbreak as Watch Level 2 on 7 April 2016. The WHO declared it a grade 2 event on its emergency response framework having moderate public health consequences.
Many countries have entry restrictions on foreigners that go beyond the common requirement of having either a valid visa or a visa exemption. Such restrictions may be health related or impose additional documentation requirements on certain classes of people for diplomatic or political purposes.
The International Sanitary Convention for Aerial Navigation (1933) was an international sanitary convention, drawn up in 1932 and signed at The Hague on 12 April 1933 and came into force on 1 August 1935 to protect communities against diseases liable to be imported by aircraft and to protect air crew against diseases due to flying. It contained a number of regulations consisting of measures to prevent the spread of plague, cholera, yellow fever, typhus and smallpox. It was formally ratified by around ten countries. Service aircraft were included in March 1939. Intelligence on infectious disease at ports was provided to health authorities by the health organisation at the League of Nations. It was amended in Washington on 15 December 1944, to form the International Sanitary Convention for Aerial Navigation (1944), which came into force on 15 January 1945.
Animal vaccination is the immunisation of a domestic, livestock or wild animal. The practice is connected to veterinary medicine. The first animal vaccine invented was for chicken cholera in 1879 by Louis Pasteur. The production of such vaccines encounter issues in relation to the economic difficulties of individuals, the government and companies. Regulation of animal vaccinations is less compared to the regulations of human vaccinations. Vaccines are categorised into conventional and next generation vaccines. Animal vaccines have been found to be the most cost effective and sustainable methods of controlling infectious veterinary diseases. In 2017, the veterinary vaccine industry was valued at US$7 billion and it is predicted to reach US$9 billion in 2024.
An immunity passport, immunity certificate, health pass or release certificate is a document, whether in paper or digital format, attesting that its bearer has a degree of immunity to a contagious disease. Public certification is an action that governments can take to mitigate an epidemic.
Vaccination requirements for international travel are the aspect of vaccination policy that concerns the movement of people across borders. Countries around the world require travellers departing to other countries, or arriving from other countries, to be vaccinated against certain infectious diseases in order to prevent epidemics. At border checks, these travellers are required to show proof of vaccination against specific diseases; the most widely used vaccination record is the International Certificate of Vaccination or Prophylaxis. Some countries require information about a passenger's vaccination status in a passenger locator form.
A COVID-19 vaccine card is a record often given to those who have received a COVID-19 vaccine showing information such as the date(s) one has received the shot(s) and the brand of vaccine one has received, sometimes including the lot number. The card also contains information identifying the recipient and the location where the shot was given. Depending on the country, it could serve as an official document verifying one has received vaccination, which could be required by some institutions, such as a school or workplace, when boarding a cruise ship, or when crossing an international border, as proof that one has been vaccinated.
A vaccine passport or proof of vaccination is an immunity passport employed as a credential in countries and jurisdictions as part of efforts to control the COVID-19 pandemic via vaccination. A vaccine passport is typically issued by a government or health authority, and usually consists of a digital or printed record. Some credentials may include a scannable QR code, which can also be provisioned via mobile app. It may or may not use a COVID-19 vaccine card as a basis of authentication.
Travel requirements for stateless persons are public health and administrative entry restrictions by the authorities of states placed on stateless persons.