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In response to a new respiratory virus with pandemic potential in 2025, governments worldwide introduce digital "immunity passports", QR-code-based systems linked to health databases that verify an individual’s vaccination status or proof of natural immunity. These passports become mandatory for accessing public spaces like restaurants, public transit, and workplaces, effectively creating a two-tiered society where those without proof of immunity face exclusion. While the system helps control outbreaks, it sparks ethical controversies: privacy advocates warn of surveillance risks as the app tracks users’ locations and health data, with reported breaches compromising sensitive information; low-income communities struggle to participate due to lack of smartphones or reliable internet, exacerbating existing inequalities; and a religious minority’s refusal to vaccinate, based on deeply held beliefs, leads to their exclusion from essential services and employment. This scenario forces a reckoning with how far societies should go to prioritize public health over individual freedoms, technological equity, and minority rights.

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The concept of "immunity passports" presents an ethical dilemma that intersects with several key philosophical concepts from our course. As governments implement digital systems to verify vaccination status or natural immunity, tensions arise between public health objectives and individual rights. Privacy advocates highlight concerns about data breaches and constant location tracking, while marginalized communities face exclusion due to technological barriers. These issues mirror our discussions on libertarian principles, as the passports could be seen as violating negative rights to privacy and freedom of movement. However, following Brennan's "clean hands" argument, one might contend that such measures are justified to prevent collective harm in a pandemic scenario, extending his logic to digital surveillance, a novel application of this framework. This case study also directly engages with Navin's nudge theory in a contemporary context. The passport systems often employ behavioral economics techniques like default auto-enrollment and positively framed messaging ("Keep others safe!") to encourage compliance. Though these may seem like harmless persuasion tactics, the digital format raises new concerns about the erosion of autonomy, as technological nudges can be more pervasive and difficult to resist than the clinical nudges Navin originally examined. The case thus pushes us to reconsider where to draw the line between ethical persuasion and manipulative coercion in public health technology. Significant justice concerns emerge when examining the disproportionate impact on vulnerable populations, creating clear parallels to the Joyce Echaquan case we studied previously. Like systemic racism in healthcare, neutral technological solutions can perpetuate and amplify existing inequalities when low-income individuals lack access to necessary smartphones or data plans, and when religious minorities face exclusion due to inflexible exemption policies. This challenges us to apply the equity principles from public health ethics to new emerging digital tools and question whether the public health benefits justify these secondary harms. What makes this case particularly valuable for our discussion is how it updates traditional bioethical debates for the digital age. While this module focuses on physical vaccination mandates and clinical nudges, immunity passports introduce new dimensions of data privacy, algorithmic bias, and digital exclusion. This case tests whether philosophical frameworks like Brennan's libertarian approach or Navin's nudge theory can adapt to these technological complexities, or if they require substantial revision. As many countries continue to debate and implement such systems post-COVID, this case study grounds our theoretical discussions in pressing real-world applications, inviting us to consider how centuries-old ethical principles should guide emerging public health technologies.