Note: Written prior to Omicron but keep in mind Omicron is less severe than other variants and evades vaccination more than other variants

To prove the necessity of COVID-19 vaccine passports and mandates that violate understood basic human rights, it is suggested that several criteria would need to be satisfied with exceptional, indisputable scientific evidence:

• A significant threat must be present for a large portion of the population.
• Transmission from unvaccinated, asymptomatic infections must be a significant driver of the pandemic.
• There are no other effective, safe treatments available.
• The vaccine must be safe beyond any reasonable doubt.
• The vaccine must significantly reduce transmission from asymptomatic infections and symptomatic cases.

Considering the above criteria, the purpose of this article is to examine the current evidence regarding the necessity and effectiveness of COVID-19 vaccine passports and mandates to determine if governments, public health officials, and employers should re-evaluate COVID-19 vaccination policies.

This page will not focus on vaccine safety or current treatment options as these are topics covered on other pages.

Safety

https://mail.google.com/mail/u/0/#inbox/WhctKKXHFXWXPcJJCNqNQvxsQzRxsdSFlHNCsjpcHsxkQkLjSnzBSSmghBXpFdXMtGXbHtg

https://roundingtheearth.substack.com/p/confirmation-of-vaccine-associated

Treatment/Prophylaxes

https://covid19criticalcare.com/covid-19-protocols/

https://www.campfire.wiki/doku.php?id=sars-cov-2_covid-19_treatment_research

Early in the pandemic, Based on data from China, it was thought that asymptomatic infections were rare, meaning that the case fatality rate (CFR) would be approximately the same as the infection fatality rate (IFR). As such, this early data put the case/infection fatality rate at 3.4% ¹⁾. Eventually, asymptomatic infection was discovered to occur more frequently than initially thought and the widely accepted IFR was determined to be approximately 0.9 – 1% ²⁾. An IFR of 1%, in addition to an estimate that around 81% of the world’s population would be infected, led to the prediction that over 2 million deaths would occur in the United States and upwards of 50 million deaths worldwide ^{3) 4)}. Numbers such as these would have been comparable to the 1918 influenza pandemic. Although these are the models that governments worldwide based initial lockdown measures on, it is fortunate that these initial estimates were not accurate.

Such grave estimates were based on a modeling study by Imperial College and became the basis for the spread of COVID-19 fear messaging to the public from governments and media outlets worldwide. Such messaging was permitted even though the lead author of the study had previously made grossly inaccurate estimates about the mortality impact of the Bird Flu, Swine Flu, and Mad Cow Disease ⁵⁾. As ongoing data and evidence emerged, the mortality and morbidity risk associated with COVID-19, for much of the population, was much less than originally thought and does not appear to warrant the degree of fear messaging that has continued throughout this pandemic.

While initial COVID-19 IFR estimates were as high as 3.4%, current evidence places the IFR somewhere between 0.15% and 0.09%, well within the IFR range of seasonal influenza ^{6) 7) 8) 9)}. While this is the IFR at a population level, we know that, as with many infectious diseases, the elderly are at a much greater risk of mortality from COVID-19 and the risk of mortality from COVID-19 differs by age group. Stratified by age group the IFRs are estimated to be: 0-19 years = 0.0027%, 20-29 years = 0.014%, 30-39 years = 0.031%, 40-49 years = 0.082%, 50-59 years = 0.27%, and 60-69 years = 0.59% ¹⁰⁾. Additionally, for the elderly in community dwellings, the IFR is estimated to be 2.4% while the elderly in non-community dwellings is 5.5% ¹¹⁾. The elderly are classified as those above age 69 and IFR increases significantly in elderly groups containing a higher percentage of those over 85 years. Additionally, as with the rest of the population, other health factors such as obesity increase the mortality risk in the elderly demographic ¹²⁾. To put these numbers into comparative context, even the common cold can have an IFR of up to 10% in care homes ¹³⁾.

Another way to examine the mortality risk presented by COVID-19 is to look at age of death data. For instance, 76% of deaths to date in the United States have been in individuals over the age of 65 and 83% of deaths to date in Canada have been over the age of 70 ^{14) 15)}. Additionally, the average age of death from COVID-19 is approximately 75 years in the United States, only 3 years below the country’s average life expectancy ¹⁶⁾. Approximately 81% of individuals who died of COVID-19 in Canada were residents of long-term care homes or senior homes ¹⁷⁾. The United Kingdom has reported a median age of death of 83 years and a mean age of death of 80 years, while the country lists an average life expectancy between 79 and 83 years ¹⁸⁾. The data are clear, age is the main risk factor when it comes to COVID-19 mortality, yet public health measures and fear messaging to the public do not match the data.

The above mortality numbers are generally calculated using widely accepted mortality data from the mentioned countries. However, there has been criticism regarding how these numbers are gathered, suggesting there has been an overestimation of the total deaths caused by COVID-19. Before RT-PCR testing was widely used, COVID-19 diagnosis did not require laboratory confirmation; the CDC changed physician instructions for completing death certificates for COVID-19 only, downplaying the role of comorbid diagnosis; and RT-PCR reliability and accuracy has been consistently criticized regarding cycle threshold ^{19) 20) 21) 22) 23) 24)}. Based on the available evidence in 2020, a court in Portugal ruled that RT-PCR COVID-19 testing has up to a 97% false-positive rate above a cycle threshold of 35 and is not a suitable test for COVID-19 diagnosis ²⁵⁾. The available literature supports that RT-PCR tests lack suitability for accurate COVID-19 diagnosis ^{26) 27) 28) 29) 30) 31)}. The United States Center for Disease Control and Prevention (CDC) has also advised they will be removing emergency use authorization for RT-PCR as a diagnostic test for COVID-19 as of January 1, 2022 and laboratories must transition to FDA-approved tests ³²⁾.

Furthermore, court documents from Portugal indicate that it is possible that as of May 19, 2021, only 0.9% of officially tracked COVID-19 deaths were caused solely by COVID-19 ³³⁾. Additionally, the CDC states that only 5% of officially tracked COVID-19 deaths were solely caused by SARS-CoV-2 without any contributing factors such as comorbidities ³⁴⁾. Italy lists similar data with only 2.9% of COVID-19 deaths not having contributing comorbidities ³⁵⁾.

All these factors imply an overestimation of mortality numbers. Some research implies that the impact of these factors not only supports an IFR in the range of seasonal influenza but also a total death toll in the range of seasonal influenza ³⁶⁾.

Finally, regarding mortality risk, a recent systemic review and meta-analysis concluded that vitamin D levels of 30 ng/mL significantly reduce COVID-19 mortality, and levels of 50 ng/ml can theoretically reduce COVID-19 mortality to zero ³⁷⁾. This study suggests that even without pharmaceutical treatment, a reduction of IFR to statistically zero could be achieved simply through vitamin D3 supplementation.

In determining the risk presented by SARS-CoV-2, we must also look at morbidity along with mortality. Based on the available literature, it is difficult to estimate the infection hospitalization rate (IHR) with similar accuracy to the IFR. In the early stages of the pandemic, it was suggested that 10% of identified cases would need hospitalization ³⁸⁾. However, there is a difference between the case hospitalization rate and IHR, as we have already determined with mortality numbers. Based on studies performing RT-PCR tests on groups of people using multiple different selection criteria, the IHR lands somewhere between 0.09% and 15% ^{39) 40) 41)}. However, based on study designs, these numbers can not truly be viewed as IHR but rather some unknown combination of IHR and case hospitalization rate. The CDC currently estimates the total number of infections (including asymptomatic unconfirmed infection) in the United States to be 120,259,370 and the confirmed number of hospitalizations to be 6,156,065 equaling an IHR of 5.12% ⁴²⁾.

Nevertheless, there is concern regarding the accuracy of hospitalization numbers. COVID-19 screening is a common practice in healthcare facilities during the pandemic ⁴³⁾. Such practices involve COVID-19 testing upon admission to a healthcare facility for any reason. Understandably, such screening may identify possibly infectious individuals and limit facility outbreaks; however, it also identifies mild to moderate, and asymptomatic cases that would not require hospitalization for COVID-19 symptoms. Thus, it is suggested that official hospitalization numbers are overestimated. It’s estimated that before widespread vaccination, 36% of hospitalizations were for mild or asymptomatic infections and since widespread vaccination began, 48% of hospitalizations were for mild or asymptomatic infections ⁴⁴⁾. This data indicates that between 36% and 48% of COVID-19 hospitalizations were not hospitalized for COVID-19 symptoms and were likely counted as COVID-19 hospitalizations based on COVID-19 screening practices while being admitted for other reasons. This disparity is even greater for COVID-19 hospitalizations in pediatric populations. Multiple studies reveal that only 7.7% to 14% of COVID-19 pediatric hospitalizations had significant symptoms ^{45) 46) 47)}. This data indicates that for between 92.3% and 86% of documented pediatric hospitalizations, the patients were admitted for something other than COVID-19 symptoms and the hospitalizations were only officially tracked because of healthcare facility screening practices. Given these findings, and the RT-PCR false positive rate previously noted, the IHR of 0.09-15% noted above should be significantly reduced, possibly by more than half.

So-called “Long COVID-19” is also frequently noted as a consideration regarding COVID-19 morbidity risk. However, a recent study using a control group and 26,823 participants found that the belief of previously having COVID-19 was associated with having all persistent symptoms of Long COVID-19 but serological confirmation and physician diagnosis of actually having COVID-19 was only associated with one Long COVID-19 symptom, anosmia (loss of smell) ⁴⁸⁾. Symptoms associated with Long COVID-19 are quite common in the general population and it is difficult to determine causation from previous COVID-19 infection. By using a control group, this paper highlights that these symptoms may not be related to actual COVID-19 infection and therefore, Long COVID-19 is significantly less of a concern than originally thought.

It is also well known that comorbidities significantly increase the risk of morbidity and mortality posed by COVID-19. The above-outlined data showing that the risk from COVID-19 is comparable to seasonal influenza does not consider the full contribution of comorbid conditions. It is well documented that, next to age, comorbid conditions are the highest risk factor for poor COVID-19 outcomes. The USA CDC states that at least 2.9 comorbidities are present in those listed as COVID-19 deaths and 94% of COVID-19 coded deaths have additional causes listed on the death certificate ⁴⁹⁾. A recent peer-reviewed study out of the United Kingdom, with a sample size of 6.9 million people, indicates that for those under the age of 60 years, obesity alone accounts for up to 74% of the risk of hospitalization, 85% of the risk of intensive care unit (ICU) admission, and 90% of the risk of death ⁵⁰⁾. In addition to obesity, other comorbidities that increase the risk of poor COVID-19 outcomes include diabetes, cardiovascular disease, chronic obstructive pulmonary disease, and cancer ⁵¹⁾. Therefore, in addition to COVID-19 risk being comparable to seasonal influenza, those that do have poor outcomes from COVID-19 are highly likely to be immunocompromised due to obesity, comorbidities, increased age, or a combination of all three.

The information presented above is not meant to dismiss any risk that SARS-CoV-2 presents. However, our public health responses and messaging to the public must match the actual risk determined by high-quality data and quickly adapt as new information is gathered. At this time the level of fear messaging to the public and the severity of public health measures, do not appear to match the true level of risk presented by SARS-CoV-2.

The ability for asymptomatic SARS-CoV-2 carriers and presymptomatic cases of COVID-19 to transmit the virus to others is difficult to study and much of the literature on this topic comes from studies completed early in the pandemic. For the purpose of this article, which is reviewing the necessity for COVID-19 vaccine mandates/passports, data from this period can still provide an understanding of the risk of asymptomatic transmission from unvaccinated individuals.

A study that entered preprint in March of 2020, using a mathematical model based on early data from China and a small number of studies, suggested that asymptomatic transmission is equal to symptomatic transmission ⁵²⁾. However, this paper remains in preprint status as of November 2021, indicating it did not pass peer review.

A review study published in May of 2020 concluded that the majority of transmission occurs from asymptomatic infections and the presymptomatic phase of cases ⁵³⁾. In review of the literature cited by this paper, the authors based their conclusion on viral load data from RT-PCR testing, a few small cluster studies showing possible asymptomatic transmission, and studies estimating the proportion of asymptomatic infections in the population. It is also important to note that this paper cites the above-mentioned paper that has yet to pass peer review for over a year and a half.

While most of the small case studies cited in the above noted May 2020 paper show that asymptomatic/presymptomatic transmission is possible, they do not show it as the major mode of transmission. One cited study indicates that presymptomatic transmission accounts for 20% of transmission and found no asymptomatic transmission ⁵⁴⁾. Another cited study suggests presymptomatic transmission accounts for only 6.4% of transmission ⁵⁵⁾. A third study followed 24 confirmed asymptomatic infections and only found evidence of transmission in 1 of the 24 participants ⁵⁶⁾.

Additionally, viral load alone cannot determine the risk of transmission from asymptomatic infection. For instance, viral load of influenza in asymptomatic and presymptomatic infections can reach levels similar to symptomatic cases; however, it is well established that the vast majority of influenza transmission occurs from symptomatic individuals ⁵⁷⁾. Additionally, while asymptomatic infections may present a high viral load in the mucosal membrane and upper respiratory tract, they are less likely to expel as much virus as those with symptoms simply because they lack symptoms (coughing, sneezing, etc.).

A small cohort study from May 2020 also suggested a high rate of presymptomatic transmission (44%). However, the authors made calculation errors in their initial paper and had to make a correction following publication. The correction stated that presymptomatic transmission accounted for 37–48% of transmission versus the originally published 46–55% ⁵⁸⁾.

It seems that initial lockdown measures were based on early data suggesting that asymptomatic and presymptomatic transmission was driving a non-trivial proportion of population transmission. However, data published later in 2020 challenged these earlier findings.

A study published in Nature Communications in November 2020 found zero evidence of asymptomatic transmission ⁵⁹⁾. Nearly 10,000,000 residents of Wuhan, China were screened, and 300 asymptomatic infections were identified. A total of 1174 close contacts of the asymptomatic participants were tracked and tested for COVID-19, none of which tested positive. Additionally, the researchers were unable to culture the virus from the 300 asymptomatic carrier samples, suggesting that the innate immune response had neutralized the virus in these samples. This would indicate that expelled virus from these individuals would not be infectious. While it is possible that false-positive RT-PCR testing contributed to these findings, SARS-CoV-2 antibody testing was positive in 190 of the 300 asymptomatic cases.

Madewell et al. published a meta-analysis in December 2020 of 54 studies reporting on household secondary transmission rates ⁶⁰⁾. The findings of this meta-analysis report that the risk of asymptomatic/presymptomatic transmission is only 0.7%.

There was also one study from early 2020 that followed 455 contacts of a confirmed asymptomatic infection and found zero evidence of transmission ⁶¹⁾.

The evolving evidence of SARS-CoV-2 transmission dynamics before widespread vaccination suggests that asymptomatic/presymptomatic transmission is possible in the unvaccinated; however, it is likely rare and not a major driver of the COVID-19 pandemic. Additionally, as of June 2020, the World Health Organization advised that most COVID-19 transmission occurs through symptomatic cases ⁶²⁾.

The available evidence accumulated by the end of 2020 and the World Health Organization’s stance on asymptomatic transmission calls into question the necessity of much of the pandemic lockdown measures. Additionally, since unvaccinated, asymptomatic/presymptomatic cases are at low risk for transmission, the necessity of COVID-19 vaccine passports and mandates is also called into question.

The evidence presented thus far reveals that 2 of the necessary conditions to prove the need for COVID-19 vaccine mandates have not been satisfied: the virus must present a significant threat for a large portion of the population and transmission from unvaccinated asymptomatic infections must be a significant driver of disease transmission. Lack of evidence for just 1 of the 5 outlined conditions would be considered sufficient to conclude that the vaccine passports/mandates are not necessary. However, one of the key criteria when considering this topic is whether the vaccines significantly reduce transmission.

At the start of vaccination campaigns around the world, official country data showed that the vaccines were effective at reducing hospitalizations and deaths in at-risk demographics, matching the primary outcome measures of the vaccine clinical trials. Official tracking data by country also appeared to show a decline in cases (symptomatic) which lends support to the suggestion that mass COVID-19 vaccination will also reduce transmission rates in the population; less symptomatic cases should equal fewer chances for transmission. However, as time passed from the start of mass vaccination a different picture emerged.

Much data suggest that the COVID-19 vaccines are still protective against hospitalization and death from COVID-19 specifically; however, their effectiveness against symptomatic cases and asymptomatic infections wanes quickly and significantly. A report from Israel’s Ministry of Health in early July 2021 reported that vaccine effectiveness against infection had dropped to 39% (CI 9%-59%) ⁶³⁾. Recent studies have also confirmed the observations noted by Israel. COVID-19 vaccine effectiveness decreases to approximately 50% by as early as 3-4 months following full vaccination and to statistically zero by 5-6 months following vaccination ^{64) 65) 66) 67) 68)}. To put this into perspective, early in the pandemic, the United States FDA listed a minimum effectiveness of 50% for any COVID-19 vaccine to be considered for emergency authorized use ⁶⁹⁾. Therefore, the evidence suggests that, as early as 3 months after complete vaccination, the current COVID-19 vaccines no longer meet the minimum required level of efficacy for authorized use.

Such significant decreases in COVID-19 protection against SARS-CoV-2 infection is further supported by drastically reduced neutralizing antibody levels within months of vaccination ⁷⁰⁾. Levin et al. compare this rapid reduction in SARS-CoV-2 neutralizing antibodies over a few months with neutralizing antibody levels from other common vaccines where only a 5-10% per year reduction in neutralizing antibody levels is seen ⁷¹⁾.

Not only does COVID-19 vaccine effectiveness against symptomatic cases wane quickly, but the current vaccines are also less effective against emerging variants. A growing body of evidence shows that SARS-CoV-2 variants such as the currently dominant Delta, along with the Lambda and Gamma variants are more resistant to vaccine-based immunity in comparison to wild type SARS-CoV-2 and the Alpha variant ^{72) 73) 74) 75) 76) 77) 78)}. Additionally, genetic studies suggest that continued mutations in SARS-CoV-2 spike protein may create variants that fully evade current COVID-19 vaccine-based antibodies ⁷⁹⁾. Variant A.30 provides real-world evidence of this theory ⁸⁰⁾.

As outlined, a large body of evidence supports the rapid waning of COVID-19 protection against symptomatic cases and reduced protection against emerging variants. However, this evidence also shows that protection against asymptomatic infection is even weaker. At peak timing of vaccine effectiveness, protection against asymptomatic infection may only reach 44% to 63.7% effectiveness ^{81) 82)}. By 5 weeks following full vaccination, effectiveness against asymptomatic infection decreases to approximately 50%, by week 10 effectiveness decreases to 38.5%, and by week 15 effectiveness decreases to statistically zero ⁸³⁾)). Additionally, seroconversion evidence suggests that asymptomatic infection in the vaccinated occurs frequently ⁸⁴⁾.

At first glance, since the evidence outlined earlier in this article shows that unvaccinated asymptomatic transmission is not a main driver of the COVID-19 pandemic, asymptomatic breakthrough infections should not be concerning. However, recent evidence shows that asymptomatic and presymptomatic vaccine breakthrough infections can carry a higher viral load than asymptomatic unvaccinated infections ^{85) 86) 87) 88)}. Furthermore, evidence from Vietnam shows that vaccinated infections carry viral loads up to 251 times higher than viral loads measured before the start of vaccination ⁸⁹⁾.

Although viral loads in asymptomatic infection are not proof of asymptomatic transmission, emerging evidence continues to show that transmission is occurring from asymptomatic/presymptomatic breakthrough infections ^{90) 91) 92)}. Since vaccination reduces the severity of symptoms, it is likely to reduce the chance that someone with a breakthrough infection will get tested. Therefore, since vaccination does not prevent viable viral replication in the mucosal membrane, prevents the severity of systemic symptoms, and reduces the chance of being tested, it is suggested that the transmissibility of asymptomatic breakthrough infections may be underestimated by a factor of 2 ⁹³⁾. Additionally, new evidence shows that the risk of household transmission from the vaccinated to the vaccinated is higher than from the vaccinated to the unvaccinated ⁹⁴⁾.

Aside from asymptomatic/presymptomatic breakthrough transmission, evidence shows that transmission from symptomatic breakthrough cases is also common. Viral loads in unvaccinated and breakthrough cases are consistently shown to be equal, and breakthrough case transmission is clearly being demonstrated in contact tracing studies ^{95) 96) 97) 98) 99) 100) 101) 102) 103) 104) 105) 106)}. At best, there is a 45-50% reduction in transmission from the vaccinated compared to the unvaccinated; however, this evidence comes from vaccinees during the peak timing of vaccine effectiveness (full vaccination occurred within 3 months of the study) and not during periods of Delta variant dominance ^{107) 108) 109)}. Evidence from other studies, particularly during Delta variant dominance, shows that there is little to no difference between transmissibility from vaccinated or unvaccinated symptomatic cases ^{110) 111) 112) 113)}.

The scientific literature provides evidence that the effectiveness of the vaccines wane quickly, they are not effective against new variants, they do not significantly reduce SARS-CoV-2 transmission, and may even enhance transmission. This evidence is also being seen in real-world data.

Recent data from the weekly government COVID-19 surveillance reports out of the United Kingdom show that the case incidence per 100,000 people is higher in the vaccinated population for all age groups above age 29 years than it is for the unvaccinated ¹¹⁴⁾.

In a peer-reviewed paper out of Harvard, published in September 2021, Subramanian and Kumar analyzed the data from OurWorldInData.org to determine the relationship between population vaccination coverage and COVID-19 cases per million people ¹¹⁵⁾. Of the 68 countries with fully reported vaccination data, no relationship between the percentage of population vaccinated and COVID-19 case rate per million people was found. The authors further suggested that there is a marginally positive association such that the higher the percentage vaccinated, the higher the COVID-19 case rate per million people is. As an example, Israel had over 60% of their population fully vaccinated at the time and they had by far the highest case rate. Further perspective can be gained through data from Iceland and Portugal who, at the time, had over 70% of their populations fully vaccinated yet had higher COVID-19 cases per million than Vietnam and South Africa who only had 10% of their populations vaccinated.

Subramanian and Kumar also made this comparison between United States counties from data obtained through the White House COVID-19 Team ¹¹⁶⁾. Complete vaccination data were available for 2947 counties. The author’s comparison yielded the same findings as the country comparison, no relationship between the percentage of population vaccinated and COVID-19 case rate per 100,000 people was found. Furthermore, out of the 5 counties with the highest percentage of population vaccinated at that time, 4 of them were listed as high transmission counties by the CDC. Additionally, 15 out of the 57 counties (26%) listed by the CDC as low transmission counties, had less than 20 percent of their populations vaccinated.

The evidence that vaccine effectiveness wanes very quickly; is less effective against emerging variants; does not reduce transmission from symptomatic breakthrough cases; allows for transmission from asymptomatic/presymptomatic breakthrough infections, which is rare in unvaccinated infections; and COVID-19 case numbers are not associated with the percentage of the population vaccinated suggests that the unvaccinated population does not pose a greater risk of SARS-CoV-2 transmission than the vaccinated. Furthermore, the vaccine passports/mandates convey the impression that the vaccinated are not at risk of transmitting to others, leading to increased behaviors in the vaccinated population that promote ongoing transmission, including socializing in close quarters with mild to moderate symptoms. Thus, the presented evidence challenges the popular narrative that the pandemic is now one of the unvaccinated, it may possibly be one of the vaccinated. Regardless, it is inherently wrong to vilify either of these groups of people as history shows that discrimination and segregation of any group of people is dangerous to our humanity ¹¹⁷⁾.

Aside from the serious concerns about vaccine efficacy and the fact that they do not significantly reduce transmission for a substantial period, the law of diminishing returns should also be considered. From an economics standpoint, this theory predicts that beyond a certain point, additional inputs produce smaller and smaller outputs. This theory is also applied to clinical medicine and has been explained as follows: “For example, when the risk of an adverse event can be reduced in several different ways, the impact of each intervention can generally be shown mathematically to be reduced by the previous ones. The diminishing value of successive interventions is further reduced by adverse consequences (eg, drug-drug, drug-disease, and drug-nutrient interactions), as well as by the total expenditures of time, energy, and resources, which increase with each additional intervention.” ¹¹⁸⁾.

Applied to the necessity for vaccine passports/mandates, the COVID-19 vaccines are the input/intervention, and COVID-19 cases and infections are the output/adverse event. Therefore, if many countries have had almost all the elderly and other high-risk populations fully vaccinated, along with 65% or more of the remaining population, and the pandemic continues, having the remainder of the population vaccinated cannot be considered the solution as the return from each increasing percentage of the population vaccinated will continue to diminish in its impact on case/infection numbers. This law would still apply even in a best-case scenario where the vaccines do not suffer from the numerous flaws outlined above.

The introduction of this article suggested five criteria that would need to be satisfied with exceptional, indisputable scientific evidence to prove the necessity of COVID-19 vaccine passports and mandates that violate basic human rights. The scope of this article was to review the evidence regarding three of the five outlined criteria:

• A significant threat must be present for a large portion of the population.
• Transmission from unvaccinated, asymptomatic infections must be a significant driver of the pandemic.
• The vaccine must significantly reduce transmission from asymptomatic infections and symptomatic cases.

Upon review of the scientific literature, it is concluded that exceptional, indisputable evidence does not exist in support of these three criteria. Specifically, a threat significantly greater than seasonal influenza is not present for much of the population, asymptomatic/presymptomatic transmission from the unvaccinated is not a significant driver of the pandemic, the vaccines do not significantly reduce transmission from breakthrough cases, the vaccines allow for transmission from asymptomatic breakthrough infections, and vaccine population coverage percent is not associated with reduced COVID-19 cases. Therefore, since the current evidence does not support three out of the five outlined criteria, this review finds the vaccine passport/mandate policies unnecessary and ineffective.