Skip To Navigation Skip To Content Skip To Footer
    Insight Article
    Home > Articles > Article
    By Howard L. Smith, PhD; David N. Gans, MSHA, FACMPE; Zung Vu Tran, PhD, FACSM, FSS; Nina Nichols; Brett Goldman; Ryan Hawkos; and Neill F. Piland, DrPH

    Editor’s note: This article contains the expressed opinions and experiences of the authors and do not necessarily represent the position of MGMA.
    Even before COVID-19 vaccinations began to be widely disseminated, concerns were expressed about which agencies would document and monitor them. Just as quickly, the federal government took the position that it was not going to institute a system of passports. Those who were inoculated would receive a CDC vaccination card and that was the end of discussion at that time. Well, not quite. Wishful thinking on the part of our government to avoid vaccination documentation and verification has created a formidable crisis about the integrity of vaccinations at a pivotal juncture.
    Vaccinated and unvaccinated alike want to return to some semblance of normalcy that reflects any of the millions of ways that people work, play, pray or interact. This has become possible due to widespread immunization of the U.S. population coupled with prudent social distancing and mask use, which momentarily dampened COVID-19 case counts until variants proliferated. However, as long as a sizeable number of people avoid vaccination, the virus will find ways to thrive.
    Increasingly, businesses, bars and restaurants, entertainment venues, sporting events, colleges, state and municipal governments, the Veterans Administration and federal agencies require proof of vaccination or continual tests. This has nurtured fertile ground for counterfeit cards. Anti-vaxers do not want to be prevented from partaking in such activities; plus, many people simply enjoy beating the system or proving that no one can make them do what they do not want to do regardless of the expense to their health or society. This self-centeredness is costing the United States some $2.3 billion in hospitalization for unvaccinated people during June and July 2021 alone.1
    As we struggle to reopen our society and rejuvenate our economy, the long-ignored challenge of instilling integrity into vaccination documentation must be overcome. But does anyone really trust that the person sitting, standing or otherwise in their personal space has actually been vaccinated as they espouse or claim with a little sheet of paper? Remember, it only takes one exposure to acquire a virus that might kill you.
    The preceding thoughts clearly underscore that it is past time for a viable and efficient vaccination verification system. Such a system would function much like the Good Housekeeping Seal of Approval or OSHA’s “Nationally Recognized Testing Laboratories,” in which valid third-party organizations with appropriate qualifications perform safety testing and certification of products. The CDC, or other health-related agency, could oversee a national vaccination verification system. For example, sources approved by the CDC (e.g., Nationally Recognized Verification Entities) could create highly recognizable electronic passports that substantiate COVID-19 vaccination. The technology and products already exist as private firms have looked ahead to now — when vaccination certification would be paramount to a functioning society.
    Currently, the lack of a secure verification system is facilitating fraud as people falsify credentials, forge vaccination cards or hack digital certification tools to meet entry requirements for health facilities, mass gatherings and places of business. Physical and digital health records such as the CDC card and IBM’s Excelsior pass have been easily falsified.2
    Cell phone-enabled vaccination verification should be an immediate reality. The world relies on cell phones to do most anything and everything. Verification needs to be easy to use at point of entry (e.g., into a restaurant, bar or entertainment venue), inexpensive, and widely recognized as one of the CDC-approved “Good Health Keeping Passports of Vaccination.” This will facilitate disease prevention, efficient use of health services and facilities and reduce healthcare costs, as well as invigorate economic activity and development.
    It is time to quit stalling. All along we have known that there would be a need for bulletproof verification of vaccination to re-boot societal functioning. Let’s invest a modicum of resources in a reliable vaccine verification/certification system of high integrity as we have in developing the vaccines and confidently move onward and upward.

    About the authors

    • Howard L. Smith, PhD, Professor, Milgard School of Business, University of Washington Tacoma,
    • David N. Gans, MSHA, FACMPE, Senior Fellow, Industry Affairs, MGMA, 
    • Zung Vu Tran, PhD, FACSM, FSS, Founder, Chief Science Officer, MedAware Systems, Inc., Research Professor (ret.) of Biostatistics & Pediatrics, Anschutz Medical Campus, University of Colorado
    • Nina Nichols, CEO,,; Founder, Global Women in Blockchain; Co-Founder, ClueChain, LLC,   
    • Brett Goldman, Advisor, Government Affairs, VXPASS,
    • Ryan Hawkos, Deputy Director, VXPASS International Affairs,
    • Neill F. Piland, Dr.P.H., Research Professor Emeritus. Institute of Rural Health, Kasiska Division of Health Sciences, Idaho State University,


    1.Amin K, Cox C. “Unvaccinated COVID-19 hospitalizations cost the U.S. health system billions of dollars.” Peterson-KFF Health System Tracker. Aug. 20, 2021. Available from:
    2. Frenkel S. “Online Scammers Have a New Offer for You: Vaccine Cards.” The New York Times, April 8, 2021. Available from:

    Explore Related Content

    More Insight Articles

    Ask MGMA
    Reload 🗙