A Documentary History of the Immunity (or Vaccine) Passport: Health Certificates of Public Health, Personal Identity and Power from the Plague to the Coronavirus Pandemic

Summary

The immunity (or vaccine) passport of the coronavirus pandemic, as a concept and object, is not unprecedented. This health and identity document features a history spanning over half-a-millennium and appearing across diverse geopolitical and sociocultural contexts. This article presents a documentary history of the immunity passport and its heterogeneous material instantiations, uses and effects across divergent historical settings. It illuminates how the immunity passport has helped shaped identities and public health, as well as impacted individual and institutional agency, during health crises. Four historical cases are explored, including the plagues ravaging the Renaissance Mediterranean region, the 1665 Great Plague of London, the yellow fever outbreaks in the antebellum slave-era southern USA and the chronic cholera conditions confronting colonial-era British India. Although disparate, these historical cases share the immunity passport as a non-pharmaceutical intervention into their respective health crises that played important roles in people’s lives during these troubled times.

Since the World Health Organization declared the coronavirus (also referred to as COVID-19) a global pandemic in March 2020,¹ multiple waves of contagion continued upending the world over the course of the subsequent few years (and indeed continues to do as at the time of this writing in the second and third quarters of 2022). As COVID-19 public health responses and vaccination distribution remains uneven, most countries have instituted, reinstituted, and in some recent cases rescinded, lockdowns and imposed, reimposed, and again in some recent cases rescinded, non-pharmaceutical interventions, including quarantines, social distancing and masking. One non-pharmaceutical intervention that has been implemented and employed across various settings at different points throughout this pandemic is the so-called immunity, or vaccine, passport.

Serving as documentary evidence of individuals’ COVID-19 immunity, vaccination or risk-free status, this document has been deployed in diverse instantiations, from pieces of paper to color-coded apps to QR codes, in different countries worldwide. Depending upon the country issuing it, various names are given to this document, including immunity passport, vaccine passport, COVID-19 passport, health certificate, health license, COVID-19 certificate, coronapass and green pass (for the remainder of this discussion, the term ‘immunity passport’ will be used for the sake of clarity and convenience). Regardless of the name or label bestowed, each document represents the same phenomenon: namely, a material confirmation of an individual’s health and personal identity revealing their health status in relation to the coronavirus, which is, in turn, employed to help regulate their physical and social mobility. Exempting immune, vaccinated or otherwise risk-free individuals from restrictive public health measures, this document presumably helps contain and curb the disease’s spread and return documented individuals to daily activities and travels.

A growing interdisciplinary and specialized literature is exploring heterogeneous aspects of COVID-19 immunity passports.² Notwithstanding this rich scholarship, there appears to be minimal reference to, or passing acknowledgement of, the history of this document. Beyond Matthew Newsom Kerr’s historical overview of this document’s surveillance aspects,³ there is not a discrete discussion exploring its particular, and in some cases peculiar, history, nor is there an explicit document-oriented historical approach to framing or analyzing its manifold kinds, objectives, uses and effects. Yet, as a concept and object, the immunity passport is not unprecedented. As Kerr argues, ‘as with most seemingly novel practices, this one has a long and complicated history. Health passes will aid in constructing a “new normal” that nonetheless retains echoes of the past’.⁴ The immunity passport, and its variegated versions, features a history spanning over half-a-millennium and appearing across disparate geopolitical and sociocultural contexts. From the bubonic and pneumonic plagues in the fourteenth century to the coronavirus pandemic of the present day, the immunity passport has a long and complex history.

By intervening in this important scholarship, this article foregrounds the immunity passport as a document requiring, and worthy of its own, historical attention and analysis. Drawing upon scholarly literature and secondary sources related to various histories of public health responses to historical health crises, this article offers the start of a documentary history of the immunity passport. The aim is not to introduce the immunity passport as a new, unnoticed or overlooked phenomenon, but instead to center it, as a concept and object, within broader public health conversations and histories.

Specifically, a documentary history of the immunity passport is presented, along with its disparate material instantiations, uses and effects across diverse historical contexts. This history supplies a systematic and conceptual approach to situate, analyze and understand the rich diversity of documents and material practices that have been significant to the historical genealogy of the immunity passport. It therefore not only showcases aspects of the immunity passport’s history but also its particular, and often peculiar, implications for individual and institutional encounters and experiences with plagues and pandemics. Incidentally, this approach also aligns with growing historical interest in materiality, including the ways in which the material world establishes and shapes identities and their associated agencies, by revealing some of the ways in which the immunity passport has influenced health identity and impacted individual agency during health crises across history.

Four historical cases, taken from different geopolitical and sociocultural settings, of the immunity passport are furnished. The intention is to elucidate the centrality of this document (and its variegated versions) and the ways it has been employed to establish and verify identity to, then, regulate physical and often social mobility during health crises. The cases include the plague ravaging the Mediterranean region during part of the Renaissance period, the (last) Great Plague of London in 1665, the seasonal yellow fever outbreaks menacing the antebellum slave-era southern American states, and the chronic cholera conditions confronting colonial-era British India. Although myriad, these four historical cases share the immunity passport as a public health response to their respective health crises that played important roles in people’s lives during these troubled times.

It is important to note, however, that this article does not intend to provide detailed historical analyses, literature reviews or general overviews of these four historical cases. There is indeed rich and expansive interdisciplinary scholarship on their many complexities from various vantagepoints including those of public health and politics. While comprehensive surveys of these four historical cases are beyond the scope or space of this article, the objective is to specifically concentrate on the documentation involved in addressing these health crises. The point, in other words, is to center the immunity passport as an important disciplinary instrument within health crises by highlighting its (convergent and divergent) emergences, roles, uses and effects. There are twin hopes for this article. First, it is hoped these documentary stories of the past can provide insights to present considerations for the possible resurrection of the immunity passport in the contemporary coronavirus pandemic and beyond. Ultimately, this article aims to contribute to emerging scholarly efforts that are critically interrogating public health and political responses to the continuing coronavirus pandemic. Second, it is also hoped that this article’s critical discussion of the immunity passport’s history can help inform these ongoing interrogations reflecting the contemporary moment and, in so doing, simultaneously raise awareness of parallel previous responses that could warn of potential risks of repeating mistakes or replicating social perils.

The following discussion is arranged into six interconnecting sections building upon each other. The first and second sections outline the similarities between the immunity passport and the national passport. As identity documents, they are twin objects insofar as their formats and objectives are concerned. This outline provides the necessary foundation for the third section’s material-documentary framework. This section establishes and explains the framework’s usefulness for historically approaching and analyzing documents like the immunity passport; further, this section also describes the additional framework of documentary registers for buttressing this approach and analysis from a conceptual angle. The fourth section furnishes the four historical cases of the immunity passport in its variegated versions. The fifth section conceptually situates these cases within the documentary registers framework. Finally, the conclusion offers possible implications for other studies on the immunity passport and similar health and identity documents. It also calls for further histories of documents that impact identities, societies and lives. Let us first explore the intimate intersections between the immunity passport and its arguably more recognized and prominent documentary brethren, the national passport.

The Passport, Identity and Identification

The immunity passport is closely related to the national passport. With a long history, the national passport has been and remains an object of identity, verification, mobility, control and discipline. The original meaning of this document’s name is derived from the French words passer (to pass) and port (a harbor or haven). Literally translated, it means to pass through or leave a port or harbor. The national passport’s form, format and functions, however, have been fluid throughout its history, changing in different historical and sociocultural contexts.⁵ Some versions of this document have been applied to foreigners, foreign travel or egress, whilst others have been mandated for citizens, internal movements or ingress. Some versions have been based on geopolitical location, religious affiliation or ethnicity, whilst others have been determined by social position, financial status or, indeed, health.

Notwithstanding its historical and contextual contingencies, the national passport is ultimately an object of identity and verification. Its consistent characteristic is its evidentiary status establishing and verifying identity and, in turn, determining rights and regulating mobility. This document is considered as evidence offered ‘to serve other purposes such as establishing one’s identity. The passport is evidence offered as a substitute for firsthand knowledge of a person’s identity and citizenship. Its use depends on social regulations backed by military force’.⁶ It enables governments to entrench ‘enduring identities that permit them to “lay hold of” their subjects/citizens’.⁷ This laying hold involves binding individuals into designated enclaves and further holding them within institutional clutches. The national passport, in these ways, helps governments lay hold of their citizens or subjects by regulating the latter’s movements, determining their rights and mediating their experiences as they navigate space and society.

The national passport has therefore been crucial for governments implementing ‘restrictions on movement and residence by establishing the identity of those to be so restricted’.⁸ This document is consequently central to various regimes of verification that intend ‘to capture the specific ways in which individual identity is defined, the evidence needed to verify that identity, and the authorities who could ultimately determine an individual’s (official) identity’.⁹ Formal verification necessitates ‘a clearly defined or stable object to which to compare evidence. What becomes accepted as objective practices of verification in “fact” produce the very criteria they utilize—verification produces the verifiable object it requires’.¹⁰ The national passport functions as this clearly defined, stable, verifiable, evidentiary object of identity. The resulting documented identity is coupled with identification; in fact, with the national passport, identity and identification are conflated to the degree that the former becomes a result or product of the latter. With the national passport, an individual thus becomes both identified and identifiable by governments, institutions and individuals.

Regimes of verification that are built up around the passport can also be considered as complementary to or parts of a ‘mobility regime’.¹¹ The national passport not only identifies and verifies identities but also, enforces ‘closure, entrapment and containment’¹² within designated categories and spaces. Individuals encounter closure since this document defines their national identity, thereby closing off affordances and other possibilities for self-identification. This closure, in turn, entraps them within contained spaces, or ‘enclave societies’,¹³ insofar as their mobility and other rights are concerned. Enclave societies are established when governments and other institutions regulate spaces for various purposes—political, economic, social, medical and so on—with the goal of immobilizing flows of people, resources and trade. Individuals hence become ‘trapped’ by their documented identities since these documents either permit or prohibit various rights, freedoms and opportunities; for instance, their abilities to travel across, and sometimes within, jurisdictions can be expanded or curtailed by documents like the national passport. In other words, institutional barriers, regulations, registrations and documentation, like the national passport, exclude, separate and sequester individuals within these specially designated quarters.

Exclusion based upon an undocumented, and hence unverifiable, identity, is another deliberate product of such regimes of verification. The national passport plays a prominent part in exercising exclusion by distinguishing and enforcing boundaries between citizens and non-citizens. Individuals issued the passport are conferred citizenship status and included in its associated rights and mobilities; meanwhile, individuals who are not issued this document and/or remain undocumented are denied citizenship status and excluded from its associated rights and mobilities. These documentary distinctions between citizens and non-citizens have direct effects on individuals’ lives. The national passport not only facilitates ‘the flow of assorted benefits that come with [state] recognition’, but also in so doing ‘render invisible particular groups by denying them [that same] documentation’.¹⁴ In this sense, it is often with and through the national passport that ‘the vagaries of state bureaucracies are felt with full force and the hierarchies of [those included in the state’s citizenship categories] and [their] denial generate everyday hardships’.¹⁵ Documented citizens are ‘made into’ citizens with various rights and mobilities whilst the undocumented are ‘made into’ non-citizens by virtue of not being issued or not possessing it.

Twin Identity Documents

Converging in significant respects, the national passport and immunity passport can be considered as twin documents. Both deal with identity, identification, verification, mobility, control and discipline. Both share similar functions of establishing identity and, in turn, identifying and verifying that identity. Both have parallel purposes of determining and regulating movements and other related rights. Both control and discipline individuals’ agency insofar as their identities, mobilities and other related rights are concerned.

Despite these convergences, these twin documents nevertheless diverge in important respects regarding identity, implementation and regimes of verification. The national passport, on the one hand, establishes and enforces a national or state identity; that is, it nationalizes individuals and serves as material evidence of that nationality. Required by governments to identify citizens, it is used on a continual basis within sundry states’ regimes of verification. The immunity passport, on the other hand, establishes and enforces a health identity; in this way, it can therefore be seen to bio-politicize individuals by conferring material evidence of their (alleged) immunity, inoculation or otherwise risk-free status from disease. By materializing a biopolitical identity based upon health status, the immunity passport is offered as a substitute for firsthand knowledge of individuals’ health, thereby serving as documentary evidence of their alleged healthy bodies. Required by governments, businesses and other institutions to single out immune individuals, it is used, usually temporarily, during a health crisis within regimes of health or immunity verification. Specifically, it regulates individuals’ mobility by authorizing and supervising their rights and freedoms to travel. This authorization and supervision induce pre-determined responses by institutions and individuals interacting with this document including permitting or prohibiting passage through, ingress, egress or residence within particular quarters, communities or countries.

The national passport and immunity passport, moreover, share similar concerns between political, communal and bodily immunities. In fact, immunity, as a concept, is intimately intertwined with politics, law, medicine, health and social relations.¹⁶ Beyond the individual body and human biology, immunity also frames politics, laws, borders, science and so on, insofar as these different domains are preoccupied with, and work towards, (different kinds of) immunization from external risks and threats. These different domains, from politics to medicine, strive to immunize their borders from unauthorized or invading ‘others’, whether armies, ideas or viruses. Immunizing borders transforms the inside into an ‘object of care’¹⁷ to be shielded from outside threats. As an object of care, the inside is ‘separated off and closed up inside progressively desocialized spaces…meant to immunize it’.¹⁸ Immunity, in this sense, seals off the inside from the outside by erecting borders to separate what or who belongs and should be included from what or who does not belong or should be excluded.

Thus, to legitimate their respective borders, the national passport and immunity passport appeal to the logic and function of immunity. While the passport helps enforce national borders ensuring immunity from non-citizens and external threats, the immunity passport helps enforce health borders—such as bodily, biological and viral—between the immune and non-immune. During health crisis, moreover, national and health borders often intersect when the need for medical and social surveillance converge. Involving medical and social ‘surveillance of “undesirable elements”—whether these are of an ethnic, national, racial, economic, political, ideological or medical character’,¹⁹ this convergence can be traced back to the medieval era’s introduction of quarantine measures to counter plague and leprosy outbreaks. Medieval quarantine was a bipartite model in which leprosy resulted in the placing of the sick ‘into individual settings that would allow them to be numbered, registered and assiduously controlled’.^20,21 This bipartite model was scalable to the extent that ‘the entire territory [could be] gradually divided into strictly separate zones based on the need for both medical and social surveillance’.²² Quarantine thus enabled the bordering, immunizing and othering of individuals. This bordering, immunizing and othering not only occurred on the basis of individuals’ health but also often aligned with their social status. Privileged groups, for instance, could often attain exemptions from quarantine based upon their social positions as opposed to their actual health (as will be illustrated in the example below).

Immunizing borders is therefore concerned with and connected to ‘bodies’, including the individual body, collective body and body politic. Immunizing means that ‘life becomes government business…just as government becomes first and foremost the governance of life’.²³ As medical and social surveillance converge, especially during health crises, these different bodies become increasingly intertwined to the degree that it becomes ‘impossible to imagine politics that doesn’t turn to life as such, that doesn’t look at the citizen from the point of view of his living body’.²⁴ The national passport and immunity passport are instrumental mechanisms in situating ‘the body at the center of politics and the potential for disease at the center of the body’.²⁵ While it is national life for the passport, and public health for the immunity passport, both documents help superimpose the sphere of the living—bodily, biological, viral—onto the governance of life.

Ultimately, these twin documents are both kinds of identity documents that play important roles in shaping the identities, movements and lives of their bearers. They dictate who can move in pre-determined ways; who is granted or denied permission to cross borders; who is regarded with suspicion or favor; and who is subjected to interrogation. A material-documentary perspective, coupled with four documentary registers, can help to further contextualize these historically contingent dictates.

A Material-Documentary Perspective and Four Registers

A material-documentary perspective illuminates and emphasizes the importance of documents. It ‘cuts across the dual oppositions of document and information, giving special attention to matter by examining the materiality of documentation and the practices, processes, and assemblages involved in the materialization of information’.²⁶ Applying this perspective involves placing ‘a specific document, or documents, at the center of observation, study and analysis and thereby develops documentary dialogues about and for it, uses the document to better illuminate its [historical] context, and integrates the document in teaching and researching information’.²⁷ First, a document—or multiple documents, or an object regarded as having documentary evidence of something—is placed at the center of observation, study and analysis. Second, the document itself is used to analyze the wider context in which it emerges. This analysis helps reveal the document’s implications for its wider context as well as the wider context’s influences upon it. Third, the document is integrated into research, not necessarily or only as a source of research but, importantly, as the object of concern; for example, the document can be scrutinized as an object with its own history and historical value.

Documents like the immunity passport, in fact, are imbued with their own histories. These objects have ‘historicity’²⁸ in the sense that their forms, formats and associated practices depend upon specific historical and sociocultural contexts. An object considered a document in one historical sociocultural context, for instance, may not be the same kind of document, or even considered a document, in the same or another place and period. Practices with a document, moreover, may only be possible in one specific setting but not in another, or at least not practiced in the same way or for the same reasons. The ‘historicity’ of the immunity passport sheds light on how this object is intimately bound up with its diverse documentary instantiations across divergent historical and sociocultural contexts. In this case, the immunity passport is placed at the center of observation to help develop specific documentary dialogues about and for it. The immunity passport itself is then used to analyze its implications for its wider historical context and vice versa. Ultimately, the immunity passport is being historically researched and examined as an object in its own right. This focus on the immunity passport as a document with its own history can thereby ‘provide more helpful directions for information, illuminating the cultural, institutional, material, social, organizational, and technical aspects of information while helping to anchor [historical] discussions in specific material situations’.²⁹ It can help uncover the immunity passport’s centrality, necessity and usages as a particular, even peculiar, kind of object and, in so doing, exhibit the documentary nature of identity, personal and public health, disease and health crises.

Hence by shifting focus to a document-oriented history, the important roles played by the immunity passport as a material object during health crises are revealed. It helps expose ‘the bureaucratic tentacles that actually do, in a material sense, reach into and control ordinary lives, helping to ensure the effective functioning of governance and governmentality and to manage embodied subjectivities’.³⁰ The immunity passport, in this material sense, helps ensure the effective operations of governance and the implementation and practice of public health regulations. It further connects the government, health authorities and disease to individuals, disciplining and managing their bodies by both categorizing them and controlling their physical movements and other mobility rights.

Foregrounding the immunity passport within this material-documentary perspective, this document can be further unpacked and analyzed within the conceptual framework of ‘four registers’ of the national passport, comprised of history, government, jurisprudence and resistance.³¹ Intimate interconnections are, as aforementioned, shared between these documents; indeed, they share parallel, and in some respects co-constitutive, histories. To begin, along the documentary register of history, the passport is ‘an object of history that functions as a technology of statecraft and emerged with the consolidation of the modern territorial nation state’.³² Emerging with the development of modern governments and international law, this object is designed and deployed to help establish countries’ frontiers and manage people’s mobility across or within these geopolitical jurisdictions.

The materiality of the national passport is also historically contingent. Its materiality ‘has not only shaped the contours of the object itself, it has also helped enmesh the passport within changing technological systems’.³³ Affecting people’s travel and mobility experiences, whilst expanding states’ surveillance and security capabilities over individual travelers, ‘the technical [material] characteristics of the passport thus both facilitate “legitimate” movement, and are implicated in coding which forms of movement are deemed legitimate in the first place’.³⁴ Whether paper, plastic, metal, silicon or combinations thereof, the materials used in the construction of the document, in addition to the wider analogue and/or digital infrastructure within which it operates, depends upon the time, place and sociocultural setting of its creation, authority, power and use.

Similarly, the immunity passport is an historical object functioning as a document technology associated with health crises. It has not emerged in historical vacuums, but instead has arisen along with, or in parallel to, other (similar) identity, verification and travel documents. The ostensible objective is to curb and contain the spread of disease. In formal cases certifying, and in informal cases claiming, an individual’s health—particularly immunity—status, this document permits or prohibits movements and determines other related rights. Its materiality, moreover, is also dependent upon its historical context, appearing in variegated versions—in terms of materials used, designs, provisions and documentary genres (formal or informal, certificate, letter, advertisement etc.)—at different times and places.

Next, along the documentary register of government, the national passport is ‘an object of government that works towards the control of individuals, the construction of border regimes, and the global segregation of populations’.³⁵ Concerned with identifying individual’s national identity and, in so doing, connecting it to a state’s official citizenship and other identity categories, the national passport serves ‘as an important document for distinguishing between citizens within a state [and between states]’.³⁶ This document is an object of concern, on the one hand, for governments to verify and regulate movements of citizens, and by extension non-citizens, traversing across and within its terrains; on the other hand, it is also an object of concern for international travel in order for states to manage traffic entering and exiting their respective borders.

Correspondingly, the immunity passport is an object of governments, and/or other health, security or business institutions, that work towards the control of individuals, the construction and immunization of public health borders, and the separation of people according to actual or perceived health as well as the state’s formal categories of health, particularly immunity, status. Dually concerned with identity and health, the immunity passport, on the one hand, materializes and certifies individuals’ health status during health crises; on the other hand, the immunity passport helps enforce public health measures aimed at quelling health crises, in this case by regulating people’s movements and travel. Further, the immunity passport facilitates the material making of the health crisis in question. While a virus or disease cannot necessarily be seen with the naked eye, it is often documents, like the immunity passport, that ‘enable the virus [or disease] to be seen and the pandemic [or health crisis] to be an experienced reality’.³⁷ The immunity passport helps mediate individuals’ experiences with the virus and accompanying health crisis and, in so doing, helps produce the context within which that documentation, and resulting documented, identity is legitimated.

Along the documentary register of jurisprudence, meanwhile, the national passport is a ‘jurisprudential object that crafts a particular juridical human’.³⁸ It is a state-mandated document materializing the formal legal archetype of citizen or nationalized person. This document ‘is not just a prerequisite artefact for exercising the right to physically leave one’s country, it also paradoxically symbolizes the legal binding of individuals to states and thereby constructs a compulsory form of social and national identity’.³⁹ In this sense, it is a jurisprudential document allowing for adjudication of identity and associated rights, freedoms, and other legal and political considerations.

Likewise, the immunity passport is a jurisprudential object that crafts a particular kind of medical-juridical person. As a product of inoculations, medical treatments or other medical tests, and their resulting interpretations and decisions regarding an individual’s health and immunity to disease, the immunity passport is often imbued with institutional power and authority to adjudicate the legal medical archetype of health status and immunity to disease. Yet, throughout most of its history, this document was not given to an individual based upon scientific determinants; instead, it was largely coupled to bodily and social status without much, if any, scientific support. This document, after all, has been required, or expected, of an individual for different reasons, by different actors, in different times in history. People imbued with authority to decide whether someone was deserving of an immunity passport included government officials, soldiers and sentinels, clergymen and physicians; moreover, other people who also required, or expected, someone to show an immunity passport included administrators, employers, merchants, innkeepers, and, sometimes, the overall community. The ways in which someone was bequeathed an immunity passport often involved visual cues, like their bodily appearance, personal or communal standing, like being known to/within the community, and social standing, like being wealthy or impoverished. Although determinations and understandings of health status and immunity to disease admittedly differ across historical and sociocultural settings, there are nevertheless certain continuities in dealing with these phenomena, such as the imposition of non-pharmaceutical interventions into health crises like the immunity passport. Attesting to one’s health and immunity status, this document either permits or prohibits its bearer’s mobility, travel and often other rights and freedoms during the health crisis in question.

Finally, along the documentary register of resistance, the national passport can be ‘an object of resistance taken up in political struggles to challenge the nation-state’s asserted monopoly on territorial authority’.⁴⁰ It can be used to contest states’ borders and, by extension, their monopolistic power to regulate individual movement and travel. Some Indigenous groups, for example, have used the national passport as an object of contestation in demanding greater recognition of land sovereignty, in addition to countering and even refusing the jurisdictional claims of settler states. Or, as another example, some migrants have resisted governments’ requirements for formal travel documents authorizing their ingress or presence within their respective jurisdictions by manipulating or undermining ‘these official state processes, including accessing false documents or making their legal identity difficult to establish by destroying any passports they may have prior to entry to obstruct or delay any subsequent state deportation attempts’.⁴¹

Comparably, the immunity passport can be used as an object of resistance taken up in challenges to governments’ monopoly over public health, travel and individual mobility. It can, for instance, be falsified to misrepresent one’s health and immunity status thereby subverting public health measures and simultaneously circumventing various mobility regulations and restrictions. This document can also be forged to construct an entirely fake health and immunity status that, if undetected, could deceive health verification procedures and mobility enforcement, thereby defying institutional controls implemented to manage the health crisis. Depending upon context, resistance to the immunity passport can also be formally built into its procedures by allowing for (the consideration of) petitions to override some of its provisions, in addition to exemptions from usage for particular individuals or health cases.

Along each of the four documentary registers, the national passport establishes and materializes national identities, strengthens political and legal order, entrenches social control and facilitates travel across, and sometimes within, borders. Indeed, it ‘offers insight into the history and ontology of international law as well as the regimes, epistemologies, and material practices of its institutions and actors, revealing how the deeply state-centric order produced through international law regulates human mobility and identity’.⁴² In parallel, the immunity passport, during health crises, establishes and materializes health and immunity statuses, enforces public health measures, and determines movements and other related rights and freedoms. As an object of health and immunity identity, public health, mobility and social control, the immunity passport therefore offers insight into the history of health crises by shedding light on how immunization—of diseases, bodies, borders and societies—produced through this document, and its multiple instantiations, has helped regulate identity, mobility, public health and power.

Four Historical Cases of the Immunity Passport

Foregrounding the immunity passport within a material-documentary perspective, let us now turn to a historical overview of the immunity passport and its variegated versions, different justifications, and diverse uses across sundry sociocultural contexts.

Renaissance Mediterranean Region

From the fourteenth through to the eighteenth and nineteenth centuries, plagues swept across Europe threatening public health and jeopardizing sociopolitical stability. Caused by ‘the Yersinia pestis [bacterium]’,⁴³ plague symptoms included fevers, headaches, chills, weakness and swollen lymph nodes (called buboes). Controlling the disease and mitigating its effects required public health interventions including ‘restrictions on movement, bills of health, quarantine regulations for travellers and shipping’.⁴⁴ These mechanisms not only ‘implied serious restrictions on individual liberty’⁴⁵ but also ‘necessitated the growth of local administrative machines and an expansion of state power’.⁴⁶ Across parts of the Mediterranean region, pioneering plague controls were devised consisting of mobility restrictions comprised of quarantines and health certificates. In 1377, for instance, the city of Dubrovnik (Ragusa) is regarded as one of the first cities in the region to impose a quarantine (of 30 days) on suspect travelers.^47,48 Consolidating control over borders and populations, quarantines and health certificates cordoned off physical spaces, restricted movements, and facilitated joint medical and political surveillance of individuals. The primary concern of these mobility restrictions was protecting the health of both the individual body and the body politic from disease, in this case, the plague and its potential carriers.

Specifically, these mobility restrictions banned the entrance and exit of individuals arriving from areas affected by plague and severely limited movements within the region’s respective city–states.⁴⁹ Quarantines involved spatial and administrative practices of enclosing towns or neighborhoods and establishing isolation hospitals and lazarettos.⁵⁰ Immunity passports—referred to as bills of health, health passes or health licenses—further entrenched quarantines by constraining individuals’ movements between these segregated enclaves. By standing in for the body of the individual, bills of health established and verified individuals’ (alleged) immunity that, in turn, helped immunize the body politic from external disease. Immunity passports thus assisted the state in adopting institutional practices examining documentation about individuals instead of individuals themselves. Further, these documents facilitated joint medical and social surveillance, scalable from the level of the individual to the population. These mobility restrictions gradually became commonplace as ‘cities across the European continent embraced these Mediterranean-originating methods of limiting contact and [began to] routinely utilized public health efforts that included quarantines, travel bans [and passes], and isolation hospitals’⁵¹ to similarly immunize their communities from the threat of plague.

These anti-plague controls were important developments in the history of passports.⁵² Quarantine and health passes, after all, contained people to confined quarters and curtailed movements within and across territories. Bills of health thus functioned as mechanisms of power that were ‘not simply repressive but productive of specific relationships [between the state, people, and public health]’.⁵³ Repressive in their restrictive injunctions on people’s movements, these documents were simultaneously productive, for better or worse, in expanding state control, connecting individuals to governments, and conceptualizing and presumably protecting the public health of city–states and the international community; after all, these restrictions were often imposed on residents and aliens alike.

Official boards of health were established by the administrations of these city–states to oversee the anti-plague efforts attempting to curb and contain the disease’s transmission. Although employing physician knowledge, these health boards were not under medical control and operated relatively independently of prince or government. Staffed by administrators and physicians, the administrative control of these health boards represented ‘one aspect of the growing power of central administration vis-à-vis the particularistic interests of social and professional groups’.⁵⁴ Initially intended to be provisional, many of these boards gradually transformed into more permanent offices as their duties and actions, beyond preventing and controlling epidemics, became increasingly wide-ranging.

During times of plague, however, these health boards concentrated on ‘those laws that related to the plague, as well as to issue [health] passes to and from the city’.⁵⁵ They were particularly concerned with implementing and enforcing these mobility regimes. Their primary role, in fact, ‘was to vet potential travelers wishing to flee from the city and the examination of potential entrants to the city’.⁵⁶ Health passes were important disciplinary instruments in these vetting and examination processes. Individuals were hence assigned material objects—health passes—issued by these health boards representing the state’s otherwise abstract health categories and also the immaterial characteristics of being free from plague. These documents, typically handwritten pieces of paper, attested to their bearers’ not having the plague or its symptoms, thereby establishing and verifying their health status. Anyone exiting the respective city-state had to obtain the health pass, not only to leave and travel abroad, but also to assure ‘other states and sovereign rulers that the bearer was safe…[and that] he/she was free of the plague’.⁵⁷ Individuals in possession of these documents could present them as evidence of their clear immunity status as well as an official guarantee substantiating their claims of good health. These health passes therefore served an evidentiary function of enabling authorities to assess individuals’ health, not by examining their bodies, but instead by consulting their documents.

Importantly, health passes were not only issued to individuals but also to other objects and multiple or groups of people. They could, for example, be applied to and expected from ships and accompanying crew, passengers and cargo. Health passes for ships also functioned as documentary evidence establishing and verifying the ship, and its living or inanimate contents, as being either free from or stricken with plague. Specifically, these documents categorized the ‘health’ of ships as either clean or foul; thus, a clean health pass expanded travel options whilst a foul health pass contracted them.

Granting or refusing the issuance of health passes tended to revolve around social standing and/or economic concerns. The poor and marginalized—the usual scapegoats of blame and targets for discrimination—were disproportionately governed by these health boards, especially through the restriction of their movements. Disease, in fact, was often associated with poverty. Unlike the rich and connected, the poor and marginalized could not afford to flee when plague or other disease struck. Hence, when disease seemed to concentrate and circulate in poorer areas, these presumed associations between disease, poverty and disorder were confirmed.⁵⁸ The poor and marginalized were considered infectious and consequently threats to the overall body politic. Since ‘in Renaissance Italy, bodily disease was associated with social ills’, these health boards particularly ‘controlled [the poor and marginalized] to a much greater extent than the rich’.⁵⁹ The anti-plague measures like quarantine and health passes were, in part, designed to constrain the movements and repress the social behaviors of the poor and marginalized to ostensibly control the plague; or, in other words, anti-plague control was social control, particularly geared towards the already socially disenfranchised. As their movements and travels were restricted, the poor and marginalized were largely confined to quarantined and plague-stricken areas that the rich had fled, reinforcing ‘legislators’ conclusions that the plague was a disease afflicting the lower social groups or classes’.⁶⁰ Confined in quarantined or plague-stricken areas, these people became conflated with disease and, therefore, express targets of plague control.

Some health boards defended issuing health passes to the poor and marginalized on the basis that their movements were allegedly obscure and difficult to trace; as a result, their movements needed to be closely regulated. Many health boards ‘noted that they often did not know the itinerary of a wanderer or mendicant, whereas the recent travel of someone of the upper classes could be verified easily’.⁶¹ For example, health passes were often stipulated for certain kinds from so-called undesirable people like beggars, itinerants, prostitutes, mendicants and wanderers, but they were less often required from higher-class people including the rich, aristocrats, clergy, politicians and ambassadors. In Florence, for instance, city gate-keepers were warned to prohibit ingress by ‘“scoundrels, swindlers and the poor, or other people on foot who [came] begging”…[Yet] as the [health] licences issued to enter a territory show, exceptions were always made for ambassadors and wealthy travellers, even though they came from plague-stricken areas’.⁶² A general reluctance, meanwhile, was also espoused by health boards to strictly enforce these documents upon society’s upper echelons or commercial classes. Indeed, social status and economic interests could often trump public health in the issuance of health passes.

In the case of shipping, for instance, ‘declaring a foul bill of health or re-routing a vessel interrupted commerce, undermined naval strategies and could easily and expediently turn passengers into prisoners of war’.⁶³ In some cases, ‘the granting of licences to pass through a town or stay overnight would have been particularly important for merchants and tradesmen’⁶⁴ for their business activities and other economic concerns. To avoid conflicts with commercial interests resentful of mobility restrictions upon their business activities, health passes could often be granted or conversely the need to present them waived, in the interests of money.

Health passes in the Renaissance Mediterranean region therefore not only helped control and discipline movements but also exercised material effects over social and personal life. When an outbreak of plague was declared outside a city, health boards mandated the closure of ‘the city gates, leaving only one or two open for traffic. Guards posted at those few open gates demanded that travellers present health certificates for both themselves and any merchandize they carried, verifying their town of origin and health’.⁶⁵ Armies were deployed to enforce these plague controls by patrolling quarantined areas, intercepting individuals attempting to either enter or exit or otherwise break confinement, and checking the health passes of those individuals, particularly the poor and marginalized, entering and/or exiting the cities.⁶⁶ These documents served the evidentiary function of authenticating their bearers’ freedom from plague (for the rich), or implicitly indicating their often questionable or unsavory social status (for the poor). Individuals with health passes were nonetheless permitted ingress and egress from cities; meanwhile, (poor and marginalized) individuals without health passes were prevented from leaving infected or quarantined areas, which perversely compounded the disease’s impact, expansion and association with disadvantaged groups.

1665 Great Plague of London

Erupting in 1665 and lasting for over 1 year, the so-called Great Plague of London was the last major outbreak of plague in Britain.⁶⁷ The capital and other English cities enacted the dual mobility restrictions of quarantines and health certificates in attempts to control this deadly scourge. These mobility restrictions, in fact, were already in operation in the years preceding this alarming outbreak.

In 1663, for instance, the international threat posed by plague in Amsterdam and Hamburg prompted London’s Lord Mayer, Sir John Lawrence, to quarantine incoming ships from those cities. Further, Thomas Chiffinch, the Groom of Chambers to King Charles II, argued ‘for the issue of health certificates for anyone who was to land and the isolation of those who were sick, at first on board and then by being kept apart on shore’.⁶⁸ Entry and exit into the capital were rigorously regulated with Navy ships patrolling the Thames estuary to intercept all maritime traffic and ascertain their origins. Vessels originating from plague-free places ‘were given certificates of health by the captains of the patrolling ships and the commanders of the fort at Tilbury and the blockhouse at Gravesend on the south side of the Thames, opposite Tilbury, were instructed not to allow any vessel to pass unless they had such a certificate’.⁶⁹ When the plague eventually appeared in Britain in the summer of 1665, however, these mobility restrictions were additionally incorporated for and applied to internal movements.

Travelers to and from London were obliged to possess health certificates. According to King Charles II’s rules and orders for the prevention of plague, non-residents were denied entry to towns unless possessing certificates of health.⁷⁰ Certificates of health were intended by the authorities to serve as evidence of their bearers’ plague-free status permitting their entry or exit from the city. This documentary requirement aligned with similar preventive action taken by towns and surrounding locales, including ‘the exclusion of those who were regarded as a risk, and the introduction of health certificates for travellers’.⁷¹ Without this document, individuals could not flee plague-infested areas; however, even with this document, they could nevertheless still encounter problems whilst fleeing, such as increased scrutiny from sentinels, hostility from townspeople and inability to secure accommodations.

The poor and marginalized were often singled out as risks and their health certificates particularly scrutinized. The authorities of the town of Lincoln ‘directed the petty constables to apprehend vagrants and “wandering persons”, to examine other travelers and strangers, and to prevent them from taking accommodation unless they could demonstrate that they were free from infection, presumably by producing a health certificate’.⁷² Although obliged to possess health certificates, the rich and upper classes were less likely to have these documents inspected compared to impoverished and lower-class people. Like in the Mediterranean region in the previous centuries, the former’s wealth and social status would often trump strict documentary scrutiny since disease, and its transmission, was associated with the latter. For important and well-known figures, moreover, this documentary requirement could even be overlooked; for example, Samuel Pepys, a high-ranking government official, was permitted entry into Greenwich despite arriving from London without a health certificate.⁷³

Another important documentary mechanism accompanying health certificates were ‘bills of mortality’ published by London’s Company of Parish Clerks. Bills of mortality—which were single sheets of paper listing mortality figures for London’s 130 parishes on one side and the causes of death on the other—not only served as ‘a complex hybrid of commercial news service, public health measure, and scientific publication’,⁷⁴ but also became ‘closely tied to the most contentious social practices during the plague: flight and household quarantine’.⁷⁵ Distributed by subscription or single sales, the bills were widely consumed within the capital and ‘read far outside of London, and possibly even beyond the British Isles’.⁷⁶ Shaping real-time perceptions of and responses to the plague as it unfolded throughout 1665, the bills enabled the tracking of the epidemic across the city and, as a result, the planning of moving around, and entering or exiting, the city. The bills were consequently used by authorities to establish quarantines and other public health measures, whilst they were consulted by Londoners regarding what parishes, and other neighborhoods, to avoid. The bills also assisted individuals, especially wealthy ones, in deciding when to leave London. Residents of parishes considered uninfected could acquire health certificates to free up their movements; however, bills identifying parishes as infected resulted in the restriction of residents’ mobility since they consequently ‘could not obtain health certificates to travel’.⁷⁷

Broader economic interests also impacted the use of health certificates. Local populations in towns and surrounding regions to which Londoners escaped were largely hostile to their arrival and presence, especially farmers upon which the capital depended for food. The plague’s ravages were compounded as more and more Londoners were denied health certificates and ergo unable to depart from the city. In these cases, the need to secure food supplies, ensure London remained fed, and by extension keep the economy functioning, yet again trumped public health considerations.

Aiming to strengthen the authority and credibility of health certificates, the authorities employed other documents—namely newspaper advertisements and warning notices—to counter forgeries and illegal markets. Newspaper advertisements were issued clarifying what offices and/or church parishes provided health certificates including the procedures and qualifications required to apply for them. For instance, the churchwardens of St. Gregory’s issued a newspaper advertisement in July 1665 explaining ‘that they gave certificates only to those known to them to be free from plague, and that all such documents emanating from them were printed [not handwritten]’.⁷⁸ Since handwritten health certificates were being forged, church parishes eventually adjusted their documentary procedures by producing and signing printed documents exclusively for people known to them or the wider parish community.

Warning notices, meanwhile, were published to identify individuals ignoring or violating this documentary requirement. The justification for these notices was that those travelers not in possession of health certificates were potential carriers of the disease. Londoners departing the capital without a health certificate could be identified by these notices. When, for example, ‘the maid of an upholsterer in Covent Garden died, he and several others living in the house left, taking some possessions with them [without obtaining the necessary health certificates], but a notice in The London Gazette gave their names and ordered that a search should be made for them’.⁷⁹ The goal was to identify and quarantine the documentary violators as well as identify and close all places in which they lodged outside of London.

Antebellum (Southern) USA

Yellow fever, a mosquito-borne flavivirus, was a common but fatal disease during the nineteenth-century antebellum period in the southern USA. The infectious disease presented an annual threat terrorizing southerners, particularly the region’s main urban center of New Orleans. In 1853, for example, ‘over 12,000 people died of yellow fever in New Orleans … with still more deaths in rural areas in south Louisiana, marking the single highest annual death rate of any state during the entire nineteenth century’.⁸⁰ During the six decades leading up to the American Civil War in 1861, ‘New Orleans experienced 22 full-blown epidemics, cumulatively killing over 150,000 people…The virus killed about half of all those it infected and it killed them horribly, with many victims vomiting thick black blood, the consistency and color of coffee grounds’.⁸¹ People who survived yellow fever, colloquially called Yellow Jack or the Saffron Scourge, became immune or so-called acclimated to the disease.

During this racialized slave-era, New Orleans was considered ‘an outlier among American cities, characterized by its Caribbean-esque tripartite social system of whites, gens de couleur libres, and slaves. But there was another rigid, if invisible, hierarchy at work: Orleanians were either yellow fever survivors, in a probationary period awaiting acclimation, or dead’.⁸² Immunity, or the lack thereof, was layered upon New Orleans’s already stratified social structure of Whites, free Coloreds and Black slaves. This ‘immunological discrimination was just one more form of bias in a city premised on inequality’.⁸³

Being acclimated or unacclimated therefore mattered. But it mattered differently depending upon an individual’s origin, class, race and by extension, their freedom or enslavement. The disease produced ‘an “insider” mentality shared by comfortable “acclimated” New Orleanians who felt no affinity for the “outsider” elements associated with the disease and poverty’.⁸⁴ Insiders were acclimated ‘locals’ in New Orleans or Louisiana, whether White or Black; ‘outsider’ were susceptible and unacclimated White immigrants or Black slaves alien to the region. Yellow fever was consequently considered a ‘stranger’s disease’.⁸⁵ Yellow fever was further associated with poor or indigent immigrants specifically, and the impoverished generally. The disease tended to be ‘confined to poor neighbourhoods’,⁸⁶ especially since the rich could escape during the infectious season, whilst locals claimed that immigrants ‘living in squalor, represented a public health scourge’.⁸⁷

For White people, immunity status determined employment, earnings, credit access, residence and marriage prospects. Unacclimated White people were considered unemployable, unreliable for credit, risks for renting or purchasing property, and ineligible for marriage. They consequently existed on the lower rungs of this racialized hierarchy. There were also imagined ‘racial divisions in susceptibility’⁸⁸ by physicians and the public alike. People advocating abolition of slavery were deemed to be more likely to contract yellow fever⁸⁹; meanwhile, White masters or laborers who performed outdoor work in the summer sun that slaves were supposed to do ‘violated the laws of nature’ and were consequently susceptible to the disease.⁹⁰ Government officials and pro-slavery advocates argued that slaves’ acclimation protected White society by permitting ‘whites to socially distance themselves…[since] they could stay at home, in relative safety, if black people were forced to labor and trade on their behalf’.⁹¹ Thus, for Black slaves, immunity status was commoditized and considered important for the health of White society. Slaves’ acclimation translated into economic assets by increasing their owners’ capital; in fact, ‘enslaved people who’d acquired immunity increased their monetary value to their owners by up to 50 percent’.⁹² While acclimation bestowed a positive immune-capital on/for Whites, it simultaneously burdened the enslaved with negative immune-capital benefiting not them but their owners.

White people desired, and in some cases were desperate, to become and then prove their personal, or their slaves’, yellow fever acclimation. After all, ‘acclimation meant surviving yellow fever, but to have immunocapital, Orleanians had to convince others of their immunity’.⁹³ While New Orleanians were socialized to recognize immunity cues, documents were also used to identify and verify individuals’ acclimation. Ships entering New Orleans, for instance, had to present ‘certificates of acclimation from the U.S. [government]’ (Daily Picayune 1857).⁹⁴ But immunity certificates were not officially mandated for internal movements. Other informal documents claiming immunity—including newspaper employment profiles, physicians’ letters and slave advertisements—served similar roles as kinds of immunity passports evincing acclimation. While these documents similarly permitted or prohibited mobility, they further determined social mobility. As documents of social mobility, they were used by acclimated, or presumably acclimated, White people to secure work, acquire housing, leverage social opportunities, improve marriage eligibility and/or sell slaves.

Employers stipulated that prospective employees’ present these informal documents. They ‘demanded parental residency, proof of local birth, or a physician’s letter certifying acclimation … [Indeed, from] the boss’s perspective, it was a waste of resources to train someone for a detail-oriented job only to see him stricken or dead by autumn’.⁹⁵ Prospective employees, meanwhile, posted newspaper profiles declaring their acclimation in the hopes of assuaging fears of potential employers and thereby capitalizing on their immunity status. These newspaper profiles often listed ‘well acclimated’⁹⁶ as one of the individual’s top credentials. These informal documents, in other words, functioned as versions of immunity passports in the dual sense that they served as testaments to yellow fever acclimation and, in turn, facilitated their physical and social mobilities.

Acclimated slaves were in the highest, sometimes only, demand thereby commanding high prices. For instance, Walter Campbell, a slave trader, established a ‘“holding pen” eighty miles outside New Orleans to hasten the acclimation of his human property so that he could sell them at a premium’.⁹⁷ Many slavers and slaveowners refused to conduct any transactions without these documentary-guarantees of acclimation. Slave advertisements were used to claim and verify enslaved people’s immunity status and, by extension, their physical fitness and durability for exploitation. Slave advertisements, conjoining immunity status with other essential exploitable skills, typically marketed slaves in the following manner: ‘“A Choice lot of young Negroes, males and females, who have been here during the summer and therefore are partly acclimated”’,⁹⁸ or ‘“FOR SALE—A valuable family of slaves—consisting of a GRIFFE WOMAN, of 35 years, good Cook, Washer and Ironer, acclimated, willing subject and of obedient disposition”’.⁹⁹ The word ‘acclimated’ was therefore a common inscription in these documents ‘that conveniently reduced a person’s suffering to a marketable asset’.¹⁰⁰ These documents consequently functioned as kinds of immunity passports applied to slaves, thereby facilitating commercial transactions, transportation logistics and continued enforced labor practices.

Ultimately, these informal documents of social mobility—newspaper profiles and slave advertisements—functioned as kinds of unofficial immunity passports by identifying and claiming acclimation to yellow fever. Although informal in the sense that they were not issued by governments or medical institutions, these documents nevertheless served as (alleged) evidence of this immunity status of acclimatization. Further, they not only helped materialize and prove this immunity status but also helped confer the accompanying privileges for acclimatized White people, such as economic capital and social status, and associated burdens for acclimatized Black people, principally enslavement’s further justification and entrenchment.

British India

Cholera outbreaks were so frequent throughout the 1800s that it has been called the ‘“classic epidemic disease of the nineteenth-century”’.¹⁰¹ Caused by a bacterial infection of the small intestines resulting in mild to severe symptoms of muscle cramps, diarrhea and vomiting, cholera particularly impacted colonial-era British India, which ‘was the source of the cholera pandemics and itself suffered millions of deaths from the disease during the nineteenth and early twentieth centuries’.¹⁰² As people moved to, within, and from India—including colonial officials, settlers, troops and laborers—cholera spread across the British Empire and elsewhere. In fact, its imperial reach was as extensive as that of its resources; put differently, ‘cholera was notoriously Indian, a more distinctive export than the subcontinent’s indigo, jute and tea, and by Independence the nation’s emergence from British India experienced 99 per cent of global fatalities’.¹⁰³ Anticholera measures attempting to contain the disease’s spread included health certificates restricting individuals’ movements and opportunities. Applying specifically to Indians, these restrictive documents were implemented not only by British India’s colonial administration but also by foreign governments to control, and in many cases curtail, Indians’ mobility, presence and opportunities in their jurisdictions.

As documents of physical and social mobility, health certificates of British India helped establish and enforce three different, but allied, kinds of mobility and opportunity restrictions for Indians. First, the US government and other colonial governments in the British Empire, such as Canada, required Indians to possess health certificates, coupled with their national passports, to enter their respective territories. Second, both the Ottoman Empire and India’s colonial administration instituted the so-called pilgrim passport, which functioned as a

health certificate, for Indian Muslim performing the Hajj pilgrimage to Mecca. Pilgrim passports were also expected from ships conveying the pilgrims. Third, British India’s colonial administration demanded employees and prospective employees for administrative and agricultural occupations present health certificates of their medical fitness for such employment.

British colonies and other countries, like the USA, enacted anticholera legislation to stop cholera from reaching their shores. The anticholera legislation enacted by the governments of Canada and the USA, for instance, particularly focused Indian immigration to their countries. This focus conflated health status and racial identity. Authorities in Canada and the USA used these health and racial characteristics to prevent Indian immigration to North America on the grounds that, primarily, Indians’ posed cholera threats to public health, but also that they were biologically unsuited and culturally unsuitable for the climate.¹⁰⁴ Indians’ entry to either country therefore had to be limited and preferably belayed. Health certificates played a major part in these exclusionary efforts. Both Canadian and American governments required all incoming ships arriving from British India to present health certificates verifying the cholera-free health status of the ship and its passengers and cargo; further, passengers aboard these ships had to present personal health certificates testifying to their individual cholera-free health status. Without these documents, ships were declined from docking and/or passengers were denied from disembarkation.

The Ottoman Empire adopted similar anticholera actions against Indian Muslim pilgrims from entering and traveling within its imperial borders. Indian Muslim pilgrims were characterized as deadly conduits of cholera by the governments of the Ottoman Empire and British India. Described as pathogenic dangers in official discourse, Indian Muslims performing the Islamic Hajj represented ‘the problem of the diseased pilgrim … [who were] a “public nuisance” and a microbe-generating hazard’¹⁰⁵ and, hence, whose movements must be curtailed. The Ottoman Empire therefore demanded that British India regulate this ‘public nuisance’ throughout the mid-to-late nineteenth century and early twentieth century. British India was called upon ‘to ensure that pilgrims did not just drift across on overcrowded sailing ships, but were counted, medically inspected, and put onto licensed steam-ships’.¹⁰⁶ The Ottoman Sultan, for instance, suggested pilgrim passports as a solution to stemming the cholera tide from crashing over his imperial realms. In 1911, for instance, Sultan Mehmed V ‘insisted once again on a compulsory [pilgrim] passport for pilgrims from India’.¹⁰⁷

Justified on the grounds that Indian Muslim pilgrims posed cholera threats to the international community, British India complied with international demands for pilgrim passports to help curb, contain and prevent the disease’s spread. These documents served twin objectives at both individual and state levels. At the individual level, pilgrim passports served as evidence of their bearers’ cholera-free health status. They were required from all Indian Muslim performing the pilgrimage to Mecca in the Ottoman Empire. This documentary requirement further extended to all individuals traveling on ships arriving from India to the Ottoman Empire; in fact, pilgrim passports were ‘meant for all travellers who embarked on a ship licensed for the Red Sea pilgrim traffic even if they were setting out for some other purpose’.¹⁰⁸ Additional costly documents, namely prepaid return travel tickets, were conjoined with pilgrim passports. Applying for and receiving the latter was often conditional of purchasing the former. Formalized by an amendment to the Indian Merchant Shipping Act, itself a major legislative document, pilgrim passports were linked to ship tickets, constituting ‘composite artefact[s] of colonial governmentality’¹⁰⁹ implicitly designed to help complicate and diminish pilgrimage from India.

Concurrently, at the state level, pilgrim passports assisted British India in demonstrating ‘in international forums that the Government of India was a modernizing regime, capable of counting and documenting pilgrims and monitoring them for contagious disease’.¹¹⁰ The colonial administration thus assumed responsibility for issuing and guaranteeing pilgrim passports. While the regular British Indian passport was produced by India’s foreign department, pilgrim passports were produced by the country’s interior department for the practical reason that ‘unlike the regular passport, the pilgrim passport could be issued from any district office, and that the traffic involved sanitation, medical inspection and orderly embarkation’.¹¹¹ The issuance of these documents, in other words, could be more easily monitored, managed and tracked at local points of departure, permitting more granular surveillance and control over Indian Muslim pilgrims, their movements and overall pilgrimage traffic between British India and the Ottoman Empire.

Finally, within British India, official imperial interests desired greater surveillance over local populations to control and discipline communities whilst simultaneously mobilize demographic resources for different economic activities from administrative to agricultural works. This surveillance necessitated ‘the verification of personal particulars…and in the interests of rationalization, certain uniform criteria for employment had to be imposed and monitored’.¹¹² Personal identification documents became instrumental tools in helping the colonial administration identify, verify and surveil its subjects; in fact, ‘documents of individual identification were necessary to such procedures to monitor certain uniform criteria of age, education and medical fitness’.¹¹³

Indians’ physical and social mobility were defined by these identity documents that uniformly inscribed personal identities and health statuses into standardized formats. In fact, ‘the physical monitoring of populations that were the particular concern of the state’¹¹⁴ elevated local medical officers to positions of power since they were formally authorized to document, and thus determine, individuals’ medical fitness for work. Employment rules in most settings obliged Indian employees and applicants to submit identification documents indicating their medical fitness; additionally, workers, in some cases, were required to submit separate ‘medical certificates … for appointment and leave’.¹¹⁵ Moreover, medical officers even had to oversee the recording of the personal health status of prisoners, particularly those laboring on plantations and in mines. Prisoners’ health certificates eventually ‘became compulsory in the descriptive roll sent with convicts transported to the Andamans [and other areas]’.¹¹⁶ Free, indentured, and imprisoned labor, in other words, all required these health and identity documents.

These health and identity documents further acquired international importance arising from various mobility, medical and political economic concerns. Worried about the spread of cholera across British India and imperial borders, these documents were employed by the colonial administration to help monitor ‘the movement of indentured labour, pilgrims and free emigrants’.¹¹⁷ Further, they could be used by municipal governments to justify rejecting applications for pilgrim passports based on individuals’ undesirable medical fitness, such as ‘someone mentally or physically defective, or who suffered from “loathsome, dangerous or contagious disease”’.¹¹⁸

From the fourteenth century until today, variegated versions of the immunity passport have been implemented as public health responses to ostensibly curb and contain the spread of disease. Whether formal or informal, each documentary version has been concerned with establishing and ‘proving’ good health during heterogeneous health crises. Connections and parallels between these different documents can be further drawn by situating them within the aforementioned four documentary registers.

Four Documentary Registers of the Immunity Passport’s History

Applying the conceptual framework of four documentary registers as a framing device to conceptually unpack the immunity passport helps to further illuminate this document’s histories and sociocultural contexts. The first documentary register of history foregrounds the immunity passport as a historical object establishing, verifying and materializing individuals’ health, particularly immunity, status during health crises. In the Renaissance Mediterranean region, health passes, issued by health boards set up by city–states, attested to their bearers’ being free from plague. During the 1665 plague in London, health certificates were similarly authorized by the city council, furnished by either judges or church parishes, establishing and verifying the health status of travelers leaving or coming from London. Throughout the slave-era in the southern USA, personal profiles and slave advertisements, largely published in newspapers, promoted the acclimation to yellow fever of White people and Black slaves alike. In British India, the colonial administration produced health certificates and pilgrim passports guaranteeing Indians’ freedom from cholera and overall medical fitness.

The second documentary register of government approaches the immunity passport as an object controlling physical, and in certain circumstances social, mobility. The dual modes of plague control involving quarantines and health passes across the Renaissance Mediterranean region restricted people’s physical movements between cities and regions. The health certificates demanded by London during the Great Plague authorized military actions to intercept incoming maritime traffic to the capital and also to supervise individuals’ ingress or egress from the city and surrounding vicinity. The antebellum American government similarly demanded incoming ships from the Caribbean to New Orleans and other southern ports to have certificates of acclimation to yellow fever. British India, along with foreign governments like Canada and the Ottoman Empire, mandated pilgrim passports with attestations to their holders’ cholera-free status to regulate and limit Indians’ international mobility, such as their economic migration and religious pilgrimage.

The purposes and uses of these documents, however, further extended to restricting individuals’ civil rights and socioeconomic opportunities. In this sense, this documentary register of government also approaches the immunity passport as an object constraining not just physical but also social mobility. Without health passes, Renaissance merchants and traders could neither conduct business nor sell products. In 1665 London, health certificates were often beyond the financial or reputational reach of the poor and marginalized, thereby confining them to the plague-stricken city and compounding their already dire health and socioeconomic circumstances. The social mobility of White people in antebellum New Orleans hinged upon published profiles and other documents, such as birth certificates, parental residencies and physician’s letters, claiming their yellow fever acclimation in order to secure employment, residency and other social opportunities. The further enslavement of Black people was entrenched by similar documents, mainly slave advertisements, verifying their acclimation, which, in turn, proclaimed their physical fitness and durability for laboring in the swampy Louisianan climate. These documents were vital to the slave market since slavers and slaveowners would neither buy nor sell slaves without them. India’s colonial administration also demanded health certificates vouching for the medical fitness of Indian employees and job candidates across administrative and agricultural sectors within the colony.

The third documentary register of jurisprudence stresses the immunity passport as a jurisprudential object that constructs medical-juridical individuals. Yet, across most of this history, the bequeathment of these documents were not determined by scientific actors, approaches or tests but instead by bodily and social factors. Scientific knowledge for determining and verifying immunity, after all, was not available throughout much of these aforementioned centuries. Thus, the actors imbued with the authority to impose immunity passports upon individuals were not informed by science but instead by bodily and/or social status. Nevertheless, individuals presenting specific documents attesting to their immunity to disease—from health passes to newspaper profiles to pilgrim passports—tended to be privileged, to varying degrees, with favored or ‘higher’ medical-juridical standing. These documents allegedly ‘proved’ their bearers’ good health, thereby entitling them to special exemptions and privileges to various physical and social restrictions. Individuals denied or otherwise without these documents typically became burdened with a ‘lower’ medical-juridical standing. The interrogation or lack of these documents transformed these individuals into public health ‘nuisances’ and risks necessitating restrictions to their physical and social mobility. The full weight of mobility and social restrictions, in other words, was largely brought to bear upon undocumented individuals but relaxed or lifted for documented individuals.

The fourth documentary register of resistance uncovers the immunity passport as an object of resistance that could be exploited to challenge political authority insofar as mobility restrictions were concerned. There are legal and illegal forms of documentary resistance. Resistance could be legally incorporated into policies or applications for the immunity passport; for instance, petitions could be permitted to acquire special exemptions from mobility restrictions. In Renaissance Spain, quarantined individuals could petition to acquire health passes to be released from social isolation and exempted from other travel curtailments. In 1665, fearing the wrath of angry farmers from the arrival of London’s plague refugees into the countryside, the city authorities began limiting the number of people eligible to receive health certificates permitting their egress from the capital. Illegal resistance, moreover, could be manifested through documentary falsifications or forgeries. Fake health certificates were a pressing problem confronting city authorities during the Great Plague of London. As illegal markets for fake documents spread along with the plague, the authorities were forced to publish newspaper advertisements clarifying legitimate health certificates’ material forms and formats. They were also forced to produce warning notices of individuals suspected of traveling without these documents.

Ultimately, the immunity passport has a long and complicated history involving identity, mobility, public health and social control. Emerging during different health crisis across diverse settings, it has been manifested in variegated versions, and supported or extended by associated formal and informal documentation, from health passes, health certificates and bills of mortality to newspaper advertisements, employment records and pilgrim passports. Indeed, some of these versions have been official documents formally produced by governments whilst others have been unofficial documents informally created by individuals.

Notwithstanding this documentary diversity, every version of the immunity passport has been concerned with immunity, specifically immunity from disease coupled with the immunization of bodies, borders and communities. Whether in the Renaissance Mediterranean region, 1665 London, antebellum America, or British India, there are connections between the immunity passport’s versions and sociocultural contexts. Each version of the immunity passport has shared the objectives of establishing and verifying health identity—thus distinguishing between immune and non-immune and by extension insiders and outsiders—and, in turn, enabling joint medical and social surveillance of individuals. These shared objectives also helped facilitate and enforce physical and social control and discipline of documented, and undocumented, individuals; put differently, individuals’ physical and social mobilities have been, to different degrees, monitored, managed and regulated by their documented, or undocumented, health identity. In these ways, each version is an important component within regimes of verification of immunity; specifically, each version represents non-pharmaceutical interventions, often accompanying or conjoined with other public health measures like quarantines, into health crises.

Each version of the immunity passport also had parallel effects on individuals and societies. Physical restrictions were implemented by all versions, with often constraining effects on documented, and even undocumented, individuals’ movements, work, trade and access to various other business and social opportunities. Yet, in many cases, the effects were more social than simply physical; for example, factors of social rank often trumped those of actual (or alleged) immunity or illness. Nearly every version of the document, on the one hand, disproportionately targeted poor and marginalized segments of society, thereby associating the disease in question with poverty and impoverished quarters and, in turn, compounding deprivations for the already destitute. Enhanced scrutiny was focused on the immunity passports of those poor and marginalized individuals who could access or afford the documentation. On the other hand, nearly every version of the document tended to favor, in one way or another, wealthy and privileged people who could often more easily access immunity passports or, conversely, avoid or be exempted from having to possess them altogether.

Layered atop and complicating these social effects were racial and religious factors in the cases of antebellum America and British India respectively. In antebellum New Orleans and America’s deep south, the informal versions of the immunity passport were racialized. White individuals, especially newly arrived immigrants to the region, self-published personal profiles in newspapers proclaiming their alleged acclimatization to yellow fever to better secure employment and access other business and social opportunities. Slave advertisements in newspapers, bought and placed by slave owners and traders, marketed enslaved Black people’s acclimatization to yellow fever to guarantee their good health, promote their fitness for labor, increase their monetary value and thus stimulate transactions. While the newspaper profiles of White individuals proclaiming their immunity intended to expand their professional success and elevate their social standing, the newspaper advertisements for Black slaves proclaiming their immunity intended to further entrench their forced exploitation.

In British India, meanwhile, the immunity passport was not only concerned with health but also with religious affiliation. Specifically, the pilgrim passport, functioning as a health certificate for international travel, was officially required, by both the Indian colonial government and the Islamic Ottoman Empire, of Indian Muslim individuals performing the Hajj pilgrimage to Mecca. Both governments viewed Indian Muslim pilgrims as potential cholera-carriers whose movements had to be closely monitored and curtailed. Pilgrim passports conflated Indian Muslims’ national, religious and health identities into the reductionist category of diseased danger that, in turn, constrained their travels and circumscribed their religious observances and practices.

Conclusion: The Immunity Passport, Identity and Public Health

The immunity passport is not a new phenomenon to the contemporary coronavirus pandemic. This document has a long history manifesting in different instantiations across disparate health crises and sociocultural contexts ranging from the Mediterranean region in the 1300s and the 1665 Great Plague of London to slave-era USA and British India. As an object of history, government, jurisprudence and resistance, this document, and its variegated versions, has served important roles in helping establish, verify and materialize health identity, regulate physical and social mobility, and, in many cases, underpin complex regimes of health verification and related public health responses across the troubling history of plagues and pandemics.

By illuminating the immunity passport as a concept and object with its own unique history, the preceding discussion has provided the start of a historical overview and analysis of this object. It can serve as a point of departure for other possible historical, as well as conceptual, examinations of this document and/or similar or parallel kinds of identity documentation during times of health or other crises. Further possible studies might identify additional historical cases or examples of the immunity passport or perhaps even delve deeper into aspects of one of this article’s historical cases. Overall, it is hoped that this article can provoke more conversations and inform considerations of this document’s many complexities in both contemporary and historical contexts.

Individuals’ (health) identity, physical and social mobility, opportunities, and very lives have been regulated, and in many cases controlled and disciplined, by the immunity passport in the past. While the immunity passport has been used, both formally and informally, as a non-pharmaceutical intervention into health crises, and can thus be seen as a practical or utilitarian public health measure, it nonetheless has had serious consequences and effects on people’s lives in ways that have curtailed or dispossessed them of various rights and liberties. After all, ‘the fences and barriers which…are [erected by this document in its immunization of bodies, communities, and borders] against outsiders have a more sinister aspect and are potentially a challenge to civil [rights] and liberties’.¹¹⁹ Even with pragmatic intentions, the immunity passport, as well as other non-pharmaceutical interventions like quarantines, has, historically, diminished, and in some cases denied, civil rights and liberties.

The immunity passport’s (re)introduction during the current coronavirus pandemic therefore necessitates closer scrutiny of this document, including of its past incarnations and ramifications. Awareness of this document’s history is vital to better grasp its potential implications for any present usage or future adoption. Forearming ourselves with a more complete picture and understanding of the immunity passport’s history can indeed forewarn us of its possible perils, and perhaps promises, for this present pandemic and beyond.

Acknowledgements

The author gratefully acknowledges the encouragement of and support for this article by the peer reviewers.

Marc Kosciejew is a Senior Lecturer and previous Head of Department of Library, Information and Archive Sciences at the University of Malta in Msida, Malta. He received his PhD from Western University in London, Canada and holds undergraduate and graduate degrees and certificates from the University of Toronto and Harvard University. In 2016–2017, Malta’s Minister of Education and Employment appointed him Chairperson of the national Malta Libraries Council. Presently, he serves as the Book Review Editor for the Journal of the Association for Information Science and Technology.

Footnotes