Covid vaccine pass: How Sweden's e-Health Agency plans to roll out pass to more groups

The e-Health Agency was asked in late August to investigate whether more people could be given the vaccine pass, for example people vaccinated overseas and those lacking a personnummer.

The agency has so far issued around 4.5 million vaccine passes since the service first launched on July 1st. 

But as The Local has reported, many people are not able to access the digital certificates, including those who lack a Swedish personnummer (a ten-digit social security code) and those who were vaccinated overseas.

Before the passes were launched, Sweden’s eHealth Agency initially told The Local that people with a samordningsnummer would be able to apply using the paper form, but when the pass was launched on July 1st, this was not the case. Annemieke Ålenius, deputy director general of the agency, later told us this was because including samordningsnummer in the system was both “more complicated” and affected fewer people than expected.

One reason for this was that several regions recorded people's vaccines with a reservnummer even if they had a samordningsnummer, and even in some cases where the person had a personnummer. Because reservnummer are issued regionally and are not unique at a national level, this made it hard to match up the vaccine data with an individual's personal data.

The report revealed that across Sweden, between January and September 6th, almost 36,000 vaccinations were registered under a reservnummer, around 40 percent of them in Stockholm. That compared to only 3,267 registered to a samordningsnummer, suggesting that many people were allocated a reservnummer who should not have been.

In its report, the agency noted that people had a right to the vaccine pass under EU law if they were vaccinated in Sweden.

The vaccine pass is not currently used for any domestic activities in Sweden, as is the case in many European countries. However, the government has said it cannot rule out that proof of vaccination may be required in future for access to large events, for example, and the e-Health Agency said that it would become "even more important" to have the correct procedures in place if this were to happen.

Additionally, the pass is used to facilitate foreign travel, and is needed for entry into some countries, and to avoid quarantine or additional tests in others. 

If you have a samordningsnummer or personnummer

As noted above, some of the people who struggled to get a vaccine pass already had a national identity number: either the personnummer used in the population register, or the samordningsnummer which is given to people who do not meet personnummer requirements (those who will be staying for less than a year, for example).

In September, the Public Health Agency recently ordered all regions to re-register the vaccines of people who have a samordningsnummer or personnummer if this was not registered at the time. September is also when it became possible to receive a vaccine pass using a samordningsnummer.

This group can then apply for a vaccine pass using the standard method, either using their digital ID if they have one, or using a paper form.

If you were vaccinated in Sweden but do not have a samordningsnummer or personnummer 

For people who only have a reservnummer, the situation is slightly more complicated. 

The solution proposed by the agency is that people in this group should be able to contact whoever carried out their vaccination -- for example, their doctor, or one of the larger companies such as Vaccina, Capio or Doktor24 which run many of Sweden's vaccine centres. Then, these medical professionals would verify the person's identity and, with their consent, submit this to the e-Health Agency so that the vaccine pass can be issued. 

This is similar to the process under which so-called recovery certificates are currently issued via the vaccine pass. 

The agency noted: "Since the process is similar for the recovery certificates, it would be relatively simple for the regions to further develop the process or function to also include reporting of information registered to a reservnummer."

Because this is only a proposal, it is not clear when it would be possible. The e-Health Agency said it plans to start work on developing the system for this group in November 2021, assuming that the necessary agreements with SKR (the umbrella organisation for Sweden's regions, which are responsible for healthcare) are in place by then.

If you were vaccinated overseas

As for people who live in Sweden but received their vaccine abroad, there is no immediate resolution. The e-Health Agency's report referred mostly to Swedes living abroad, but this issue also affects foreign residents in Sweden who travelled to their home countries for vaccination (several The Local readers reported doing this due both to the faster pace of the rollout in their home countries and due to complications accessing a vaccine without a personnummer), as well as those who moved to Sweden after receiving their vaccine at home.

Foreign vaccinations cannot be added to the national vaccination register, so adding these to the vaccine pass would require a new set-up.

People who had their vaccine in another EU country have been advised to get that country's version of the Covid pass, but for people who were vaccinated in third countries it's more difficult. The EU has recommended that countries recognise vaccines carried out abroad if using EU-approved vaccines, but Sweden has not yet put this into practice.

The e-Health Agency recommended in its report that the government appoint one national authority to be responsible for authorising foreign vaccinations, but did not suggest a specific authority, saying that the five weeks given for the report was not sufficient for this. Two which were mentioned in the report as possible choices were the National Board of Health and Welfare (Socialstyrelsen) and the Social Insurance Agency (Försäkringskassan), but the report also noted that embassies could be asked to verify the vaccinations, for example.

It will now be up to the government to decide whether it will task an agency with doing this, which means it could be some time before people vaccinated overseas can actually receive their pass. Potential hurdles raised in the report include choosing which agency will be responsible, deciding how the task will be financed, and assessing whether any legal changes are needed to allow the chosen agency to handle this personal data.