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Coronavirus vaccine - information for the public
The purpose of vaccination against COVID-19 is to prevent disease or to give a milder disease course without being exposed to serious side effects. We will inform about the effect and potential side effects so everyone can make an informed choice.
The purpose of vaccination against COVID-19 is to prevent disease or to give a milder disease course without being exposed to serious side effects. We will inform about the effect and potential side effects so everyone can make an informed choice.
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About vaccination
The solutions used for appointments vary between municipalities. Check your municipality's website for information about the local arrangements. Contact your municipality if you need an interpreter or other special arrangements for vaccination. The vaccine and vaccination is free.
Do not turn up for vaccination, and tell the centre as soon as possible, if on the day you have cold symptoms or a fever over 38 °C.
Tell the person giving the vaccine:
- if you have had earlier doses of coronavirus vaccine
- if you have had COVID-19 disease and how long ago
- you have received another vaccine within the last 7 days
Before vaccination you will be asked to answer some questions about your health:
The vaccine is given by an injection in the upper arm.
After you have had the vaccine, you will be asked to wait for 20 minutes in case you experience any reactions. Everyone who administers vaccines has had training and necessary medication will be available to treat possible allergic reactions.
It is not recommended to take another vaccine on the same day as the coronavirus vaccine. There should be at least 1 week between the coronavirus vaccine and other vaccines. If there is a strong need to take several vaccines at the same time, you should consult a doctor.
The coronavirus vaccine can be given at the same time as the regular seasonal influenza vaccine. For other vaccines, it is recommended that these are not given at the same time as the coronavirus vaccine, but there should be at least 1 week interval between vaccinations. If there is a strong need to take several vaccines at once, you should consult a doctor.
More information about the vaccines used in Norway, available in many languages:
Brochures
Interval between dose 1 and 2 (primary vaccination)
We distinguish between the primary vaccination series and booster vaccination. For booster vaccines, see the separate section below.
For most groups who are offered the coronavirus vaccine, the primary vaccination series comprises of two doses. The second dose should be given after 3-12 weeks. It is important that you try to take the second dose at the scheduled time.
|
Vaccine |
Number of doses to complete primary vaccination |
Recommended minimum interval between dose 1 and 2 |
|
Comirnaty (BioNTech and Pfizer) |
2 |
21 days |
|
Spikevax (Moderna) |
2 |
28 days |
|
Nuvaxovid (Novavax) |
2 |
21 dager |
|
Combination of Comirnaty, Spikevax or Nuvaxovid |
2 |
28 days |
The interval between doses can be important both for the degree of protection and for the validity of the COVID-19 certificate.
Not everyone is given primary vaccination with two doses:
People with severely weakened immune systems (immunosuppressed) often have a poorer effect of vaccines than others. This means that many of these do not get a good enough effect from the first two doses. This group is therefore offered dose 3 in order to complete primary vaccination. For these, an interval between the 2nd and 3rd dose is recommended to be a minimum of 4 weeks. More information about this group can be found here:
Combination of different vaccines
Different types of coronavirus vaccines can be combined if it is difficult to give two doses with the same vaccine, or is requested for other reasons. Good protection is expected even if different vaccines are used. Other types of side effects have not been observed when different vaccine types are combined.
Booster doses
Vaccine recommendation for autumn/winter season 2022/2023
The Norwegian Institute of Public Health (NIPH) recommends that the following groups should take a booster dose of coronavirus vaccine before the autumn/ winter season 2022/2023:
- adults aged 65 years and above
- adults aged 18-64 years with underlying risk of a severe disease course
- adolescents aged 12-17 years with severe underlying conditions
- pregnant women in their second and third trimesters
For most people this will be their 4th dose, but for those with severely impaired immune systems, this will their 5th dose.
The recommendation to take a new booster dose also applies if you have recently recovered from COVID-19. Having had COVID-19 will give good protection after you have been ill and you can therefore wait 3-4 months before you need to be given a new dose. If you want to have a booster dose earlier, it can be given provided that at least 3 weeks have passed since recovery, although a longer time interval will give a better immune response.
The recommended interval between a previous vaccine dose should be a minimum of 4 months.
You can take the regular seasonal influenza vaccine together with a booster dose of coronavirus vaccine. Check with your municipality or doctor where you live.
It is also possible for people in the 18-64 year age group without underlying risk conditions can choose to take a new booster dose if they wish.
Vaccine recommendation for spring 2023
The Norwegian Institute of Public Health (NIPH) recommends that the following should be vaccinated with a booster dose in spring 2023:
-
People in the age group of 75 years and older and nursing home residents where more than 6 months have passed since the last dose.
A new dose will be particularly appropriate if you have not yet had COVID-19 disease and if, in addition to old age (75 years or older), you have an illness or condition that gives an increased risk of a severe COVID-19 disease course if you are infected (see separate section on risk groups).
The combination of infection and vaccination gives better protection than vaccination alone and lasts well over time. The need for a new dose this spring is therefore lower if you have had COVID-19 disease in addition to vaccination.
The NIPH considers it likely that a recommendation for a further new dose for the elderly will come in autumn, before the 2023-24 winter season. In order for sufficient time to pass before the planned autumn dose, you should look for vaccination in your municipality as soon as possible and preferably during April.
How do mRNA vaccines work?
The coronavirus vaccines used in the coronavirus immunisation programme, Comirnaty (from BioNTech/Pfizer) and Spikevax (from Moderna), are mRNA vaccines.
The vaccines contains the recipe (messenger RNA, or mRNA) for the characteristic spikes on the coronavirus encased in small fat bubbles. The body uses this recipe to make harmless copies of these spikes for the immune system to practise on. In this way, the immune system learns to recognise the coronavirus spikes and can defend the body if it becomes infected with the virus.
The messenger RNA is rapidly broken down by the body and has no effect on the body's genetic material.
In addition, the vaccines contain substances to keep them stable during production, storage and transport, as well as to provide the right pH, which is important for reducing pain during injection. These substances are water, salts and sugar.
- The vaccines do not contain live virus and do not cause COVID-19 disease.
- Antibiotics are not used in the production process, so the vaccines do not contain antibiotics or antibiotic residues.
- The vaccines do not contain adjuvants, which are substances that are added to some vaccines to increase the immune system's response. The vaccines do not contain products derived from pigs. The vaccines do not contain mercury.
The coronavirus vaccines act to prevent disease. They cannot cure an ongoing illness.
More information about mRNA vaccines:
- Vaccine against coronavirus - Comirnaty (BioNTech and Pfizer)
- Vaccine against coronavirus - Spikevax (previously COVID-19 Vaccine Moderna
How does Nuvaxovid (Novavax) work?
(January 2023 - Nuvaxovid is currently unavailable from the NIPH)
The coronavirus vaccine Nuvaxovid (from Novavax) is a protein-based vaccine based on a traditional vaccine technology. Similar technology is used in vaccine against hepatitis B and whooping cough. It contains a variant of the characteristic spikes (spike protein) on the coronavirus that the immune system can practise on. This is how the body learns to recognise and defend itself against real coronavirus if you later become infected.
The vaccine also contains a new ingredient (adjuvant) containing saponins from soap bark and fats (cholesterol and phospholipids). This helps to enhance the body's own immune response to get the best possible effect from the vaccine. Nuvaxovid also contains an emulsifier (Polysorbate 80) which ensures that fats and water in the adjuvant remain evenly mixed.
In addition, the vaccine contains water, various salts and sugar compounds that will keep it stable during production, storage and transport, as well as provide the right pH that is important for reducing pain during injection.
- The vaccine does not contain live viruses and does not cause coronavirus disease.
- Antibiotics are not used in the production process, so the vaccines do not contain antibiotics or antibiotic residues.
- The vaccine does not contain products from pigs and does not contain mercury.
The coronavirus vaccine has a preventive effect. It cannot cure an ongoing illness.
More information about Nuvaxovid:
• Vaccine against coronavirus - Nuvaxovid (Novavax)
Vaccination with different coronavirus vaccines
For most people, two doses are needed to complete the primary vaccination series, and several groups are also recommended to have a booster dose to get the best possible protection. Some will be offered, or request, a different coronavirus vaccine as dose 2 or as a booster vaccine than the one they began with. In principle, you are recommended to accept the vaccine you are offered, but it is also possible to choose which type of vaccine you want to take.
Side effects and symptoms after vaccination
Risk groups
By risk groups we mean people with an increased risk of a severe COVID-19 disease course. These include:
- Residents in nursing homes
- Everyone who is 65 years or older
- People aged 5–64 years with one or more defined diseases / conditions that increase the risk of a severe disease course and death from COVID-19. See the section below for specification of different diseases / conditions and age groups.
People in the 18-64 year age groups with the following disease/ conditions are defined as medical risk groups:
- Organ transplant*
- Immunodeficiency*
- Hematologic (blood) cancer in the last 5 years*
- Other active cancer, ongoing or recently finished treatment for cancer (especially immunosuppressive therapy, radiation therapy to the lungs or chemotherapy)*
- Neurological or muscular disease with impaired coughing strength or lung function (e.g., ALS and cerebral palsy)*
- Downs Syndrome*
- Chronic kidney disease or significantly impaired renal function
- Chronic liver disease or significantly impaired liver function
- Immunosuppressive therapy, e.g. with autoimmune diseases
- Diabetes
- Chronic lung disease, including severe asthma that has required the use of high-dose inhaled steroids or steroid tablets during the last year
- Obesity with body mass index (BMI) of ≥ 35 kg/m2 or higher
- Dementia
- Chronic cardiovascular disease (except high blood pressure)
- Stroke
Other serious and / or chronic diseases may also increase the risk of a severe disease course. If you are unsure whether you are in a risk group, consult your doctor.
* These diseases/ conditions can give a high risk for a severe disease course and death among younger people.
For children and adolescents, the following diseases/conditions can give an increased risk of a severe disease course:
- Organ transplantation
- Immunodeficiency (for example, congenital immunodeficiency or the use of drugs that cause significant systemic immunosuppression)
- Haematological cancer (e.g. leukaemia, lymphoma) within the last five years
- Other active cancer, ongoing or recently completed (within the last six months) anti-cancer treatment - especially immunosuppressive treatment, radiotherapy to the lungs or chemotherapy
- Neurological diseases or muscle diseases that cause reduced coughing strength or reduced lung function
- Chronic kidney disease with significantly reduced kidney function
- Severe heart disease (children with heart failure, severe pulmonary hypertension, cyanosis, single ventricle disease/"Fontan patients")
- Severe lung disease (e.g. cystic fibrosis, very severe asthma with deterioration requiring emergency admission to hospital within the past year)
- Other severe disease. Vaccination in such cases is assessed individually by a paediatrician.
For more detailed information about diseases/conditions that can give an increased risk for a severe COVID-19 disease course see:
Vaccination of pregnant and breastfeeding women
Vaccination of children and adolescents
Children and adolescents rarely have a severe COVID-19 disease course, although some may be admitted to hospital. Vaccination reduces this risk and will be appropriate for children and adolescents with serious underlying conditions. The coronavirus vaccine from BioNTech/Pfizer (Comirnaty) is used for those under 30 years of age. Children aged 6 months–4 years and 5–11 years will be offered a specific child dose of this.
Immunity following infection, with or without a single dose of vaccine, can also provide broad and lasting protection in children and adolescents. Recovery from COVID-19 therefore reduces the need for the number of vaccine doses.
| Who | Children/adolescents with severe underlying conditions | Healthy children/adolescents |
|
16-17 years* (30ug/dose) |
Should complete the primary vaccination series (2 doses) with 8-12 week intervals between doses.
Adolescents with severely weakened immune systems should complete the primary vaccination series with 3 doses.
A booster dose is recommended before the upcoming autumn/winter season (2022), with
a minimum interval of 4 months since the previous dose.
|
Can have 1 or 2 doses if the adolescent wants the vaccine.
|
|
12-15 years (30ug/dose) |
Should complete the primary vaccination series (2 doses) with 8-12 week intervals between doses.
Children with severely weakened immune systems should complete the primary vaccination series with 3 doses.
A booster dose is recommended before the upcoming autumn/winter season (2022), with
a minimum interval of 4 months since the previous dose.
|
Can have 1 or 2 doses if the guardian/child wants the vaccine. |
|
5 –11 years (10 ug/dose) |
Should complete the primary vaccination series (2 doses) with 8-12 week intervals between doses.
Children with severely weakened immune systems should complete the primary vaccination series with 3 doses.
A booster dose is recommended before the upcoming autumn/winter season (2022), with
a minimum interval of 4 months since the previous dose.
|
Can have 1 or 2 doses if the guardian wants the vaccine. |
|
6 months–4 years |
May complete the primary vaccination series (3 doses) after consultation with a doctor who knows the child.
|
Not available
|
* Adolescents born in the 2004-2005 cohorts that were part of this group in autumn 2021 were recommended a primary vaccination series. This advice is not continued for new cohorts in the same age group because of changes in the pandemic status.
Other countries may require more vaccine doses for children and adolescents than recommended upon arrival.
Read more about the recommendation for 5-15-year-olds:
- Coronavirus vaccine for children 5-11 years - brief information with illustrations
- Coronavirus vaccine for adolescents 12-15 years - brief information with illustrations
About consent from parents and the child's right to co-determination
Vaccination is voluntary. Those who have reached the age of 16 are of legal age and can consent to vaccination themselves. For children who are offered the coronavirus vaccine, but have not yet reached 16 years of age), parents must consent to vaccination. In the case of joint parental responsibility, both must consent. Children and adolescents under 16 should be consulted, based on age and maturity and their opinion should be given weight.
- Consent form - vaccination of children aged 6 months up to, and including, 4 years
- Consent form - vaccination of children and adolescents from 5 up to, and including, 15 years of age
For children under the care of the child protection service, the consent competence is given to the child protection service. For unaccompanied young asylum seekers under the age of 16, the consent competence is given to the child's representative. Consent from the child protection service or representative should be confirmed in writing in a separate document.
Right to tailored information
Children have the right to receive tailored information. Parents should talk to their children about the decision to vaccinate and help to convey important information about this. The texts below and the links to tailored information material are intended to assist in this.
- Coronavirus vaccine for children 5-11 years - brief information with illustrations
- Coronavirus vaccine for adolescents 12-15 years - brief information with illustrations
- What is a vaccine? (film)
- How do vaccines work? (film)
- Why do we get vaccinated against COVID-19? (film)
Questions and answers about vaccination of 5-15-year-olds:
Why are healthy children aged 5-15 offered a coronavirus vaccine?
The NIPH does not have a general recommendation for the coronavirus vaccine for children aged 5-15 years unless they have an underlying condition, but it is available. Those who want to take the vaccine can choose whether they want 1 or 2 doses. The NIPH considers that when children have COVID-19, it provides at least as good protection as vaccination. Children who have had an infection therefore have a reduced need for a vaccine to protect themselves against a new infection as they will have some immunity.
Other countries may have stricter requirements in connection with entry restrictions. If you need a valid COVID-19 certificate for travel, you must check which requirements apply for children at your destination.
Can vaccination of children against coronavirus reduce transmission in society?
The NIPH considers that the societal benefit of vaccinating children should not be given as much weight as the individual benefit. Vaccination of children may have some effect on transmission, but the vaccine's effect against transmission of the omicron variant appears to be lower and has a shorter duration than against previous virus variants. Therefore, the effect on transmission by vaccinating the entire child population will be limited, when the infection will transmit regardless among the vaccinated.
How ill can 5-15 year olds become from coronavirus?
The risk of a severe COVID-19 disease course among healthy children is very low. The immune systems of children in this age group work faster and more effectively than in adults. They therefore become less ill, and recover faster than adults. The omicron variant also leads to a severe disease course in children less often than previous variants, both in terms of acute admissions for COVID-19 and a rare inflammatory condition called MIS-C.
Severe COVID-19 disease in children is particularly associated with this condition, MIS-C. It is estimated that the condition occurs in about 1 in 12,000 infected children during the wave in winter 2022, and is more common in children of primary school age than in adolescents, with an average age of 6-7 years. The hallmarks of MIS-C are persistent high fever and inflammatory reaction in several organs that occur 2-6 weeks after infection, and the children need hospital treatment. There is effective treatment for the condition, but the most serious cases still need intensive care. Hospital stays for these children last 5 days (median) in Norway. Follow-up 4-9 months after MIS-C internationally indicates a good prognosis, and this is also the experience in Norway.
People who have had COVID-19 disease may, in some cases, have persistent symptoms for a long time afterwards. In adults, a clear correlation has been seen between the severity of acute COVID-19 disease and the severity of long term problems. It may seem that such late effects are less common in children than in adults, but knowledge about this is limited. The most commonly reported symptoms are fatigue, tiredness, difficulty concentrating, stuffy nose, sleep problems and pain. The number of reported symptoms appears to decrease over time.
Which vaccine is offered to the 5-15 year age group?
In Norway, children and adolescents are only offered the Comirnaty vaccine from BioNTech/ Pfizer, even though Spikevax from Moderna has been approved. This is to minimise the risk of rare side effects in the form of heart inflammation. It is also one of the most widely used coronavirus vaccines in children. Comirnaty is approved from 6 months years and upwards and the age group 6 months–4 years and 5–11 years will receive an adapted child dosage.
How good protection do 5-15-year-olds get from coronavirus vaccine?
Children and adolescents receive very good effect from vaccines, and get a very good immune response from the coronavirus vaccine. Therefore, they can get the same measurable immune response even with a reduced dose strength of the vaccine. At the same time, people of all ages receive poorer protection against omicron infection and mild disease than was shown for previous virus variants, while protection against serious disease with omicron is good and lasts longer. For earlier variants, it has been shown that protection against serious disease is good as early as three weeks after vaccination with one dose.
What side effects can 5-15 year olds get from COVID-19 disease?
The vast majority of side effects occur 1-2 days after vaccination, are mild / moderate and disappear after a few days. For some, the symptoms may be more severe. The coronavirus vaccines cause more of the common side effects than other vaccines. Younger people often have slightly more severe side effects than older people.
Common side effects are injection and swelling at the injection site, fatigue, headache, muscle aches, chills, joint pain and fever. Children aged 5-11 years more often experience pain at the injection site, but slightly less common side effects such as fatigue, headache, muscle aches and fever compared to adolescents and young adults. Allergic reactions occur in some people, including children and adolescents.
The most common adverse reactions in infants aged 6 months to 4 years who received a primary dose included fatigue, injection site tenderness, injection site redness, and fever. For children aged 6 months to 2 years, irritability, drowsiness and decreased appetite were also observed.
Among the rarer side effects reported are inflammation of the heart muscle (myocarditis) and inflammation of the pericardium (pericarditis). The condition most often occurs in adolescents and adolescents, more among boys than girls. It is also described in children aged 5-11 years, but is less common than among adolescents. The condition occurs primarily after the second vaccine dose. The symptoms are chest pain, wheezing, palpitations and fever. It usually occurs within a week after vaccination. Most of those who get this condition are admitted to hospital for a few days. The prognosis is good and most people recover within one month. In case of symptoms that may be compatible with inflammation of the heart muscle or pericardium, you must consult a doctor to be examined. Norwegian cardiologists have assessed that COVID-19 disease may cause more severe cardiac effects in some people than the vaccine, and that this rare side effect should not prevent children from being offered the vaccine.
Cases of menstrual disturbances have been reported as a possible side effect after coronavirus vaccine. Several population studies have now been carried out based on these reports. For women between 18 and 30 years of age, an increased incidence of menstrual disorders has been shown after dose 1, while the investigations after dose 2 are still ongoing. For children between 12 and 15 years of age, an increased incidence of menstrual disturbances has also been shown after the first set of vaccine doses, with similar results, but to a somewhat lower degree than in adults. There is no suspicion that the vaccines affect women's fertility.
The coronavirus vaccine is used to a lesser extent among children under 11 years of age, and there is therefore a smaller numerical basis for assessing rare side effects in this age group. We cannot rule out hitherto unknown side effects for this age group, rare side effects or side effects that arise long after vaccination.
How do I get vaccinated?
The organisation will vary between the municipalities. See your municipality's website for information about the local offer.
How do I get an overview of vaccination status in children and adolescents?
For children under the age of 16, the parents can see the vaccines the child has received by logging in to the vaccine service on helsenorge.no and choosing the child in question.
Since the legal age of majority in Norway is 16 years, parents do not have access to their child's immunisation status after their 16th birthday. Buypass ID is available from the age of 13 years. Adolescents with this ID can check their vaccines themselves by logging in to the vaccine service at helsenorge.no.
Adolescents between the ages of 16 and 18 years who do not have a BuyPass ID can order a vaccination card directly from the Norwegian Institute of Public Health. NB! This is NOT a COVID-19 certificate.
Read more about how to order a COVID-19 certificate:
- COVID-19 certificate for non-digital users (Helsenorge.no)
Vaccination of people who are sick, on medication or have allergies
It is common to postpone vaccination in cases of acute illness and with a fever above 38 °C.
Mast cell disease or uncontrolled asthma: If you have a mast cell disease, ask your doctor for an individual assessment, and of how you should be followed up both before and during vaccination.
Previous allergic reaction to COVID-19 vaccine or other serious allergic reaction to other vaccines, food, medicines, etc.: Contact your doctor for a personal assessment. If a doctor recommends that you be vaccinated, special precautions and a longer period of observation after vaccination may be necessary in order to manage any allergic reactions.
Increased bleeding tendency: If you are taking blood-thinning medication, you can be vaccinated in the normal way. If your bleeding tendency has increased due to another underlying medical condition, you should contact your doctor for an individual assessment. If you have haemophilia and are being treated with coagulation factor, you should be vaccinated on the same day as you receive your last dose of coagulation factor.
Severely impaired immunity: If you have severe immunodeficiency or are taking medications which severely impair your immune system, for example, due to haematological cancer, bone marrow transplant, organ transplant, etc., a shorter interval between doses is recommended for some vaccines. Tell the vaccination centre that you belong to this group, so they can adjust your vaccination schedule accordingly. If you are
unsure whether or not you belong to the group, consult the doctor who is treating you for advice.
Breastfeeding and pregnancy: Vaccination is recommended for breastfeeding women, there is no known risk of transfer of coronavirus vaccines to breast milk. Studies indicate that coronavirus vaccination is safe for both the pregnant woman and the foetus.
Vaccination is recommended for all pregnant women, regardless of trimester.
Why do we vaccinate?
Having undergone an infectious disease will often provide some protection (immunity) against reinfection, but some diseases can cause such a strong inflammatory reaction in the body that, for some people, it can become dangerous. Some people become severely ill and may die, or have serious medical complications.
A vaccine gives the body something to practise on that resembles the disease virus, but that cannot cause the disease. The immune system is stimulated so the body can recognise and fight the virus. The vaccine quickly disappears from the body but has taught the body to defend itself if it is later exposed to infection. We can easily and effectively protect ourselves against some of the dangerous infectious diseases, without having to be exposed to the risk of having the disease.
In addition, vaccination can help to limit transmission in society.
Post-registration of coronavirus vaccines
How are EMA-approved coronavirus vaccines given outside Norway post-registered?
Vaccinations given in Norway are registered in SYSVAK, according to the SYSVAK registry regulations § 1-3 on maintaining an overview of vaccination coverage in the population.
If you were given an EMA-approved vaccine in another country, a COVID-19 certificate issued in the EU / EEA should primarily be used for border crossing, contact tracing and quarantine.
If you intend to stay in Norway for a longer period or have moved back, COVID-19 vaccinations approved in the EU can be post-registered in SYSVAK provided there is credible written documentation.
Who can you contact to post-register coronavirus vaccine(s) in SYSVAK?
- General practitioner (doctor)
- Municipal health service (see Implementation above)
- Private health service
What documentation do you need?
- COVID-19 certificate issued in the EU / EEA
- Written documentation of vaccination
How do you do this?
- Request a consultation with a healthcare professional in one the above services (video or physical consultation).
- Residents must log in to Helsenorge to check the COVID-19 certificate (the time taken to update the information on Helsenorge varies due to different medical record systems, but usually within 24 hours).
The Norwegian Institute of Public Health cannot post-register vaccines on behalf of private individuals.
Vaccination cards and COVID-19 certificates
Vaccination card
A vaccination card is a documentation of which vaccines you have been given (in Norway) and are registered for you. You can log in to the vaccine service at helsenorge.no and download your electronic vaccination card. Coronavirus vaccination will also be visible on the card.
Vaccination cards are available in Norwegian and English.
COVID-19 certificate
Both the EU authorities and the World Health Organization (WHO) are considering the possibility of introducing a global vaccination certificate/"passport" for those who have been vaccinated against coronavirus (as for yellow fever vaccination). The idea is that this could give certain rights, for example, to fly, cross borders and participate in events.
The Norwegian Institute of Public Health, in collaboration with the Norwegian Directorate of Health, the Directorate for e-Health, the Norwegian Health Network SF and other relevant actors, has been commissioned by the Ministry of Health and Care Services (HOD) to map the requirements and possible solutions for establishing an international vaccine passport.