Ethical and social experiences of vaccination, belonging, and exclusion under South Korea’s vaccine passport: a qualitative interview study

Abstract Background Despite the introduction of vaccine passports with the aim of facilitating pandemic control, their compulsory nature gave rise to controversies, debates, and ethical and social concerns. Existing literature has predominantly focused on vaccine passport acceptance or vaccine hesitancy, with empirical data on vaccine passport usage remaining scarce. This study addresses this gap by examining the perceived influence of vaccine passports on vaccination and the social and ethical issues associated with their implementation in South Korea. Methods This qualitative research was conducted in South Korea in 2022 and 2023. Convenient, purposive and snowball sampling techniques were employed to recruit participants across different vaccination statuses, occupations, and age groups for semi-structured interviews. Of the seventy-six interviews conducted, seventy were purposively selected for thematic analysis, based on detailed discussions regarding the rationale for vaccination and perceptions of the vaccine passport. The data were transcribed verbatim, and the initial coding, categorising, and reviewing of themes were conducted repeatedly. Results The study’s findings indicated that the predominant rationale for interviewees opting for vaccination was to continue to socialise and avoid disadvantages, rather than solely reinforcing the immune system. The mandatory scheme gives rise to socio-ethical concerns, captured in five themes: human rights concerns, stigmatisation, social discrimination and exclusion, easier surveillance, and eroded trust. Most respondents perceived that the government compelled vaccination and exercised control to ensure population conformity to its policies through the introduction of a vaccine pass, audible alerts, restrictions, and social pressure. This study further demonstrated that the vaccine passport functioned as a new digital citizenship, based on users’ vaccine status, rather than merely serving as a certificate. This article suggests that state-mediated exclusion through compliance requirements may produce a category of individuals who find themselves in newly identified vulnerable positions, particularly comprising those who had never previously been categorised as vulnerable groups. Conclusion Even during crises, fostering social discourse and upholding good governance are required to address socio-ethical problems that may arise from countermeasures. Furthermore, policymakers should consider the long-term implications of their decisions and facilitate meaningful public deliberation.