As states, federal agencies and businesses ramp up COVID-19 vaccination requirements in the face of resistance by a sizable minority of the population, a parallel but limited effort to stop the spread of fraudulent medical records is underway.

The spread of the delta variant at the same time as fraudulent records of vaccinations are circulating is frustrating experts trying to bring the pandemic under control. States with lower vaccination rates are currently seeing higher levels of transmission and more hospitalizations.

“If people who go out and buy fake vaccine cards get COVID, do they expect someone to put them on a real ventilator?” Andy Slavitt, a former Biden White House senior adviser, tweeted on Aug. 10. 

President Joe Biden announced in late July that federal government employees would have to be vaccinated against COVID-19 or take other precautions. His announcement followed similar requirements by Democratic politicians in New York City and California. Localities and some private businesses have also begun requiring vaccination for entry to bars and entertainment venues.

Vaccination reduces the likelihood of severe illness from COVID-19, but a slower uptake of vaccines nationwide and increasing numbers of fake vaccination cards threaten to prolong the length of the pandemic. The effort to address the fake cards involves both preventing the manufacture and sale of the fraudulent cards and knowing how to determine whether a card is fake.

The U.S. has no universal way to verify vaccination status or the legitimacy of a card. Federal statute prohibits the fraudulent use of an agency or department seal, but cards issued by the Centers for Disease Control and Prevention and the Department of Health and Human Services are easy to mimic and, unlike a driver’s license, don’t have a scannable barcode or watermark. Differences in the information printed on the cards, and how it’s printed, add to the difficulty of verifying them. 

Speaking Thursday at a COVID-19 task force briefing, Jeff Zients, the White House COVID-19 response coordinator, said the White House applauds local innovation to verify vaccination status.

“There are a number of ways people can demonstrate their vaccination status.  Companies and organizations and the federal government are taking different approaches,” he said. “As with all other vaccines, the information gets held at the state and local level.”

Tashof Bernton, a Colorado physician who specializes in internal medicine and occupational medicine, said the absence of a single national database and state databases with their own limitations means there’s no perfect way to authenticate cards. 

“Now we’re in a situation where we’re kind of stuck with paper cards because so many people have them,” he said.

Bernton sells a product called ImmunaBand, a bracelet tagged with a QR code that can be scanned to display a password-protected vaccination card that the company authenticates. He said the company has seen more cards submitted that don’t pass its screening process and are more sophisticated fakes. 

Zients said the White House knows of cases of fraud or counterfeit COVID-19 cards being advertised on social media sites and eCommerce platforms.  

“While the practice is not widespread, you know, I will remind everyone that it’s a crime and the Office of the Inspector General, the Department of Health and Human Services, is investigating these schemes,” he said.

Government action

The HHS Office of Inspector General says it has received 3,500 complaints to its hotline about COVID-19 scams since the pandemic began in early 2020. The OIG couldn’t provide data on how many are about fake vaccine cards, but a spokesperson said complaints arrive daily.

Matthew Charette, the special agent in charge at HHS-OIG, said there’s an increase in fraud-related tips that could be tied to the increase in vaccine mandates.

“The main message we’re trying to get out to folks who may be influenced otherwise is, if you don’t go to a legitimate trusted health care provider and receive a shot in your arm, you should not receive a COVID card,” he said.

A card missing one or both of the CDC and HHS logos and printed with a color other than the standard black ink is a red flag, he said. But not all tells are obvious.

“I can’t say that there’s something that would be immediately obvious to somebody needing the card that would necessarily make it identifiable as fraudulent right from the get-go,” Charette said.

Even some legitimate medical providers have been found to be selling real cards with information and vaccine lots numbers, without administering a vaccination, making it harder to identify the fraud. 

On Friday, U.S. Customs and Border Protection announced it had seized 15 shipments of counterfeit COVID-19 vaccination cards at the Port of Memphis in one day from China.

The agency said these fake cards are sent nationwide and this fiscal year to date, Memphis has seized 121 shipments of 3,017 fraudulent vaccination cards.

Justice Department spokesman Joshua Stueve said he is aware of only one case of charges involving fake or fraudulent COVID-19 vaccination cards. The DOJ announced in July the arrest of a California-licensed naturopathic doctor for allegedly creating false COVID-19 vaccination cards stating that individuals had received two doses of Moderna. Court documents show that the doctor gave her specific Moderna vaccine lot numbers and corresponding dates in order to avoid suspicion. 

State AGs seek crackdown

States are also trying to address the issue. Forty-six state attorneys general wrote to Twitter, Shopify and eBay in April asking them to crack down on the sale of fake vaccine cards on their platforms. The bipartisan group asked the companies to monitor for ads or links selling blank or completed cards and to take down any such links and report these records.

New York Attorney General Letitia James, who signed the letter, issued a consumer alert on Aug. 6 warning that faking vaccine cards or records and the unauthorized use of CDC and HHS seals violates federal and state law and can result in criminal and civil penalties.

“Not only do fake and fraudulently-completed vaccination cards violate federal and state laws and the public trust, but they also put the health of our communities at risk and potentially prolong this public health crisis,” she said in a statement, adding that posting images of even legitimate cards can provide bad actors information they need to create false cards.

California Attorney General Rob Bonta sent a similar consumer alert in May.

Federal officials have repeatedly resisted a centralized system like a vaccine passport to verify an individual’s vaccination status. But without a centralized system like the certificate offered in the EU, states and the private sector have partnered up with local approaches that are easier to verify as legitimate.

New York lawmakers are moving forward with legislation that would make falsifying COVID-19 vaccination records a Class E felony. Versions of the bill have passed both chambers. Some states have also implemented digital record systems to cross-check vaccination records.

Individuals who received their vaccine in New York can access proof of vaccination using Excelsior Pass Plus, which has partnered with the state to validate vaccination status. Docket is a similar app that currently verifies these records in partnership with the New Jersey Department of Health and the Utah Department of Health.

MyIR Mobile also partners with local health departments to pull immunization records. The app can verify COVID-19 vaccination in eight states and Washington, D.C., as well as specific COVID-19 certifications for the district, Maryland and Washington state.

Lara Popovich, senior director of marketing at STChealth, which makes MyIR Mobile, said four new states are also in the contracting process and will be going live soon.