In response to proposals for a so-called "immunity passport" system to be developed so that people who have recovered from COVID-19 can return to life as usual (without being subject to quarantines, etc.), many have pointed out that this was tried in 19th century New Orleans, Louisiana.

In the April 12, 2020 New York Times article "The Dangerous History of Immunoprivilege", the author observes (my emphasis),

Yellow fever, a mosquito-borne flavivirus, was inescapable in the 19th-century Deep South and a point of near-constant terror in New Orleans, the region’s hub. In the six decades between the Louisiana Purchase and the Civil War, New Orleans experienced 22 full-blown epidemics, cumulatively killing over 150,000 people.... The lucky survivors became “acclimated,” or immune for life.

...But another invisible hierarchy came to co-mingle with the racial order; white “acclimated citizens” stood atop the social pyramid, followed by white “unacclimated strangers,” followed by everyone else. Surviving yellow fever was locally known as the “baptism of citizenship:” proof that a white person had been chosen by God and had established himself as a legitimate and permanent player in the Cotton Kingdom.

Immunity mattered. “Unacclimated” white people were considered unemployable. As the German immigrant Gustav Dresel lamented in the 1830s, “I looked around in vain for a position as bookkeeper,” but “to engage a young man who was not acclimated would be a bad speculation.” Life insurers rejected unacclimated applicants outright or else charged a hefty “climate premium.” If you were white, immunity-status impacted where you lived, how much you earned, your ability to get credit, and whom you were able to marry.

In order to maintain a social system whereby non-immune persons were regularly denied employment, insurance, housing, etc., some non-trivial social structure must have existed. What did this so-called "immunity passport" look like?

  • Was there a formal or literal "immunity passport" document issued by city, state, or Federal public health authorities that people applied for and then carried around as evidence of immunity?
  • Was there no standardized document, but people carried and shared their personal medical/clinical records to show that they had already had yellow fever? E.g. "Uhh, yeah, I have a clinical record case note from Dr. Hugh R. McCary here - you can see here where the diagnosis is listed as 'yellow fever', and the date is from two years ago. Please don't deny my life insurance application kthxbai!"
  • Was there not really a formal system of documents or records per se, but the system ran on a social network of busybodies and informants who "knew" who had had yellow fever and who had not? E.g. "Sorry, I talked to most of the people who live on your block as well as half of the doctors in your neighborhood, and none of them can recall ever hearing about you getting yellow fever. You also look like one of those slick New Yorkers who are always moving here and trying to take our jobs. Application for employment denied! Next!"

The American Historical Review's article "Immunity, Capital, and Power in Antebellum New Orleans" goes further in depth on this, observing (my emphasis),

For whites, immunity translated into economic capital, with all jobs going to those who claimed to be acclimated. Merchants would not enter into a partnership with someone who could not produce an acclimation certificate, and banks would not give credit to a man unable to verify the specific year he had survived the disease. Many immigrants, especially Irish and German immigrants, who arrived in large numbers during the 1830s, figured that they should try to become acclimated sooner rather than later, so they actively tried to get sick.

This lends credence to the idea that proof of immunity was not simply social network scuttlebutt (or, for that matter, self-report), but depended in some part on formal record-keeping and evidence. The question then is if there was a standard form for this record-keeping (a literal passport) or whether people just submitted whatever they had and then argued their case as to why it should be considered sufficient proof of immunity to get a job, get insurance, rent an apartment, or do whatever it is they wanted to do.

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    It's a while since I looked at this, but my understanding was that your assumed 'immunity status' depended essentially on how long you had lived in the city, and on how many previous outbreaks of the disease you had survived. I don't remember any mention of a formal document certifying immunity (and given the, then current, medical understanding of disease transmission, any such document would probably have been of limited use anyway!). Immigrants who died were predominantly from Ireland and Germany, rather than New York, if I recall correctly. – sempaiscuba Aug 17 '20 at 13:14
  • In the mid 20th century international travelers carried immunization documents like the ones shown here, passport-like in size and format, but stamped by (I suppose) ones doctor. – kimchi lover Aug 17 '20 at 20:24
  • @sempaiscuba see my edit. I found an additional source that seems to indicate that people did have a literal document that it calls an "acclimation certificate", but doesn't indicate what would have been on the certificate or how a person who didn't have one could obtain one (from a local doctor? from local public health authorities? from a court?). – Robert Columbia Aug 18 '20 at 12:34
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    @RobertColumbia I suspect that may be describing something like the Heath & Acclimation Certificate issued in Florida & Cuba in the late 19th C. – sempaiscuba Aug 18 '20 at 13:05

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