A European Union proposal to open up travel within the bloc using digital health certificates would allow countries to decide whether to recognise Covid-19 vaccines not approved by the European regulator, as some look to China and Russia for doses. The proposal, unveiled on Wednesday, comes as countries around the world are grappling with how vaccines can be used to ease travel restrictions, and questions arise over whether governments should recognise vaccines that have not been approved within their borders. China this week relaxed its visa rules for some foreign workers looking to enter the country, but only if they had received a Chinese vaccine. Europe raised issues about efficacy and safety of Pfizer-BioNTech vaccine in November The EU proposal could allow carriers of a “digital green certificate” to move freely between member countries and would show vaccination as well as proof of negative tests or prior infection. Some borders within the EU were tightened to control disease spread. Under the proposed rules, countries can decide which public health restrictions would be waived for travellers. Any of the bloc’s 27 countries waiving restrictions under the proposed scheme would have to accept vaccination certificates for all shots authorised by the European Medicines Agency (EMA), but the proposal leaves the door open to recognise other products as well. “Member states may decide to extend this also to EU travellers that received another vaccine,” according to a summary of the plan. The vaccine roll-out in Europe has so far been dominated by the product made by US firm Pfizer and German partner BioNTech, which accounts for more than two-thirds of the nearly 65 million doses distributed in the EU, Lichtenstein, Iceland and Norway, according to financial analysis firm Finbold. Two other vaccines authorised by the EMA, one by US firm Moderna and another by British-Swedish company AstraZeneca, account for nearly all the rest. But some countries, struggling to access doses amid shortages, have looked to China and Russia for their vaccines, which are not approved by the EMA. Hungary last month became the first EU country to roll out a vaccination programme using a product made by Chinese state-owned firm Sinopharm and has agreed to buy 5 million doses of it in the coming months. The country is also using the Sputnik V vaccine developed by Russia’s Gamaleya Institute, which is under evaluation by the EMA. Both China and Russia faced criticism last year for using vaccines in their own countries before they had completed their final clinical trials. China has yet to publish details of safety and efficacy evaluations of its vaccines, despite giving market approval to four products domestically and exporting millions of doses. Besides Hungary, EU member Slovakia has accepted a shipment of Sputnik V vaccines, while the Czech Republic has expressed interest in both Russian and Chinese products. How countries use vaccinations to allow travellers to move between borders is likely to remain a subject of much debate in the coming months, experts say. All you need to know about coronavirus vaccines Beijing stirred controversy this week by moving to restore pre-pandemic immigration procedures for foreign workers from certain countries, on the condition they had received a Chinese vaccine. Critics called the move a bid to promote Chinese products, as the arrangement was offered in some countries, including India and the United States, where the vaccines are not available. China’s foreign ministry spokesman Zhao Lijian said the arrangement was different from vaccine recognition and intended to facilitate travel based on the safety and efficacy of Chinese vaccines. “I think relevant vaccine producers should file applications to competent authorities in China and the latter will make decisions in accordance with laws and regulations,” he said in response to a question on whether Beijing would recognise vaccines made outside China. In Europe, it remains unclear if countries will recognise the Chinese vaccines or others not approved by the EMA under the proposed digital certificate system, which is expected to be rolled out before summer. Covid-19 origin search abandons lab leak theory, China’s leader in joint WHO mission says John Lim, executive director of the Centre of Regulatory Excellence at the Duke-National University of Singapore Medical School, said how best to set up vaccine passports internationally was part of a broader conversation about evaluating vaccines. “There needs to be this commonality of standards, which then facilitates the sharing of information, which then potentially leads to the effectiveness of things like vaccine passports,” he said. “But if you just push ahead in this area without looking at these issues, you can have such things, but it may still raise questions and may not be fully mutually accepted,” he said. Additional reporting by Reuters