Explained: Why can’t people without a personnummer get a Covid vaccine pass, and when will this change?

After Sweden's eHealth Agency said the Covid-19 vaccine pass would only be available to people with a Swedish identity number, The Local has been investigating why the ten-digit personnummer code has become an obstacle to the document that facilitates travel.

Explained: Why can't people without a personnummer get a Covid vaccine pass, and when will this change?
The pass is intended to facilitate travel, but some of those most badly in need are excluded from the scheme. Photo: Janerik Henriksson/TT

Some of those excluded from the vaccine pass are those most dependent on EU travel.

Annie Wolohon moved to Stockholm just over two years ago, so that her partner could be close to his sons. Sadly, her partner died in early 2020. Since then Wolohon says she has been living in “limbo”, and is longing to travel home to Ireland to see friends and family for the first time in almost two years.

The reason is a ten-digit number, the Swedish social security number of personnummer which is the key to accessing services ranging from opening a bank account to joining a gym, and is used for almost all contact with Swedish authorities from doctors’ visits to paying taxes. To apply for the number, you need to meet a few criteria to prove that you have the right to reside legally in Sweden for at least one year. This often means proof of income, for example, or proof that you can support yourself.

Although Wolohon has been able to open a bank account and buy property, many parts of society remain closed off to her since her personnummer application was denied because her health insurance did not have maternity cover, even though she was aged over 50 and had already begun the menopause. 

“I am not living like any normal citizen as I don’t have a personal number,” she explains. “I have been to the tax office on many different occasions and I always get a different answer.”

While EU citizens like Wolohon are allowed to move anywhere in the EU, there are still conditions – in Sweden, for example, it is only permitted to move to Sweden as a job seeker for a maximum of six months, meaning people in that situation would not get the number.

Others excluded from the system include students who will be in Sweden for less than a year, people on short-term work contracts, and others who cannot prove they have the legal right to live in Sweden for at least one year. Some of these people may be issued with a coordination number (samordningsnummer) instead, but this still requires certain criteria to be fulfilled. Without this, the alternative is a reserve number (reservnummer) which is used in the healthcare sector to identify patients without either of the two former numbers.

Then there are the people who have only recently arrived and not yet received their personnummer. The Swedish Tax Agency, the authority responsible for issuing the numbers, told The Local that the process has been hit by delays due to the pandemic.

“We are able to process most cases within four weeks, but it might take up to 18 weeks if it involves further investigation, or if we require any additional information,” Ylva Vesterlund, press secretary at the agency, said. “Current processing times are generally longer than usual due to the Covid-19 pandemic, which has affected our operations in several ways. We apologise for any inconvenience caused by these delays.”

During the pandemic, many people without a personnummer, including Wolohon, were unable to book a vaccine, despite the fact the vaccine was intended to be available to anyone living or “temporarily staying” in Sweden, and authorities’ repeated reassurance this included those without a personnummer

After many phonecalls and persistence, Wolohon has now received two doses of the vaccine, but faces a new problem: accessing the Covid-19 vaccine pass.

These were introduced as part of an EU-wide scheme and facilitate travel to EU countries. There are two ways to get the Covid-19 pass in Sweden: through a digital ID, which itself requires having a personnummer, or through a paper form. This is different from other EU countries such as Germany, where the only requirements for the pass are a valid photo ID and the proof of vaccination issued at the appointment itself.

Sweden’s eHealth Agency initially told The Local that people with a samordningsnummer would be able to apply using the paper form only, but when the pass was launched on July 1st, we were told this was not the case. Annemieke Ålenius, deputy director general of the agency, told us this was because including samordningsnummer in the system was both “more complicated” and affected fewer people than expected.

In total, she said that around 4,000 people had been registered as vaccinated using a reservnummer as of late June, and just 800 with a samordningsnummer. These vaccines are still recorded in the National Vaccination Register for statistics purposes, but cannot be connected to individual people.

“The regions carry out the vaccination, and report into the National Vaccination Register the persons they have vaccinated. They can report the samordningsnummer or reservnummer. But the only information registered is the number, there is no name, so we have to get that, and we do it using the Tax Office’s population register. The samordingsnummer is in a separate register, so that’s why there is a problem, and we are working on a solution,” she said.

“We have said earlier we would solve [the problem of issuing vaccine passes to people with a samordningsnummer] by the paper solution, but when we looked at it, we noticed it’s not in the same register. We have been forced to prioritise other areas. One large group which didn’t have a personnummer but needed the certificate were people here for diplomatic reasons who have an ‘immunity number’. That was a large number of people so we looked at that first and were able to solve that for them.”

She said the solution for applying for a vaccine pass using a samordningsnummer is estimated to be in place in September at the earliest, the reason for the delay being that the agency has to prioritise other steps first. Under EU regulations, the vaccine pass should be able to show negative Covid-19 test results as well as proof of recovery from illness by August 12th, and because this affects more people than the samordningsnummer issue, this has been prioritised.

“We are very much aware that there is a problem for people without a personnummer, but we must take the different kind of challenges in the right order,” said Ålenius. “We are working hard to solve this because we know people need it. We aren’t sure how quickly we can get this in place. We think the earliest is September but if we can solve this quicker, depending on developments on other areas [of the vaccine pass] we will put the information on our website.”

Facilitating the pass for people with a samordningsnummer will not completely solve the problem though.

Several regions, including two of Sweden’s largest, Stockholm and Västra Götaland, have not recorded any vaccinations using a samordningsnummer. Instead, they have issued reservnummer even to people who already had a samordningsnummer, Ålenius explained. She said the roughly 800 vaccinations linked to a samordningsnummer were fewer than the agency expected for this reason.

That’s a problem because reservnummer are only unique by each region, so the agency cannot match up a reservnummer to a person and their name. Unlike the samordningsnummer, it is not as simple as connecting the system to a new database.

When The Local asked why the regions did not record the vaccines using samordningsnummer, she said: “The regions are aware of the differences between samordningsnummer and reservnummer, but for practical reasons they haven’t used the samordningsnummer. I don’t know why.”

“We are dependent on the regions to work on solutions,” said Ålenius, who added that Stockholm had said it would start work on the issue after the summer holidays, and Västra Götaland had not submitted information yet.

Until these problems are fixed, Wolohon and others like her are excluded from the Covid-19 vaccine pass scheme. Depending on where they want to travel – or need to travel, since most people without a personnummer are foreigners with close ties to other countries – lacking the pass could mean needing to take multiple Covid-19 tests at high expense, needing to quarantine, or even not being allowed into the country at all if the destination country only accepts proof of vaccine and not a negative test as a condition of entry.

However, there may be a way around this, at least for now. 

Ålenius points out that until August 12th, the regulations on the EU-wide vaccine passes are in a “transitional phase”. Until then, member states should allow entry of people from other EU countries who can prove they have had two vaccine doses, even without the Covid-19 vaccine pass itself if they have the same information (such as your name, date of birth, vaccine and date received) on another document.

Member comments

  1. Hi
    Regarding Ms Woholon’s case, if she is a EU citizen, Sweden cannot refuse to issue a personnummer if she has enough resources. The original EU state she came from shall issue a S1/E121 form which transfers her health insurance rights to Forsäkringskassan, this is EU law. We are retired and we did this 2 years ago when we moved from France to Sweden.

  2. Yesterday, July 29, I received my second jab and the nurse was very sorry, but she had no idea how I might get a COVID pass. It seems like I should maybe be able to fill in a paper form, use my reservnummer along with student residence permit number, passport number & address to get either a physical card or the app-based pass for my phone. It’s frustrating and disappointing to not have that pass even though I’ve received both vaccination shots.

  3. I received 2 vaccines on 118th May and 14th July 2021. To DATE I AM UNABLE TO GET COVID PASS BECAUSE I HAVE NO PERSONNUMMER. WHEN WILL SWEDEN SORT OUT THIS MESS////????????????

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FACT CHECK: Did Sweden have lower pandemic mortality than Denmark and Norway?

A graphic published by the Svenska Dagbladet newspaper last week claimed that Sweden had the lowest excess mortality of all EU and Nordic counties between the start of 2020 and the end of 2022. We looked into whether this extraordinary claim is true (and it is, sort of).

FACT CHECK: Did Sweden have lower pandemic mortality than Denmark and Norway?

At one point in May 2020, Sweden had the highest Covid-19 death rate in the world, spurring newspapers like the New York Times and Time Magazine to present the country as a cautionary tale, a warning of how much more Covid-19 could ravage populations if strict enough measures were not applied. 

“Per million people, Sweden has suffered 40 percent more deaths than the United States, 12 times more than Norway, seven times more than Finland and six times more than Denmark,” the New York Times reported in July 2020

An article in Time in October 2020 declared Sweden’s Covid response “a disaster”, citing figures from Johns Hopkins University ranking Sweden’s per capita death rate as the 12th highest in the world.

So there was undisguised glee among lockdown sceptics when Svenska Dagbladet published data last week showing that in the pandemic years 2020, 2021 and 2022 Sweden’s excess mortality was the lowest, not only in the European Union, but also of all the Nordic countries, beating even global Covid-19 success stories, such as Norway, Denmark and Finland. 

Versions of the graph or links to the story were tweeted out by international anti-lockdown figures such as Bjørn Lomborg, a Danish sceptic of climate action, and Fraser Nelson, editor of Britain’s Spectator Magazine, while in Sweden columnists like Dagens Nyheter’s Alex Schulman and Svenska Dagbladet’s opinion editor Peter Wennblad showed that Anders Tegnell, the state epidemiologist who led Sweden’s strategy, had been “right all along”. 

Excess mortality — the number of people who die in a year compared to the number expected to die based on previous years — is seen by some statisticians as a better measure for comparing countries’ Covid-19 responses, as it is less vulnerable to differences in how Covid-19 deaths are reported. 

But are these figures legitimate, where do they come from, and do they show what they purport to show?

Here are the numbers used by SvD in its chart: 

Where do the numbers come from? 

Örjan Hemström, a statistician specialising in births and deaths at Sweden’s state statistics agency Statistics Sweden (SCB), put together the figures at the request of Svenska Dagbladet. 

He told The Local that the numbers published in the newspaper came from him and had not been doctored in any way by the journalists.

He did, however, point out that he had produced an alternative set of figures for the Nordic countries, which the newspaper chose not to use, in which Sweden had exactly the same excess mortality as Denmark and Norway. 

“I think they also could have published the computation I did for the Nordic countries of what was expected from the population predictions,” he said of the way SvD had used his numbers. “It takes into consideration trends in mortality by age and sex. The excess deaths were more similar for Denmark, Sweden, and Norway. Almost the same.” 

Here are Hemström’s alternative numbers: 

There are two basic ways of measuring excess mortality. The simplest, and the one used by SvD/SCB, is to simply compare the death rates in the relevant period with the mean of previous years, normally five years. 

More sophisticated measures attempt to estimate the expected number of deaths by extending mortality trends seen in a certain country, adjusting for the age of the population and other factors. But this can lead to results to vary significantly depending on how mortality trends and expected mortality are calculated. 

The issue with the analysis in the SvD graph is that compares deaths in the pandemic years to deaths over just three years, a mean of 2017-2019, and does not properly take into account Sweden’s longstanding declining mortality trend, or the gently rising mortality trend in some other countries where mortality is creeping upwards due to an ageing population, such as Finland. 

“It’s very difficult to compare countries and the longer the pandemic goes on for the harder it is, because you need a proper baseline, and that baseline depends on what happened before,” Karin Modig, an epidemiologist at Sweden’s Karolinska Institute whose research focuses on ageing populations, told The Local.

“As soon as you compare between countries, it’s more difficult because countries have different trends of mortality, they have different age structures, and in the pandemic they might have had different seasonal variations.” 

She described analyses such as Hemström’s as “quite crude”. 

In an interview with SvD to accompany the graph, Tegnell also pushed back against giving the numbers too much weight. 

“Mortality doesn’t tell the whole story about what effect a pandemic has had on different countries,” he said. “The excess mortality measure has its weaknesses and depends a lot on the demographic structures of countries, but anyway, when it comes to that measure, it looks like Sweden managed to do quite well.”

Do the numbers match those provided by other international experts and media? 

Sweden’s excess mortality over the three years of the pandemic is certainly below average worldwide, but in most other analyses it remains higher than those of Norway and Denmark. 

A ranking of excess mortality put together by Our World in Data for the same period as the SvD/SCB table estimates Sweden’s excess mortality between the start of 2020 and the end of 2022 at 5.62 percent, considerably more than the 4.4 percent SvD claims, and above that of Norway on 5.08 percent and Denmark on 2.52 percent. 

The Economist newspaper also put together an estimate, using their own method based on projected deaths. In this estimate, Sweden also has a higher rate of excess deaths than Denmark and Norway (but not than Finland).   

Our World in Data uses the estimate produced by Ariel Karlinsky and Dmitry Kobak, who manage the World Mortality Dataset (WMD). To produce the estimate, they fit a regression model for each region using historical deaths data from 2015–2019, so a time period of five years rather than the three used by SCB.

What’s clear, is that, whatever method you use, Sweden and the other Nordic countries are among the countries with the lowest excess mortality over the pandemic. 

“Most methods seem to put Sweden and the other Nordic countries among the countries in Europe with the lowest cumulative excess deaths for 2020-2022,” Preben Aavitsland, the Director for Surveillance and the Norwegian Institute of Public Health, told The Local.

So if Sweden had similar excess mortality to those of the other Nordics over the period, does that mean it had a similar Covid-19 death rate?

No. Sweden’s per capita death rate from Covid-19 over the period covered by the SvD/SCB figures, at 2,249 per million people, is still more than double Norway’s 959 per million, 60 percent more than the 1,409 per million who died in Denmark, and more than 50 percent more than the 1,612 per million who died in Finland. 

Sweden’s death rate is now much closer to those of the other Nordic countries than it was at the end of 2020, however, something Aavitsland put down to the higher number of Covid-19 deaths seen in his country in the later years of the pandemic. 

“The most striking difference between Sweden and the other Nordic countries is that only Sweden had large excess mortality in 2020 and the winter of 2020-21,” Aavitsland explained. “In 2022, the field levelled out as the other countries also had excess mortality when most of the population was infected by the omicron variant after all measures had been lifted.”

So why, if the Covid-19 death rates are still so different, are the excess mortality rates so similar?

This largely reflects the fact that many of those who died in Sweden in the first year of the pandemic were elderly people in care homes who would have died anyway by the end of 2022. 

About 90 percent of Covid-19 deaths were in people above 70, Aavitsland pointed out, adding that this is the same age group where you find around 80 percent of all deaths, regardless of cause, in a Scandinavian country. 

“My interpretation is that in the first year of the pandemic, say March 2020 – February 2021, Sweden had several thousand excess deaths among the elderly, including nursing home residents,” he said. “Most of this was caused by Covid-19. In the other [Nordic] countries, more people like these survived, but they died in 2022. The other countries managed to delay some deaths, but now, three years after, we end up at around the same place.” 

So does that mean Sweden’s state epidemiologist Anders Tegnell was right all along? 

It depends on how you view the years lost by the several thousand elderly people who caught Covid-19 and died in Sweden in the first wave because Sweden did not follow the example of Denmark, Norway, and Finland and bring in a short three-week lockdown in March and April 2020. Were those two years worth the greater restrictions imposed in Sweden’s neighbours? 

Tegnell himself probably said it best in the SvD interview. 

“You’ve got to remember that a lot of people died in the pandemic, which is of course terrible in many ways, not least for their many loved ones who were affected, so you need to be a bit humble when presented with these kinds of figures.”