Travelers are crossing borders for vaccines. Is that okay?

Enno Lenze, a German entrepreneur, journalist, and museum director, had what felt like another job looking for a vaccination, a hunt he had been on since December. He lives in Berlin and had asked local doctors for leftover shots, but was willing to travel: he applied for the vaccine in Serbia, inquired about options in Israel, the United Arab Emirates, and Iraq, and even tried to get a U.S. visa to try his luck there.

Finally, an option came through. World Visitor, a Norwegian travel agency, offered a package that included flying to Moscow to get Sputnik V, the Russian vaccine. Lenze and 50 other Germans jumped at the chance and traveled there earlier this month for their first jabs. They now must return in May for the second dose. With each visit they are required by the Russian government to remain in the country for three days to be monitored, but Lenze says he didn’t mind.

“I did a lot of sightseeing,” he says. “I’m interested in the space race and wanted to see the Soviet-era spacecrafts.”

World Visitor also offers a three-week “wellness” trip in which travelers can relax at a spa in Turkey between their shots. The company is about to launch a Siberian railroad trip that comes with a vaccine. Albert Sigl, co-owner of World Visitor, says that about 600 people from Germany and Switzerland, the two European countries that have flights to Russia right now, have so far signed up for one of the trips. Russia is their first vaccine tourism offering, according to Sigl, but says it likely won’t be their last.

“As soon as a country is open for vaccine trips we will have it on our site for sale,” Sigl says. “We have no special connection with Russia, it’s a pure business model.”

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Uneven vaccination

COVID-19 vaccine distribution has taken many forms globally, with countries enacting different policies to serve their most at-risk populations. But in many places—including Germany, the home country of the BioNTech/Pfizer vaccine, where about seven percent of the population has been fully inoculated—vaccines are difficult or nearly impossible to come by. Some residents anxious for them are traveling across international borders in search of whatever jab they can find. This problem points to serious problems in global vaccine distribution and surfaces the lengths some people will go to secure one.

The United States has suffered the pandemic’s highest mortality, with more than 567,000 deaths. Nonetheless, the U.S. vaccination effort has been more efficient and effective than all but a handful of countries; so far some 28 percent of the adult population in the U.S. has been inoculated.

Every American adult is now eligible to receive the vaccine, and appointments for visitors are starting to open up in places where supply outstrips demand. This has led to some promising opportunities: In June, Alaska will offer a jab at the airport to any traveler. North Dakota is now vaccinating Canadian truck drivers. Florida, which had to enact residency rules early in the vaccine rollout after concerns that people were coming in from out of state, has been able to make allowances for part-time residents and people with businesses in-state. And in hard-hit Mexico—where less than five percent of citizens are fully inoculated—the Reforma newspaper reports that “polleros” (slang for coyotes) are helping people travel across the U.S. border for jabs.

The rules are flexible enough that some Central American and South American residents desperate for the vaccine are coming through Miami. Among these is Daniel Cordova Cayo, a Peruvian economist.

Peru’s second wave is currently worse than its first; the nation has one of the highest excess death rates in the world, with almost 59,000 deaths. Challenges with vaccine acquisition and fair distribution here have rattled the country. Former President Martín Vizcarra has been banned from holding public office for the next decade after he was found guilty of influence peddling, collusion, and making false declarations about the rich and well-connected people who were allowed to jump the queue for a vaccine.

See how COVID-19 has impacted Peru’s tourist economy.

“Peru is in a very bad situation,” Cordova Cayo says. “I’m not rich, but I have an American visa.”

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Cordova Cayo works with a university that has a campus in Florida; he flew into Miami International Airport from Lima, got a rental car, and drove straight to the vaccine site at Hard Rock Stadium. He presented university documentation and his passport and got the vaccine.

He had been in Miami for work in January, but didn’t consider trying to get the vaccine at that time because he wasn’t old enough to qualify and didn’t think it was right to take a dose from an at-risk group. But after vaccines were offered to all adults, he felt comfortable getting it. He says he knows many others in Lima who are making the same trip.

From his perspective as an economist, he says that while the countries that have been successful at getting vaccines to their citizens have pursued slightly different paths, the countries that have failed to acquire and distribute vaccines have run into the same hurdle.

“Bureaucracy is a problem, and it’s all over the world,” he says.

A tourism boost

After a year of seismic travel disruptions, some countries are looking to boost visitor numbers by offering vaccinations upon arrival. The Maldives has pursued a “3-V” strategy encouraging tourists to “visit, vaccinate, and vacation.” This will provide a “more convenient” way to visit, the Maldives tourism minister Abdulla Mausoom told CNBC. While only about 13 percent of Maldivians have been fully vaccinated, some 90 percent of front-line tourism workers have been, according to Mausoom. This statistic points to the significance of the tourism sector in the nation’s recovery prospects.

Learn how vaccines may boost the return of travel.

One challenge that many nations face is a global inequality in vaccine procurement and distribution. Eighty-two percent of the jabs given worldwide have gone to high- and upper-middle-income countries, according to a study by the Our World in Data project at the University of Oxford. Only 0.2 percent of vaccines have gone into arms in low-income countries.

To mitigate this problem, efforts have been launched, including COVID-19 Vaccines Global Access, or COVAX, a global initiative aimed at distributing vaccines. But so far, rich countries have taken the vast majority of the supply.

“If we had the right global distribution and then people were jumping the queue, that would be a problem,” says Nicole Hassoun, a visiting scholar at Cornell University and professor of philosophy at Binghamton University who works in bioethics. “That’s not the situation we have.”

Traveling for treatments with either limited availability or cheaper options than ones’ home country is not new according to I. Glenn Cohen, a professor at Harvard Law School and director of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics. A thriving medical tourism market has existed for years. In the case of COVID-19 vaccines, as long as at-risk groups have first been protected, countries with surplus vaccines could use them to jumpstart travel, if it is done carefully.

“What matters is where the net benefit goes,” he says. “It should benefit the poorest in the community and not just the rich.”

While two-dose vaccinations might tempt countries to keep visitors for longer, since it takes time to build an immune response, most post-jab tourism activities should not be rushed.

“I’d be a little concerned,” he says. “I hope these people aren’t going to markets and bazaars right away.”

Hitting the road for jabs

Serbia has also experimented with offering jabs to international travelers. Serbia bought about three million doses of Pfizer, AstraZeneca, Sputnik V, and Sinopharm; surprisingly, the nation found itself with more vaccines than citizens who wanted it. So the country offered doses to foreign nationals; more than 22,000 non-residents had secured a vaccine by the end of March, according to Euronews.

Most were residents of neighboring Balkan countries, but Canadians Alyssa Sutton and Noah Guthrie were among the lucky visitors to get a jab. Recent college graduates, Sutton and Guthrie started traveling in Europe in September. They tried to time their long-planned gap year trip with a dip in cases and followed all the quarantine rules of each country. Still, within weeks, cases started climbing back up and they were stranded in Europe, unable to afford the quarantine hotels that all Canadians flying home were required to stay in before returning.

They headed to Serbia after hearing that vaccine appointments were opening to foreigners. They used Google Translate to fill out their forms, and didn’t expect to hear back. Within a week, their application was approved and Sutton and Guthrie grabbed a bus to Belgrade from Novi Sad, a Serbian city about an hour away. They got the AstraZeneca jab without a hassle. Their YouTube video of the experience racked up thousands of views and emails from people around the world asking how to do the same. Since mid-April, however, Serbia has suspended vaccines for foreigners.

“We were lucky we were there,” Sutton says.

The pair has to be ready for the second shot, which could happen any day now. The final jab also means they will be able to travel to countries that are opening up to fully vaccinated tourists.

Even during a pandemic, wanderlust strikes. “We aren’t going to be able to do this anytime,” Sutton says, explaining that future plans like having a house and a career after their gap year will make a trip like theirs impossible. “We have to do it now.”

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