W.he more than 50 unique vaccination plans in the United States, a person’s access to the Covid-19 vaccine largely depends on where one lives. In Wisconsin, mink farmers are being considered for the next phase of vaccine prioritization. In New Jersey, smokers have priority access to the vaccine. In Colorado, journalists fall under the category of frontline workers.
This complex system has led to a new type of pandemic travel – called “vaccine tourism” – in which people traverse state or even land lines to gain access earlier. Without a standardized protocol and because of the broken US health system, tens of thousands, if not hundreds, of thousands of people have received vaccines outside of their home countries.
‘They’re from Canada, Brazil, New York, Georgia, people from Minneapolis came here. Some friends of mine in St. Petersburg [Florida] told me they were on a vaccination line with people from Venezuela, ”said Dr. Jay Wolfson, a professor of public health at the University of South Florida.
He credits advertisements from international travel agents with at least part of the influx of vaccine tourists. ‘I get calls all the time from people saying,’ Jay, can you take me somewhere? ‘- and I can’t. And I will not. “
Florida is one of the most popular vaccine tourism destinations for both domestic and international travelers, due to the state’s original policy of vaccinating anyone over the age of 65. The state recently implemented new ID rules in an effort to send more vaccines to Florida residents, but not before about 50,000 recipients were dosed out of state. While some of these vaccine recipients are seasonal residents of the state, or winterers, whose decision to spend the winter in Florida was unrelated to their vaccination prospects, many thousands have come to the state for an opportunity.
The 50,000 doses represent only about 3.4% of the total number of vaccinations administered in Florida, but even a small percentage that goes to out-of-state recipients in any state can destroy the nation’s vaccination infrastructure. to influence.
“Administering a vaccine dose requires appointments, needles and staff. And all those resources that are means of delivering doses of the vaccine are tied to a local community, state or city in terms of allocation, ”said Dr. Kyle Ferguson, a postdoctoral fellow in the department of medical ethics at New York University. Grossman School of Medicine.
Cities and states generally receive batches of the vaccine from the federal government based on the adult population in the area and plan their distribution strategy accordingly. When someone crosses city, state, or national lines to get a vaccine, it disrupts the success of vaccine rollouts in both jurisdictions.
“Vaccine tourists use their power to give themselves an unfair chance. There are design flaws that people are exploiting and taking advantage of some of the weaknesses in those systems, ”said Ferguson. “None of this should be about dignity or merit, but when someone travels for the vaccine, they are using resources, both doses and all delivery mechanisms, that are assigned to another community.”
Vaccine tourism can also be risky for patients and healthcare providers. “If you are giving a dose of the vaccine to someone who may not be able to return to get their second dose or if there is a side effect, who is responsible for it?” Wolfson asks. “If you travel long distances for an injection, you run the risk to the patient of not meeting the dosage and not being able to contact healthcare providers to get what we call continuity of care in healthcare . “
Nonetheless, many are willing to take the risk, especially if they are particularly prone to health complications from the virus or don’t have to travel far to get vaccinated across the border.
A resident of New York has seen some of her friends and family members cross state lines for vaccines. “My friend’s mother, a New York resident who is currently awaiting the Florida pandemic, will drive to New Jersey in February for a vaccination,” she said. “She has high blood pressure and has researched multiple states where she may be a candidate for the vaccine and New Jersey fit the bill.”
Her brother, a teacher hoping to safely enter the classroom, had since given up plans to travel from New York to New Jersey to get vaccinated under the state’s priority vaccination policy for teachers with pre-existing conditions. “There is no burden of proof in New Jersey to show that you are a former smoker, so it’s an easy loophole to exploit,” she said. Another family friend over 65 and immunocompromised living in New Jersey has signed up to get the vaccine in New York due to a lack of available appointments in her home state.
Wolfson said such decisions were understandable, but not necessarily commendable, especially given the widespread governmental mismanagement of the pandemic and the human instinct for self-preservation.
“If we have a limited supply of a highly sought after, life-saving product and people don’t even know how to get it, or if the phone lines are crowded and the computer logins are down and they are online at 3 a.m. at age 85 , waiting for the first dose, that only diminishes the confidence people have in this system, ”he said.
The more inconsistency you have – with one state saying, ‘We’re taking smokers’ and the other state saying, ‘We’re not going to take prisoners,’ and politicians proudly jump to the head of the line in many parts of the country – the less support you will have to follow the rules, “said Dr. Arthur Caplan, a professor of bioethics at NYU School of Medicine.” There is a little bit of excusable leeway for people in high-risk groups trying to protect themselves. “
But vaccine tourists who can cross state lines to get vaccinated are largely the ones with the resources and the ability to travel a distance – twice – for the vaccine and the technological knowledge or connections to claim an appointment. . This has contributed to racial and socio-economic differences in vaccine distribution so far: From New York to New Jersey to Chicago, vaccine recipients were predominantly white and lived in wealthier zip codes.
“Most importantly, don’t waste vaccines. I much prefer it to go in someone’s arm than in a garbage can, ”said Caplan of the reality that some vaccine doses are unclaimed at distribution locations across the country. “But we are not yet done vaccinating health workers and the elderly. So standing in line for people at higher risk of actually dying, often by those who are younger, can stay at home, go into quarantine, wear masks and protect themselves, which must be condemned. “
Beyond these individual decisions, however, there is a systemic problem, Caplan said. What happened to the vaccine stock? Why don’t we know how much we have? There has been a huge failure in leadership. “