Welcome to the New Era of Covid Vaccine Tourism

Mother Jones illustration; Unsplash

In 2021, as the first wave of Covid vaccines became more available to the general population in the US, international travelers^[2] from Latin America and elsewhere came to the country to get the lifesaving shot. At the time, an array of federal subsidies and guarantees made it possible for almost anyone to immunize themselves against Covid at little or no up-front cost—a safety net that saved countless lives.

Then, this year, the Trump administration—pandering to anti-vaccine activists—rolled back^[3] national access to Covid vaccines for everyone six months and older, falsely claiming^[4] that Covid is not a threat to healthy children and adults.

Now, in an increasingly anti-vaccine public health regime, Americans are subject to a patchwork of state rules^[5] on who qualifies for the Covid vaccine and under what circumstances, as right-wing legislators and governors like Florida’s Ron DeSantis race to outdo one another in reducing access not only to Covid shots but vaccination in general.

For a growing share of people in the US, that leaves crossing state lines as the best option to get the updated vaccine: a new era of interstate vaccine tourism.

There’s yet another layer. On Friday^[6], CDC’s Advisory Committee on Immunization Practices (ACIP), now filled with^[7] Robert F. Kennedy Jr. appointees^[8], will meet to discuss new potential Covid vaccine guidance. In states that still require prescriptions^[9] for the Covid vaccine or did until recently, many people have already reported issues^[10] in actually getting the shot.

Kennedy’s anti-vax immunization board may double down, issuing new recommendations that make it even harder to get the Covid vaccine, and some states may not offer it at all if such guidance comes out of the meeting. In the absence of a confirmed CDC director, signoffs on federal vaccine policy will likely fall to the Secretary of Health and Human Services, American Public Health Association executive director Dr. Georges C. Benjamin told me. That, of course, is RFK Jr.

Matt Powers, 34, lives in Florida and has multiple sclerosis. On September 26, he’ll start a medication, Ocrevus, which will deplete his immune system. He’s not supposed to get vaccines two weeks before or for months after.

Powers was told at a local CVS that pharmacists wouldn’t prescribe vaccines until after the ACIP meeting, even with a prescription. On a day when his MS symptoms allowed him, he decided to drive over an hour and a half to Alabama. His insurance wasn’t accepted there, so Powers had to pay more than $200 out of pocket.

“To their credit, the pharmacist that gave me the shot was extremely grateful,” Powers said, telling him, “We don’t get a lot of people anymore doing this. You went through a lot of effort to do this yourself.” He even got a free bag of popcorn.

Benjamin calls the need for interstate travel for Covid vaccines “a tragedy.”

“The federal government has been negligent,” he told me.

For people who live near state borders, interstate travel is clearly more realistic. Before Massachusetts Gov. Maura Healey’s recent order^[11] allowing people over the age of five to get the Covid vaccine, Abigail Addington-May, who is 70, traveled to a Rhode Island pharmacy to get her Covid vaccine—but that was just a 15-minute drive. She did not have to pay out of pocket.

Addington-May knows people who have died of Covid; she wanted to make sure that she got her vaccine before Thursday’s ACIP meeting, she said, in case restrictive guidance came out of it.

“It’s so frustrating that common sense and science is disappearing,” Addington-May said.

Across the country in Oregon, Lisa Marshall and her husband wanted to make sure they were vaccinated ahead of a planned trip abroad. Marshall, who is 74, went to a CVS pharmacy and was denied a Covid vaccination because she didn’t have a prescription.

“There’s this story going around [that] Oregon and California and Washington got together to make the vaccine available to everybody,” Marshall said, referring to the West Coast Health Alliance^[12], an interstate compact meant to safeguard vaccine access. “But that hasn’t happened yet in Oregon.”

“It’s our body, and we should be able to do with it what we want,” said Marshall’s husband, Shawn. “To get the vaccine denied by these people in Washington, DC, is very frustrating.”

But a CVS employee also suggested going to Washington state. Only a 20-minute drive, it was a no-brainer. At a Washington Walgreens, an employee told them a stream of Oregonians had been coming over.

James Alwine, a University of Pennsylvania professor emeritus in virology and member of the volunteer-run Defend Public Health^[13] coordinating committee, sees the West Coast Health Alliance as a potential model moving forward.

“Blue states are going to have to step up and make their own rules and allow people to get vaccinations at the pharmacies, without prints, without prescriptions, and a few states have already done that,” said Alwine, who is currently based in Arizona. Despite his expertise, it took Alwine and his wife half a day to figure out how to get the Covid vaccine (Arizona Gov. Katie Hobbs, a Democrat, has since signed^[14] an executive order expanding Covid vaccine access).

Wider guidance on who qualifies for Covid shots is also needed, Benjamin told me. “What do you do if you are a healthy oncologist who is 45 years of age, are you going to be able to be able to see cancer patients?” he asked. “You’ve got to be vaccinated.”

It would be remiss to assume the Trump administration’s vaccine crackdown will end with Covid, Alwine said. “Robert F. Kennedy, Jr. is trying to eliminate all vaccinations. And if this happens, you know what a mess we’re going to be in?”