What is vaccine tourism and is it ethical?

You may have heard of “vaccine tourism,” the practice of traveling to other countries in order to obtain a vaccine—particularly a COVID-19 vaccine—more easily. This practice, however, is likely to do more harm than good insofar as pandemic management and public health are concerned.

Not long after the COVID-19 vaccine rollout began in the United States and countries around the world, word started going around that some people were engaging in “vaccine tourism.”

Due to vaccine shortages in some areas, long waits for a vaccine to become available for a certain age group, or lack of trust in certain COVID-19 vaccines authorized locally, some people have considered the option of traveling to other countries or regions with higher vaccine availability or different vaccine roll-out rules in order to obtain their jab.

Some tourism agencies reportedly went as far as to offer vaccine tourism “packages” to those who were eager to get their dose sooner.

The eagerness to get vaccinated against SARS-CoV-2, the virus that causes COVID-19, as soon as possible, is understandable. Health experts hail vaccines as the main means of bringing the COVID-19 pandemic to an end.

Moreover, the protection that the authorized vaccines offer against severe disease means that people can return to the workplace, school, and leisure travel with more confidence.

However, vaccine tourism poses several ethical issues insofar as public health and vaccine equity are concerned.

Arthur Caplan, PhD, Drs. William F. and Virginia Connolly Mitty Professor of Bioethics at the Department of Population Health of the NYU Grossman School of Medicine in New York City, explains where the trouble with vaccine tourism lies.

The issue of vaccine inequity

“[E]verybody understands the desire to get vaccinated in the middle of a plague,” says Dr. Caplan. However, he points out, “if you're going somewhere to get ahead [of the line], to get priority, then when you go to another country [to receive a COVID-19 vaccine] you're taking it away, most likely, from somebody else.”

The speed of the vaccine roll-out has varied across the globe. While the United States, Canada, and many European countries have obtained sufficient doses of authorized COVID-19 vaccines to inoculate a significant percentage of their populations within the time frame they decided on, numerous other countries have been unable to purchase enough doses to do so.

According to the World Health Organization (WHO), the majority of COVID-19 vaccine distribution has occurred in only 10 high- and middle-income countries, meaning that the remaining countries face very limited access to vaccines.

The unequal distribution of vaccines is an important public health issue, as without an equitable vaccination rollout, SARS-CoV-2 will likely continue to spread widely around the world.

Dr. Caplan explains that, if you go to a country where vaccines are in short supply and arrange to receive a vaccine there, “then you are doing something unethical if you're pushing somebody out of the line in order to get to the head of the line.”

He also notes that vaccine tourism is predicated on having the resources to travel so as to get a vaccine sooner, which is unfair to other members of that person’s home community.

“[T]hat's unfair, it's inequitable in the sense [that] you're getting something that you couldn't get back in your home country, and you're probably [financially secure] in order to do this. It's not something that the ordinary citizen can do,” notes Dr. Caplan.

In a short statement for Lonely Planet, Ezekiel J. Emanuel, MD, PhD, Professor of Medical Ethics and Health Policy in the Perelman School of Medicine at the University of Pennsylvania, also strongly condemns vaccine tourism, for the same reasons.

“Vaccine tourism is bad,” he says, because “it rewards the well-off who can afford to fly and travel.”

“That is NOT how we should allocate vaccines,” he emphasizes.

Healthcare system concerns

Furthermore, people who engage in vaccine tourism may end up facing healthcare system issues, in that the vaccination certificate from the country where they received their jab may not be recognized in their home country.

Dr. Caplan moreover points out that “[t]here is a small amount of risk in vaccine tourism in that, if you did have a side effect and went home, it's not clear that your health system in your own country would know what to do, or even that they would identify it as being linked up to vaccination.”

He also notes that, if a person from a low-income country had the means to travel abroad to a higher-income country in order to receive a COVID-19 vaccine, they may run into problems upon returning to their home country, as there may not be enough healthcare resources in place to provide care to anyone experiencing side effects following an unaccounted-for jab.

Is it ever okay to engage in vaccine tourism?

Prof. Caplan notes that, in theory, under very specific circumstances, the negative impact of vaccine tourism on healthcare equity could be limited.

“I'm not against doing what you need to do to protect yourself or your family,” he says, “but you should not do it at the cost of others.”

“If you can find a country that has ample vaccine supply,” where there are enough vaccine doses “to give to everybody in the whole country,” then traveling there to get the vaccine may be understandable, albeit still ethically questionable, he explains.

However, he cautions that manipulating another country’s healthcare system in order to obtain a vaccine sooner than it is available in one’s own country may still mean that you are taking that jab away from someone who needs it more urgently.

“[S]omebody else who has greater need [of the vaccine] — perhaps [...] a healthcare worker, an elderly person — you could [risk] killing someone to get that vaccine” by obtaining the jab before they do and thus leaving them vulnerable to the virus, says Prof. Caplan.

How long until vaccine tourism becomes obsolete?

The bioethics expert is hopeful that vaccine tourism will eventually become a thing of the past, though he suspects that it may take a while for this risky and questionable practice to be eradicated.

“I'm a little skeptical that [vaccine tourism] is going away [sooner than] 2 or 3 years [from now],” he admits. “It's very hard to get vaccines all over the world.”

“I know that, because if you look at the campaign to get rid of polio [poliomyelitis, ed.], it's taken 30 years to reduce polio around the world. You need not just vaccines, but also [practicable] roads, refrigerators, needles, people to give vaccines [who] have to be trained,” he goes on to say.

So as the effort for an equitable COVID-19 vaccine rollout around the world continues, one small way in which each of us can help is by avoiding the temptation of vaccine tourism.

For more information on COVID-19 and travel, check out Lonely Planet's Health Hub.

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