Vaccine tourism: an emerging topic of discussion

Sir,

Vaccine tourism (also known as vaccine vacation) is a term that recently became popular once travel agents started offering tours abroad along with COVID-19vaccination doses as a package in early 2021. Vaccine tourism is a kind of medical tourism where people are offered to get two doses of COVID-19 vaccines, stay in that country, and a tour of that country.¹ It is based on a 3- ‘V’ policy: Visit-Vaccination-Vacation. ‘Vaccine passport’ is a term often confused with vaccine tourism. A vaccine passport is a document of proof that the person has taken a vaccine against that particular disease and is asked to produce it at the point of entry to a different country.² This is similar to an immunity passport in which a person is tested for an antibody after a certain duration of taking the vaccine and if the antibody is positive, that means the person is protected against that disease. The history of this goes back to the time when people entering the ‘British Pandharpur' or pilgrims to Mecca for Hajj were asked for a vaccine certificate, a scar of vaccination, or pitted face as a sign of smallpox survival.³ For COVID-19 WHO has not advised in favor of vaccine passport as the efficacy period for any vaccine till now is very short, variable, and doubtful. Due to the unavailability or non-equitable distribution of vaccines many countries are not able to provide vaccines to all the population. With the pandemic hitting the travel and tourism industry hard, countries whose major economy depends on tourism have taken up vaccine tourism as a chance to revive their economy. Pfizer-Biotech and Moderna vaccines are in high demand as they are recommended by the WHO Strategic Advisory Group of Experts on Immunization (SAGE). On the other hand, emergency COVID-19 vaccines- like Sputnik V in Russia are not recognized by WHO or European Medicine Agency though a package was offered for this vaccine. There is currently no uniform law where vaccine tourism is considered illegal if air travel is allowed but, it is not supported by many countries. For instance, Florida, United States has strictly banned vaccine tourism as they were continuously receiving crowds of beneficiaries from neighborhood countries while, New York, United States is trying to take this as an opportunity. The UK has actively prevented vaccine tourism. Maldives and Seychelles have officially launched vaccine tourism though it is not available for Indians due to the ongoing 2^nd wave of COVID-19 in India. In some countries, the government has allowed a vaccine tour for foreigners after all native residents are vaccinated, and there are other countries where government is not supporting this despite packages being offered by tour operators. In an attempt to re-open tourism, San Marino has offered Sputnik V to foreigners after all residents have received the first dose of the vaccine with a condition that foreigners have to stay in designated hotels registered for this purpose.⁴ On one hand, it is a boost to the economy amidst of COVID-19 pandemic as well as a threat also as this can be a potential source of spread of COVID-19. A SWOT analysis of vaccine tourism is presented in Figure 1.

To conclude, vaccine tourism is a relatively new concept and its ethical and legal considerations in the backdrop of pandemic should be considered before regularizing it.

REFERENCES

1. 1. Zerrweck C, Sánchez HA, Posada JA, Cervantes J. Giant congenital mesenteric hernia in the adult. Acta Chir Belg. 2009;109(5):620-2.
2. 2. WHO. nterim position paper: considerations regarding proof of COVID-19 vaccination for international travellers, 2021. Available at: https://www.who.int/newsroom/articlesdetail/intermpositionpaperconsiderationsregardingproofofcovid19-vaccination-for-international-travellers. Accessed on 20 October 2021.
3. 3. The Indian Express. From Smallpox to Covid-19: The history of vaccine passports and how it impacts international relations, 2021. Available at: https://indianexpress.com/article/research/fromsmallpox-to-covid-19-the-history-ofvaccinepassportsand-how-it-impacts-international-relations. Accessed on 20 October 2021.
4. 4. SchengenVisaInfo. These Countries Are Now Offering COVID-19 Vaccines for Tourists, 2021. Available at: https://www.schengenvisainfo.com/news/thesecounarenowofferingcovid19vaccinesfortourists. Accessed on 20 October 2021.