Mixed-vaccine acceptance for international travelers to the US
June 4, 2021 8:35 AM Subscribe
Some countries have decided that a mixed-dose strategy is appropriate, safe, and considered a full vaccination, and Canada just got on board. My province just laid out their second-dose strategy. I had the AZ (technically Covishield) for my first and am allowed to choose AZ, Pfizer, or Moderna for the second - what do I need to think about for traveling to the US?
Literally all of my family is in the US, it's been two years since I've seen them, and I don't want to cause a delay -- once I'm fully vaccinated and the border opens I'm going home to visit. I want to recognize too that a lot of people have also been separated from family for a long time and that people in many countries with slower rollouts still don't know when they'll be able to see them, so I am grateful that this is getting closer to reality for me.
The option to choose the second is throwing me though, I'm no expert, but there are initial indications that it might be beneficial to mix viral vector + mRNA. I also have no issue getting the AZ again if it makes the most sense to avoid any travel restrictions. It's pretty weird that a vaccine brand is a consumer choice but here we are.
Currently the guidance from the CDC says two of the same is required in the US to be considered a full vaccination. Any indication whether this is likely to change down the line as more countries are adopting a mixed-dose strategy? I can't tell if it's a matter of no guidance existing on this yet or if I'm just not finding it in my searches.
I'm eligible for the second at the end of this month, though it may still take some time to get an appointment. My timeline for full vaccination (dose + 2 weeks) is probably the end of July, if timing matters for the purpose of this question.
Literally all of my family is in the US, it's been two years since I've seen them, and I don't want to cause a delay -- once I'm fully vaccinated and the border opens I'm going home to visit. I want to recognize too that a lot of people have also been separated from family for a long time and that people in many countries with slower rollouts still don't know when they'll be able to see them, so I am grateful that this is getting closer to reality for me.
The option to choose the second is throwing me though, I'm no expert, but there are initial indications that it might be beneficial to mix viral vector + mRNA. I also have no issue getting the AZ again if it makes the most sense to avoid any travel restrictions. It's pretty weird that a vaccine brand is a consumer choice but here we are.
Currently the guidance from the CDC says two of the same is required in the US to be considered a full vaccination. Any indication whether this is likely to change down the line as more countries are adopting a mixed-dose strategy? I can't tell if it's a matter of no guidance existing on this yet or if I'm just not finding it in my searches.
I'm eligible for the second at the end of this month, though it may still take some time to get an appointment. My timeline for full vaccination (dose + 2 weeks) is probably the end of July, if timing matters for the purpose of this question.
I would absolutely not assume this will change on any kind of predictable timeline. Get the AZ.
posted by Lyn Never at 9:40 AM on June 4, 2021
posted by Lyn Never at 9:40 AM on June 4, 2021
Response by poster: Thanks all - it feels kind of ridiculous to ask (and AZ was my inclination) but I suppose what's driving some of this which I failed to include in my question was the perhaps (likely?) unfounded concern that the US will suddenly drop support for any AZ-vaccinated travelers. Like if the WHO delists it as recommended for example, which may not actually be a thing but who knows. So my thinking was that if I got an mRNA and then had to wait for a second, it would still be faster than having to get two mRNAs.
I got the AZ as soon as it was offered to my age group because it was the right thing to do for the community and because I knew I'd be up for a second shot sooner and therefore be able to travel sooner. Then suddenly the other types opened up for everyone the following week and the province dropped AZ. I've been heavily involved in my work in tracking the whiplash guidance changes from public health since the beginning, and it seems clear that anything can happen. Trying to make an educated decision about something I am in no way qualified to assess is a position many of us have ended up in. Will get the AZ - thank you.
posted by mireille at 9:55 AM on June 4, 2021
I got the AZ as soon as it was offered to my age group because it was the right thing to do for the community and because I knew I'd be up for a second shot sooner and therefore be able to travel sooner. Then suddenly the other types opened up for everyone the following week and the province dropped AZ. I've been heavily involved in my work in tracking the whiplash guidance changes from public health since the beginning, and it seems clear that anything can happen. Trying to make an educated decision about something I am in no way qualified to assess is a position many of us have ended up in. Will get the AZ - thank you.
posted by mireille at 9:55 AM on June 4, 2021
The CDC guidance is meant as general non-enforceable guidance for US residents, or at least the subset that care about science and public health. There's currently no requirement for proof of vaccine to enter or move around the US. There is very strong sentiment and lobbying against any sort of a "vaccine passport."
For now, you will need a PCR test when you return to Canada, along with the 14 day quarantine. They also don't care about your vaccination status, but it they did, a Canadian-approved series will surely be accepted.
My inclination would be to get the vaccine series that affords you the most actual protection according to clinical data.
posted by dum spiro spero at 10:03 AM on June 4, 2021 [5 favorites]
For now, you will need a PCR test when you return to Canada, along with the 14 day quarantine. They also don't care about your vaccination status, but it they did, a Canadian-approved series will surely be accepted.
My inclination would be to get the vaccine series that affords you the most actual protection according to clinical data.
posted by dum spiro spero at 10:03 AM on June 4, 2021 [5 favorites]
If the border reopens, I wouldn't be surprised to see a vaccination requirement imposed for entry for non-U.S. citizens/permanent residents. The evangelicals don't care about the rights of furriners.
(It's complicated, and you'll want to investigate the details carefully, but if you're a Canadian citizen or fall into certain other categories, you can enter the U.S. via plane and return either by plane or by car now [in fact, always could]. You just have to quarantine on the Canadian end.)
posted by praemunire at 10:26 AM on June 4, 2021
(It's complicated, and you'll want to investigate the details carefully, but if you're a Canadian citizen or fall into certain other categories, you can enter the U.S. via plane and return either by plane or by car now [in fact, always could]. You just have to quarantine on the Canadian end.)
posted by praemunire at 10:26 AM on June 4, 2021
Response by poster: Thank you all for your responses (I won't threadsit, I promise).
Just to answer a few questions - dual citizen, did not want to risk the health of my family pre-vaccine so haven't traveled yet (they're all vaccinated now). I'm aware of the current testing requirements in each direction. It's the mandatory expensive hotel quarantine that I'm waiting to end, I know people are skirting it but not I'm willing to risk the $5k fine. That of course wasn't in place last year... but not visiting last year was a risk-based decision and it also wasn't feasible for me to quarantine for basically a month during that time (advised on US side, required on Canadian side at the time).
slkinsey - the theory on it is basically that your system is getting both "lessons" and that it may be beneficial. But it's mostly being implemented now in countries with supply challenges.
Good to know about the current lack of vaccination proof to enter (I'm not sure where I might have gotten that, part of my work focus has been the other direction... essential worker requirements to enter Canada which has been chaotic and changed so often and so quickly, though not with any vaccination requirements) so it's hard to shake the thought that anything and everything could change at any time for entry to the US.
posted by mireille at 10:50 AM on June 4, 2021
Just to answer a few questions - dual citizen, did not want to risk the health of my family pre-vaccine so haven't traveled yet (they're all vaccinated now). I'm aware of the current testing requirements in each direction. It's the mandatory expensive hotel quarantine that I'm waiting to end, I know people are skirting it but not I'm willing to risk the $5k fine. That of course wasn't in place last year... but not visiting last year was a risk-based decision and it also wasn't feasible for me to quarantine for basically a month during that time (advised on US side, required on Canadian side at the time).
slkinsey - the theory on it is basically that your system is getting both "lessons" and that it may be beneficial. But it's mostly being implemented now in countries with supply challenges.
Good to know about the current lack of vaccination proof to enter (I'm not sure where I might have gotten that, part of my work focus has been the other direction... essential worker requirements to enter Canada which has been chaotic and changed so often and so quickly, though not with any vaccination requirements) so it's hard to shake the thought that anything and everything could change at any time for entry to the US.
posted by mireille at 10:50 AM on June 4, 2021
The common mechanism is the amazing and wonderful human immune system. A crude analogy would be this: you hired some security guards, and regularly show them photos of likely intruders. They remember it better if they see the photo twice, a month apart. It works just as well if the photo is a Polaroid, a fax, or a paint-by-numbers kit.
For more information, here's a very engaging Crash Course video.
posted by dum spiro spero at 10:58 AM on June 4, 2021
For more information, here's a very engaging Crash Course video.
posted by dum spiro spero at 10:58 AM on June 4, 2021
AZ is utterly useless against the South African variant. They had to stop using it there.
https://pharmaceutical-journal.com/article/feature/everything-you-need-to-know-about-covid-19-vaccines
I'm also in Canada, with one shot of AZ, and will be getting pfizer/moderna as a second shot for this reason.
posted by sebastienbailard at 11:16 AM on June 4, 2021 [1 favorite]
https://pharmaceutical-journal.com/article/feature/everything-you-need-to-know-about-covid-19-vaccines
I'm also in Canada, with one shot of AZ, and will be getting pfizer/moderna as a second shot for this reason.
posted by sebastienbailard at 11:16 AM on June 4, 2021 [1 favorite]
Astrazenica is not authorized for use in the US, but the CDC guidance does consider a full course of it to be a full vaccination, deferring to the WHO's authorization. So the question becomes, when will the WHO consider a particular mixed dose to be full vaccination? Probably when there's a study showing that it works, and pressure due to countries doing it wanting approval for reasons like your travel and also for use in COVAX.
One such study in the UK is underway, and amoung the things they're studying is first dose AZ followed by Moderna (but not Phizer). Result is expected this month.
posted by joeyh at 4:56 PM on June 4, 2021
One such study in the UK is underway, and amoung the things they're studying is first dose AZ followed by Moderna (but not Phizer). Result is expected this month.
posted by joeyh at 4:56 PM on June 4, 2021
Having dealt with US immigration and customs and having “irregularities”, I second the advice to do the thing that is the most boneheadedly simple and get the second AZ. These are bored cops waving through thousands of people, just looking for an excuse to fuck with the one person who looks slightly out of the ordinary. The odds of having your life seriously disrupted by a cop in the US is orders of magnitude greater than your odds of having your life disrupted by a virus that you might be a few percentage points more susceptible to, and with mixed vaccines we don’t even know what that difference is, really.
posted by Slarty Bartfast at 9:06 PM on June 4, 2021
posted by Slarty Bartfast at 9:06 PM on June 4, 2021
This thread is closed to new comments.
And let's keep our fingers crossed for a positive change on June 21.
posted by praemunire at 8:52 AM on June 4, 2021 [4 favorites]