Vaccination requirements for international travel

Vaccination requirements for international travel are the aspect of vaccination policy that concerns the movement of people across borders. Countries around the world require travellers departing to other countries, or arriving from other countries, to be vaccinated against certain infectious diseases in order to prevent epidemics. At border checks, these travellers are required to show proof of vaccination against specific diseases; the most widely used vaccination record is the International Certificate of Vaccination or Prophylaxis (ICVP or Carte Jaune/Yellow Card). Some countries require information about a passenger's vaccination status in a passenger locator form.

Historic requirements

Smallpox (1944–1981)
See also: Smallpox vaccine

The first International Certificate of Vaccination against Smallpox was developed by the 1944 International Sanitary Convention[1] (itself an amendment of the 1926 International Sanitary Convention on Maritime Navigation and the 1933 International Sanitary Convention for Aerial Navigation).[2] The initial certificate was valid for a maximum of three years.[1]

The policy had a few flaws: the smallpox vaccination certificates were not always checked by qualified airport personnel, or when passengers transferred at airports in smallpox-free countries. Travel agencies mistakenly provided certificates to some unvaccinated customers, and there were some instances of falsified documents. Lastly, a small number of passengers carrying valid certificates still contracted smallpox because they were improperly vaccinated. However, all experts agree that the mandatory possession of vaccination certificates significantly increased the number of travellers who were vaccinated, and thus contributed to preventing the spread of smallpox, especially when the rapid expansion of air travel in the 1960s and 1970s reduced the travelling time from endemic countries to all other countries to just a few hours.[1]

After smallpox was successfully eradicated in 1980, the International Certificate of Vaccination against Smallpox was cancelled in 1981, and the new 1983 form lacked any provision for smallpox vaccination.[1]

Current requirements

Yellow fever
Further information: Yellow fever vaccine § Travel requirements
Vaccination against yellow fever ten days before entering this country/territory is required for travellers coming from ...
  All countries
  Risk countries (including airport transfers)[note 1]
  Risk countries (excluding airport transfers)[note 2]
  No requirement (risk country)[note 3]
  No requirement (non-risk country)

Travellers who wish to enter certain countries or territories must be vaccinated against yellow fever ten days before crossing the border, and be able to present a vaccination record/certificate at the border checks.[3]: 45  In most cases, this travel requirement depends on whether the country they are travelling from has been designated by the World Health Organization as being a "country with risk of yellow fever transmission". In a few countries, it does not matter which country the traveller comes from: everyone who wants to enter these countries must be vaccinated against yellow fever. There are exemptions for newborn children; in most cases, any child who is at least nine months or one year old needs to be vaccinated.[4]

Polio
Further information: Polio vaccine § Travel requirements
Polio vaccination is required for travellers ...
  From all countries, to all countries
  From some countries, to all countries
  From some countries, to all countries
  From some countries, to some countries
  To some countries
  From some countries

Travellers who wish to enter or leave certain countries must be vaccinated against polio, usually at most twelve months and at least four weeks before crossing the border, and be able to present a vaccination record/certificate at the border checks.[3]: 25–27  Most requirements apply only to travel to or from so-called polio-endemic, polio-affected, polio-exporting, polio-transmission, or "high-risk" countries.[4] As of August 2020, Afghanistan and Pakistan are the only polio-endemic countries in the world (where wild polio has not yet been eradicated).[5] Several countries have additional precautionary polio vaccination travel requirements, for example to and from "key at-risk countries", which as of December 2020 include China, Indonesia, Mozambique, Myanmar, and Papua New Guinea.[4][6]

Meningococcal meningitis
Further information: Meningococcal vaccine § Travel requirements
Travellers need to show proof of meningococcal vaccination ...
  Upon arrival in the Hajj and Umrah zones (foreign and domestic pilgrims, workers, and residents of Mecca and Medina)
  Before departure to Hajj and Umrah in Saudi Arabia, and to certain African countries
  Before departure to and upon arrival from Saudi Arabia
  Before departure to Hajj and Umrah in Saudi Arabia
  Upon arrival
  African meningitis belt: vaccination recommended for visitors

Travellers who wish to enter or leave certain countries or territories must be vaccinated against meningococcal meningitis, preferably 10–14 days before crossing the border, and be able to present a vaccination record/certificate at the border checks.[3]: 21–24  Countries with required meningococcal vaccination for travellers include The Gambia, Indonesia, Lebanon, Libya, the Philippines, and most importantly and extensively Saudi Arabia for Muslims visiting or working in Mecca and Medina during the Hajj or Umrah pilgrimages.[4] For some countries in African meningitis belt, vaccinations prior to entry are not required, but highly recommended.[3]: 21–24 

COVID-19
See also: COVID-19 vaccine, Impact of the COVID-19 pandemic on aviation, and Impact of the COVID-19 pandemic on tourism
Scott Morrison: "People have the choice of two weeks of quarantine or being vaccinated."[7]

During the COVID-19 pandemic, several COVID-19 vaccines were developed, and in December 2020 the first vaccination campaign was planned.[8]

Anticipating the vaccine, on 23 November 2020, Qantas announced that the company would ask for proof of COVID-19 vaccination from international travellers. According to Alan Joyce, the firm's CEO, a coronavirus vaccine would become a "necessity" when travelling, "We are looking at changing our terms and conditions to say for international travellers, we will ask people to have a vaccination before they can get on the aircraft."[9] Australian Prime Minister Scott Morrison subsequently announced that all international travellers who fly to Australia without proof of a COVID-19 vaccination will be required to quarantine at their own expense.[7] Victoria Premier Daniel Andrews and the CEOs of Melbourne Airport, Brisbane Airport and Flight Centre all supported the Morrison government's "no jab, no fly" policy, with only Sydney Airport's CEO suggesting advanced testing might also be sufficient to eliminate quarantine in the future.[10] The International Air Transport Association (IATA) announced that it was almost finished with developing a digital health pass which states air passengers' COVID-19 testing and vaccination information to airlines and governments.[11]

Korean Air and Air New Zealand were seriously considering mandatory vaccination as well, but would negotiate it with their respective governments.[12] KLM CEO Pieter Elbers responded on 24 November that KLM does not yet have any plans for mandatory vaccination on its flights.[13] Brussels Airlines and Lufthansa said they had no plans yet on requiring passengers to present proof of vaccination before boarding, but Brussels Airport CEO Arnaud Feist agreed with Qantas' policy, stating: "Sooner or later, having proof of vaccination or a negative test will become compulsory."[14] Ryanair announced it would not require proof of vaccination for air travel within the EU, EasyJet stated it would not require any proof at all. The Irish Times commented that a vaccination certificate for flying was quite common in countries around the world for other diseases, such as for yellow fever in many African countries.[15]

CommonPass logo

On 25 November, separately from IATA's digital health pass initiative, five major airlines – United Airlines, Lufthansa, Virgin Atlantic, Swiss International Air Lines, and JetBlue – announced the 1 December 2020 introduction of the CommonPass, which shows the results of passengers' COVID-19 tests. It was designed as an international standard by the World Economic Forum and The Commons Project, and set up in such a way that it could also be used to record vaccination results in the future. It standardises test results and aims to prevent forgery of vaccination records, while storing only limited data on a passenger's phone to safeguard their privacy. The CommonPass had already successfully undergone a trial period in October with United Airlines and Cathay Pacific Airways.[16][17]

On 26 November, the Danish Ministry of Health confirmed that it was working on a COVID-19 "vaccine passport" or simply Vaccination card[18] which would likely not only work as proof of vaccination for air travel, but also for other activities such as concerts, private parties and access to various businesses, a perspective welcomed by the Confederation of Danish Industry. The Danish College of General Practitioners also welcomed the project, saying that it doesn't force anyone to vaccinate, but encourages them to do so if they want to enjoy certain privileges in society.[19]

Irish Foreign Minister Simon Coveney said on 27 November 2020 that, although he "currently has no plans" for a passport vaccination stamp, his government was working on changing the passenger locator form to include proof of PCR negative tests for the coronavirus, and that it was likely to be further adjusted to include vaccination data when a COVID-19 vaccine would become available. Coveney stressed that "We do not want, following enormous efforts and sacrifices from people, to reintroduce the virus again through international travel, which is a danger if it is not managed right."[20]

IATA Travel Pass app

The IATA Travel Pass application for smartphone has been developed by the International Air Transport Association (IATA) in early 2021. The mobile app standardizes the health verification process confirming whether passengers have been vaccinated against, or tested negative for, COVID-19 prior to travel. Passengers will use the app to create a digital passport linked to their e-passport, receive test results and vaccination details from laboratories, and share that information with airlines and authorities. The application is intended to replace the existing paper-based method of providing proof of vaccination in international travel, colloquially known as the Yellow Card. Trials of the application are carried out by a number of airlines including Singapore Airlines, Emirates, Qatar Airways, Etihad and Air New Zealand.[21][22]

It has been opined that many countries will increasingly consider the vaccination status of travellers[23] when deciding to allow them entry or not or require them to quarantine[24] since recently published research shows that the Pfizer vaccine effect lasts for at least six months.[25]

Recommendations

Various vaccines are not legally required for travellers, but highly recommended by the World Health Organization.[3] For example, for areas with risk of meningococcal meningitis infection in countries in African meningitis belt, vaccinations prior to entry are not required by these countries, but nevertheless highly recommended by the WHO.[3]: 21–24 

As of July 2019, ebola vaccines and malaria vaccines were still in development and not yet recommended for travellers.[3]: 4  Instead, the WHO recommends various other means of prevention, including several forms of chemoprophylaxis, in areas where there is a significant risk of becoming infected with malaria.[26]: 4–5 

See also

Notes
  1. Also required for travellers having transited (more than 12 hours) through a risk country's airport.
  2. Not required for travellers having transited through a risk country's airport.
  3. The WHO has designated (parts of) Argentina, Brazil and Peru as risk countries, but these countries do not require incoming travellers to vaccinate against yellow fever.

References
  1. Fenner, F.; Henderson, D.A.; Arita, I.; Jezek, Z.; Ladnyi, I.D. (1988). "Chapter 7: Developments in vaccinatino and control between 1900 and 1966". Smallpox and its eradication (PDF). World Health Organization. p. 312. ISBN 92-4-156110-6. Retrieved 4 December 2020.
  2. Whiteman, Marjorie Millace (1968). Digest of International Law. Volume 9. Washington, D.C.: U.S. Department of State. p. 1202. Retrieved 4 December 2020.
  3. "International Travel and Health. Chapter 6 – Vaccine-preventable diseases and vaccines (2019 update)" (PDF). World Health Organization. United Nations. 2020. Retrieved 3 December 2020.
  4. "Countries with risk of yellow fever transmission and countries requiring yellow fever vaccination (July 2019)". World Health Organization. United Nations. 4 July 2019. Retrieved 3 December 2020.
  5. Scherbel-Ball, Naomi (25 August 2020). "Africa declared free of polio". BBC News. Archived from the original on 26 August 2020. Retrieved 25 August 2020.
  6. "Key At-Risk Countries". Global Polio Eradication Initiative. World Health Organization. Retrieved 2 December 2020.
  7. Samantha Maiden (25 November 2020). "PM Scott Morrison signals tough new COVID-19 vaccine rules for international travellers who fly to Australia". News.com.au. Retrieved 25 November 2020.
  8. Heather Stewart, Sarah Boseley and Daniel Boffey (2 December 2020). "Covid vaccinations will begin next week, says Boris Johnson". The Guardian. Retrieved 3 December 2020.
  9. Phillip Georgiadis (23 November 2020). "Qantas to demand proof of Covid vaccination from international passengers". Financial Times. Retrieved 23 November 2020.
  10. Patrick Hatch (26 November 2020). "'No jab, no fly': COVID-19 vaccine key to opening borders, travel leaders say". The Sydney Morning Herald. Retrieved 28 November 2020.
  11. Cameron Jenkins (24 November 2020). "Airlines discussing requiring proof of COVID-19 vaccination for passengers: report". The Hill. Retrieved 24 November 2020.
  12. "Airlines mull mandatory COVID-19 vaccines for int'l passengers". Aljazeera. 24 November 2020. Retrieved 24 November 2020.
  13. "KLM: No plans to make Covid vaccine mandatory; May need more gov't support". NLTimes. 24 November 2020. Retrieved 24 November 2020.
  14. "Brussels Airlines will not make proof of coronavirus vaccination mandatory". The Brussels Times. 24 November 2020. Retrieved 25 November 2020.
  15. Conor Pope (24 November 2020). "Covid jab: Ryanair will not ask for proof of vaccination within EU". The Irish Times. Retrieved 25 November 2020.
  16. Grace Dean (25 November 2020). "5 major airlines are rolling out shared digital health passes to prove negative COVID-19 tests. They hope it's a step towards recovery for an industry set to lose $157 billion". Business Insider. Retrieved 28 November 2020.
  17. John Gapper (25 November 2020). "Those who get vaccinated deserve more freedom". Financial Times. Retrieved 28 November 2020.
  18. vaccinationcard.info (20 March 2021). "COVID Vaccination Card – Information and Resources". vaccinationcard.info. Retrieved 28 March 2021.
  19. "Danish health ministry to develop Covid-19 'vaccine passport'". The Local DK. 26 November 2020. Retrieved 28 November 2020.
  20. Marie O'Halloran (27 November 2020). "System being planned to allow vaccinated airline passengers avoid restrictions". The Irish Times. Retrieved 28 November 2020.
  21. Hendry, Justin (22 February 2021). "Air New Zealand to trial digital health pass app on Sydney-Auckland route". itnews.com.au. nextmedia Pty Ltd. Retrieved 17 March 2021.
  22. "IATA Travel Pass for Travelers". iata.org. IATA. Archived from the original on 15 March 2021. Retrieved 17 March 2021.
  23. Osumi, Magdalena (19 March 2021). "'Vaccine passports' could help global travel resume". The Japan Times. Retrieved 6 April 2021. With the COVID-19 vaccine rollout gearing up across the globe, expectations are rising for the restart of international travel. And so that travellers can move safely from one country to another without spreading the virus, Japan and other nations are looking to introduce a system of vaccine passports. On Tuesday, the European Commission proposed a Digital Green Certificate system that will show if a person has been vaccinated against COVID-19, received a negative test result or recovered from COVID-19. The U.S. and the U.K. are also looking into similar systems.
  24. Pitrelli, Monica Buchanan (14 January 2021). "No vaccine, no service: How vaccinations may affect travel plans in the future". Global Traveller. CNBC. Retrieved 6 April 2021. Though no country has announced a mandatory vaccination requirement yet, it's 'very possible' that some will once vaccinations become freely available, said Sharona Hoffman, co-director of the Law-Medicine Center at Case Western Reserve University School of Law. I would guess that New Zealand might be a country that would require proof of vaccination for travel purposes, she said, citing the country's rigid travel ban and low Covid-19 infection rate. Hoffman said countries will have to balance the need for tourist income with the inherent coronavirus risks that travellers bring with them.
  25. Ian, Sample (1 April 2021). "Pfizer vaccine has 91% efficacy for up to six months, trial shows". The Guardian. Retrieved 3 April 2021. He said scientists had become 'terribly worried' about the variant's ability to evade immunity from previous infection or vaccination. 'Studies like this confirm our sense that the vaccine gives such massive protective headroom that even with some loss of immunity, you're still safe,' he said.
  26. "Vaccination requirements and recommendations for international travellers; and malaria situation per country – 2020 edition". World Health Organization. 11 August 2020. Retrieved 4 December 2020.
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