Worried your COVID-19 vaccine won't be accepted abroad? Here's what you need to know

Fully vaccinated and ready to travel? Before booking your trip, make sure your destination recognizes your COVID-19 vaccine. As some Canadian travellers have already discovered, not all COVID-19 vaccines are considered equal. 

Here's the latest on which vaccines distributed in Canada might cause problems for travellers abroad. 

Mixed dose woes

Some countries won't recognize travellers with mixed vaccine doses as being fully vaccinated, which could create problems for the millions of Canadians whose doses don't match.

The issue first surfaced when travellers with mixed doses, including Chris Storey, of London, Ont., discovered they would have to quarantine when visiting Barbados — because they weren't considered fully vaccinated. 

"It's very frustrating; it's ridiculous," Storey told CBC News earlier this month.

However, Barbados then reversed its policy to recognize travellers with mixed doses. 

But nearby Trinidad and Tobago has yet to change its policy on mixed vaccines. The country will allow visitors with a mix of AstraZeneca and Pfizer or Moderna to skip quarantine, but travellers with a mix of Moderna and Pfizer don't qualify. 

The government of Trinidad and Tobago did not answer questions about the reasons for its policy.

U.S. position on mixed doses

The United States also doesn't approve of mixing COVID-19 vaccines — with some exceptions. 

"COVID-19 vaccines are not interchangeable," Centers for Disease Control (CDC) spokesperson Jasmine Reed said in an email. "The safety and effectiveness of receiving two different COVID-19 vaccines has not been studied."

However, several international studies have explored the effectiveness of mixing COVID-19 vaccine doses, and so far suggest it generates a strong immune response. 

And the CDC does accept mixed doses of the two mRNA vaccines, Pfizer and Moderna, in "exceptional situations," such as when the vaccine used for the first dose was no longer available.

The CDC's general disapproval of mixed vaccines won't affect Canadians entering the U.S. by air, as they only have to provide proof of a negative COVID-19 test. 

But those with mixed doses could potentially find themselves shut out of land travel if the U.S. imposes a vaccination requirement when it reopens its side of the Canada-U.S. land border to travellers. 

The CDC's position is already creating problems for some Canadians who have booked cruises that dock in the U.S. 

Norwegian Cruise Line (NCL) and Royal Caribbean are not recognizing people with any kind of mixed doses as being fully vaccinated. Several other cruise lines aren't recognizing those with a mix of AstraZeneca and an mRNA vaccine.

Bryan Holgate, of Osoyoos, B.C., is booked to take a transatlantic cruise on NCL in November. But Holgate said he will have to cancel next month — when his full payment is due — if the cruise line maintains its current vaccine policy. 

"We have a final payment at the end of September — and we're talking $20,000," said Holgate, who has a mix of Pfizer and Moderna.

"[NCL] says absolutely, categorically, that a Pfizer-Moderna mix is not acceptable. That … took my breath away."

WATCH | Travellers with mixed vaccines say they can't board some cruises:

Travellers with mixed vaccines say they can't board some cruises

3 years ago

Duration 6:34

Many Canadians who have received mixed doses of a COVID-19 vaccine are facing travel issues in countries that don't recognize them as being fully vaccinated. Travel bloggers Karen and Brian Hosier share how the 'frustrating' rules are affecting their travel plans and business.

Canadians with mixed doses may also be barred from certain U.S. venues where state rules require proof of vaccination. 

Large-scale indoor concerts in New York City next month — such as The Eagles and An Evening with Lady Gaga and Tony Bennett — require audience members be fully vaccinated. 

The New York State Department of Health said it follows CDC guidelines and does not consider people who have a mix of AstraZeneca and an mRNA vaccine as being fully vaccinated — at least not for now.

"It's important to keep in mind that CDC COVID-19 vaccine recommendations may be subject to change in the future as additional data becomes available," said department spokesperson Samantha Fuld in an email.

Europe and AstraZeneca's COVISHIELD

Canadians heading to Europe who got one version of the AstraZeneca vaccine may encounter a different problem. 

Europe has approved Vaxzevria, the European-manufactured version of AstraZeneca, however, it has yet to authorize COVISHIELD, the Indian-made version of the same vaccine.

As a result, several European countries don't recognize COVISHIELD, including Italy, Portugal and Poland, according to their government websites.

Consequently, Canadian visitors to those countries who got that particular vaccine can't take advantage of privileges offered to fully vaccinated travellers, such as being exempt from quarantine or a COVID-19 test. 

More than 80,000 Canadians have had at least one dose of COVISHIELD.

Fortunately for those Canadians, the list of European countries accepting the vaccine is growing. According to the BBC, several popular destinations, such as Spain, Greece and Iceland, accept COVISHIELD. France joined the pack last week. 

The United Kingdom's Medicines and Healthcare products Regulatory Agency has not approved COVISHIELD. But that doesn't matter much currently because although the U.K. now exempts fully vaccinated Americans and Europeans from quarantine, it has yet to extend the same privilege to Canadians.

"We are taking a phased approach to restarting international travel while protecting public health," said a U.K. Department for Transport spokesperson in an email. 

Will the rules change?

Canadians shouldn't get too worked up over differences in vaccine acceptance, says Regina-based infectious disease physician Dr. Alexander Wong.

"It's clear that the world is going to have to figure something out," he said. "People will just kind of need to be a little bit patient."

The Canadian government says it's working with its international counterparts to resolve vaccine differences. 

"Over the next number of weeks and months, there may be revisions provided by health authorities around the world with respect to these vaccine regimes," Intergovernmental Affairs Minister Dominic LeBlanc said at a news conference last week. 

In June, Canada's National Advisory Committee on Immunization (NACI) changed its vaccine guidelines to condone mixing COVID-19 vaccines, based on emerging research that found mixing AstraZeneca and Pfizer vaccines was both safe and effective.

Wong believes the U.S. will soon bend its stance on mixing vaccines, too.

"Looking at, for example, the U.S. and Canada, and how important that border is, I suspect it's going to get figured out sooner rather than later," he said.

Wong also predicts the COVISHIELD problem will soon be resolved, because there's no difference between it and the AstraZeneca vaccine manufactured in Europe.

"It's literally the exact same thing," he said. "It just happens to be manufactured in India."

What about getting a 3rd dose?

This week, the Quebec government stated it's offering a third vaccine dose to people who have an essential trip planned to a country that doesn't recognize their vaccination status. 

"People affected by these exceptional situations will be advised on the relevance of receiving an additional dose according to their situation and their needs," Quebec Ministry of Health spokesperson Marjorie Larouche said in an email.

CBC News asked the Public Health Agency of Canada (PHAC) for its take on third doses. The agency replied that NACI — which advises PHAC — does not make recommendations on vaccination requirements for travel.

"Canadians are reminded to avoid non-essential travel outside of Canada," said PHAC spokesperson Anne Génier in an email. "Now is not the time to travel."