Even as international travel restrictions are easing in many countries, the rapid spread of the Delta variant of SARS-CoV-2, the virus that causes COVID-19, means some countries and territories continue to enforce strict rules for international travelers. Self-isolation upon arrival in the country is chief among these restrictions⁠—particularly for unvaccinated people.

Depending on your destination, your country of departure, your vaccination status or the vaccine you received, self-isolating for a determined period of time upon arrival may be required in addition to COVID-19 testing⁠—or until your test results are available. Regardless of a country’s entry requirements, you also may wish to self-isolate while you await COVID-19 test results just for peace of mind, or to protect vulnerable people you may be visiting.

But how do you find accommodation for the purpose of self-isolation while abroad? And how do you self-isolate in a way that is safe? We break down the essential advice for you, with expert input from Gary Bartlett, MBBS.

First things first: before and during travel

Before worrying about what will happen at your destination, it is important to consider what preventive measures you can take before you embark on your journey and as you travel.

National and international health agencies and experts are all clear about one thing: you should get fully vaccinated against COVID-19 if you can. That’s because vaccines are currently the best way to minimize the risk of contracting SARS-CoV-2, the virus that causes COVID-19.

Dr. Bartlett also reminds us that, under all circumstances, we should stick to some key best practices for preventing the spread of respiratory viruses like SARS-CoV-2.

“Wash your hands regularly with soap and running water for at least 20 seconds. Use an alcohol-based hand sanitiser that contains at least 60% alcohol if soap and water are not available. This is particularly important after taking public transport or being in a public space,” he emphasizes.

Wearing a mask that covers your mouth and nose, particularly in indoor spaces—including airplanes—and outdoor spaces that are crowded is also an effective measure in preventing the spread of SARS-CoV-2.

“Remember face coverings in the airport and on public transport,” says Dr. Bartlett. “Face coverings do not replace social distancing and hygiene measures, but they may reduce the risk of spread,” he adds.

How to find safe accommodation

Some countries have specific requirements for where you must isolate on arrival, like a quarantine hotel. However, in some cases you may have to organize your own accommodation. If that’s the case, you’ll want to find accommodation that is as safe as it is comfortable.

Dr. Bartlett suggests booking private accommodation through a rental company. That’s so you can book an apartment that you don’t have to share, he says. This will not only ensure that sweet sense of privacy, but also that you do not have to make contact with other guests and staff, as you would in a hotel or hostel.

However, notes Dr. Bartlett, “some hotel booking sites also have the option of booking small self-contained apartments which include a kitchen” and other private facilities.

So if hotels are more your thing, look out for those that go the extra mile to ensure privacy and en-suite facilities.

However, always check with any hotel or rental to make sure they can accommodate self-isolation and what rules and safety measures are in place⁠—both for you and the staff or hosts.

Should you self-isolate with friends or family?

For many people, the first big international trip is focused on reconnecting with friends and family in other countries. Some people may have friends or family who are willing to put them up for the self-isolation period and beyond.

This may be the most cost-effective form of accommodation and has the added bonus of providing quality time with loved ones. But is it safe to self-isolate in a shared space?

Dr. Bartlett suggests considering your options well before accepting accommodation offers from friends and family⁠—no matter how much you may have missed them.

He says: “If you do decide to self-isolate at friend or relative’s accommodation, consider if that person you are staying with has received their COVID-19 jabs. And are they fully vaccinated?”

If they are unvaccinated or not fully vaccinated, you may risk exposing them to SARS-CoV-2 infection, or vice versa: you may unwittingly contract the virus while staying with them.

Moreover, “consider alternative accommodation if the person you stay with is clinically vulnerable with underlying health issues or [is] elderly, as they may be more susceptible to complications should they catch [SARS-CoV-2],” Dr. Bartlett also notes.

Should you nevertheless decide to self-isolate at someone’s house, be mindful of your hosts, and do your best to stay away from the other people in the household throughout the self-isolation period.

“Make sure you avoid communal areas, if more than one bathroom exists see if you can have sole use of the spare bathroom, [and] if only one bathroom [is] available consider using [it] at a set time every day, after everyone else has finished in the bathroom,” Dr. Bartlett advises.

He also advises cleaning the bathroom after every use, using separate towels from the rest of the household, and using separate plates, cups, and cutlery at every meal.

What to do about food and medication?

Countries that ask international travelers to self-isolate on arrival will often require that the self-isolation period last around 7 to 10 days. The question then is: how do you obtain food and, where necessary, medication if you’re self-isolating?

Those staying at hotels may be able to order meals to their room and enlist the help of hotel staff in obtaining some basic, over-the-counter medication, if necessary.

But what about if I stay in self-catering accommodation?

“If there is no help available when abroad getting food and supplies, if you need to travel to the supermarket for example, ensure that you wear a face covering and venture out at off-peak times,” Dr. Bartlett advises. Check the local rules and regulations for whether venturing to shops is allowed during self-isolation. However, many grocery stores also offer delivery services, which you could arrange in advance of travel.

He also emphasizes that, if you require specific medication, you need to make sure you can bring enough of it with you on your trip. You should make all the necessary purchases and arrangements well in advance, especially if you require prescription medication.

“Before you leave to travel abroad make sure you check with your [doctor] or pharmacist—in good time so that extra medication can be ordered if required—that you have enough medication for the trip,” notes Dr. Bartlett.

Good travel health insurance, especially during the COVID-19 pandemic, is also key in preventing any unforeseen situations.

Read more: How do you choose travel insurance that covers COVID-19?

“If you are running out of medication whilst abroad or if your return is delayed and you are concerned you may run out of medicines or medical equipment, contact your travel health insurance provider for advice about obtaining safe medical supplies at your destination,” Dr. Bartlett advises.

“Do not wait until supplies of medication [or medical] equipment are low,” he goes on to warn. “In some countries the pandemic may affect supplies.”

What can you do if you become unwell while abroad?

Despite the best precautions though, people may still become unwell while abroad, so what can you do should this happen to you?

“If you develop COVID-19 symptoms—new continuous cough, high temperature or loss/change in your sense of taste or smell (anosmia)—while abroad or during travel, you must immediately: self-isolate [...] and arrange a test locally at your destination,” Dr. Bartlett urges.

Read more: What do you do if you get COVID-19 while you're traveling?

He also advises calling your health insurance provider to discuss options for accessing medical care at destination if necessary.

It may also be helpful to “be aware of the country’s emergency services number and know where [the] local emergency department is located should you require urgent medical treatment if you do become acutely unwell,” he adds.

Preparing for a trip ahead of time, particularly during the pandemic, will ensure that things run smoothly at destination and give you peace of mind along the way, so don’t put off making all the arrangements you’ll need to make your life easier.

This article was medically reviewed by Dr. Debra Sullivan, Ph.D., MSN, R.N., CNE, COI.

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Need to self-isolate on arrival? Here’s what you need to know 

Proving you’ve been vaccinated against COVID-19 when you travel is becoming increasingly complex. How do the new set of vaccine passport apps work, and what are some of the tips and tricks to ensure that you have proof of your vaccination status when you need to? Here’s what you need to know.

Should I carry the original vaccination certificate hardcopy when I travel abroad?

After your passport, your proof of vaccination is the most important piece of travel documentation that you’ll have with you this year—and maybe for a while. Keeping it safe is strongly recommended, and whether you’ll need it when you travel depends on where you are from.

If you have access to a digital, printable version that can be authenticated—like Europe’s digital COVID-19 certificate —then it’s best to print a couple of copies and bring them with you. Stash one in your wallet, one in your carry-on and one in your hold luggage, as well as in your email. In Europe, if you have the digital version on your phone, and some printed back-ups, you should be fine to leave your hardcopy safe at home.

However, if you’re in the US, all you’ll likely have is the CDC card with the scribble of whoever vaccinated you. You’ll need to bring it when you travel internationally—but treat it with the same care and importance as you do your regular passport. Lose it and you’ll have a headache trying to replace it.

What if I lose my vaccination certificate?

If you have a digital, printable version, just hit print again. But if you’re in the US, the CDC doesn’t hold a national database. Instead, there’s a patchwork of state and city authorities with Immunisation Information Systems (IIS) that may hold a record.

It might be a smart idea to take your card with you the next time you go to your primary healthcare provider, general practitioner or family doctor. They can verify that you have indeed been vaccinated and you can ask them to write a letter—on their letterhead, signed and ideally stamped—confirming your vaccination details. You’ll want to get a couple of copies, digitise one, and keep the other very safe.

How do I convert my certification to the local system when I travel?

More countries are not only requiring vaccination certificates for entry, but also to access restaurants, cultural sites and more. But converting your proof of vaccination to another country’s⁠ (or even another US state’s⁠) system will depend entirely on where you’re coming from and where you’re going.

There’s no international standard yet, and things change on a daily basis, so check these three key places: your home country’s embassy in your destination country; your destination country’s embassy in your home country; the destination country’s health ministry; and local news sites, especially if there’s an expat community site.

While in some countries like France and Germany it’s relatively simple to get the exchange done, in others it may simply be easier to pop into a pharmacy every few days for a quick antigen test, which in most cases can be used instead of showing proof of vaccination (if you test negative, of course).

Is there an international system I can use to make things simple?

There isn’t yet an international system for proving your vaccination status, nor is there a true international standard. The closest is the EU’s Digital COVID Certificate (EU DCC), which is a standard for interoperability between various countries—so Dutch certificates work in Finland, for example.

It’s possible that the EU DCC standard will be the one that other countries adopt moving forward. That’s already happening in some ways: systems in Switzerland, San Marino and Vatican City became interoperable in July, while Turkey, Ukraine and North Macedonia joined in August, and additions so far in September have included Andorra, Monaco, Israel, Albania, Panama, Morocco and the Faroe Islands.

If you’re planning a lot of travel over the next year, or planning a multiple-country trip to Europe, consider making an early stop at one of the countries where converting an overseas COVID-19 vaccination certificate into an EU DCC version is easy.

On balance, France is probably the easiest— the TousAntiCovid vaccine certificate wallet app is available in international app stores and there’s an online process to convert international certificates. Germany’s a close second place, but its CovPass app isn’t available for Apple accounts not billed in Germany, which can be a hassle.

What do my kids use if they aren’t vaccinated?

The rules for unvaccinated children vary between countries—as do the age boundary at which the children’s rules and adults’ rules apply. Often, the rules for children depend on the vaccination status of their parent or guardian.

For example, Germany says : “Given the uncertainty surrounding vaccination for young people, unvaccinated children under 12 years of age are allowed to enter Germany if they travel with at least one fully vaccinated parent.”

In France : “The measures applicable to vaccinated adults also apply to any minors accompanying them, whether they are vaccinated or not. You can therefore travel with your underage children, whether they are vaccinated or not, and they will not need to self-isolate.”

Read more: What to know about traveling with unvaccinated kids

Check carefully before you travel.

How do I keep my vaccine card/data secure?

If you only have a paper vaccine card, guard it like you would your passport and keep copies safely at home and with you when you travel.

If you have a digital version on your phone, then taking basic security hygiene measures—like a strong password, fingerprint or face recognition, and perhaps even keeping any pictures of it you’ve taken in a password-locked or biometric-locked note—should suffice.

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How to manage vaccine certifications and COVID-19 passports for international travel

In March 2020, the pandemic halted travel around the world, leaving many would-be air passengers struggling to secure refunds as hard-hit airlines offered up travel vouchers instead.

But with travel cautiously opening back up in some parts of the world, many travelers are seeking clarity up front about what they’re entitled to if their trip can’t go ahead. Unfortunately, airline change fees, cancelled flights and ticket credits have never been so complicated. Airlines have introduced a patchwork of different policies to cope with the ongoing uncertainty⁠—so here is some general some advice to follow when navigating flight changes.

What do I do if my flight gets cancelled?

If your flight gets cancelled, you’ll probably end up with one of five options: a refund; a travel voucher or credit; rebooking with a change fee; rebooking without a change fee and no charge if there’s a difference in fare; or rebooking without a change fee but with a charge (or maybe a refund or credit) for any difference in fare.

But which of those you can take will depend on what kind of ticket you bought, when you bought it, who you bought it from, and how you paid for it.

If the airline cancelled your flight, or changed the timing to the extent that they have to notify you about it, you should be able to cancel your ticket and get all your money back.

If you want to rebook, things could get complicated. Policies vary widely, but most airlines will move you to another flight without incurring change fees or fare differences if the cancellation is their fault.

If you want to change your flight on your own, by and large most airlines are being pretty flexible about that, with the general trend being that you can rebook the flight for another date without a change fee (or with reduced change fees compared with pre-COVID times), but you will probably have to pay any difference in fare compared with your original ticket cost. Sometimes you only get one free rebooking.

Some airlines⁠—usually the nicer kind of full-service airline like Hawaiian Airlines⁠—have discontinued change fees entirely. Others have done so on a temporary basis or for certain fare classes (usually not their “basic economy” kind of offer), while others still (often the low-cost carriers) still have them, but have in some cases reduced the cost.

Can I get a refund, or does it have to be vouchers?

If it’s the airline cancelling it, then you’re usually entitled to a refund. But there are certain situations where the airline is allowed to give you a voucher or travel credit instead.

There’s no hard and fast rule here. To start with, your consumer rights depend on where your trip starts and ends, and in some cases⁠—like with European package tour regulations⁠—it will depend on whether you bought anything other than just a flight.

It will also depend on whether you bought the flight directly from the airline, from a trusted travel agent, or from an online flight search site. If you have a trusted travel agent, use them by all means, but try to avoid buying tickets from online flight search sites or from anywhere else that isn’t direct from the airline—it adds another layer of hassle when it comes to getting refunds.

It will also depend on how you bought your flight: if you used a credit card, you can often get the credit card company to refund you, especially if the airline has promised a refund but not delivered in a reasonable time—reasonable according to the credit card company, that is. So it’s worth considering putting the charge on a credit card if you’re concerned about cancellation.

Many travelers spent much of last year waiting for refunds—has that changed now?

While it would be great to think that after a year of COVID-related travel disruptions, all airlines had foolproof systems in place to cope with customers who have had flights cancelled or delayed. However, that is still not always the case, and calling an airline could still leave you on hold for hours.

If you’ve had a flight cancellation recently, but the airline’s website couldn’t process the change or was otherwise buggy, it’s worth trying to contact the airline through one of their social media channels, preferably via direct message.

Airlines have got a little better—but not much—about taking forever to issue refunds and vouchers, but there isn’t really a hard and fast trend here either.

Airline by airline guides

Every single airline is different, and their websites change so frequently, so it's important to check the latest rules. Run a quick web search for [airline name] change policy or [airline name] ticket flexibility and you’ll be right there.

Overall, though: if you can, this is the time to spend a little more to get yourself out of basic economy or to fly with the airline that has a better reputation rather than the one that’s the butt of all the jokes.

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Since the pandemic began in March 2020, PCR tests, antigen tests, and LAMP tests have all entered the common lexicon. But what’s the difference between all of the ways to test for COVID-19 and which one do you need to travel?

It’s a labyrinth of acronyms and technologies, but getting it wrong when traveling can be a real headache of denied boarding ⁠—or even being sent back to where you came from. We explain what they all are, when you need them and how to find them when you’re on the road.

What’s a PCR test and why do I need one?

A Polymerase Chain Reaction (PCR) test looks for genetic material within a sample via a process that takes a matter of hours. For COVID-19 purposes, it amplifies the sample taken from your nose, throat or saliva to try to find genetic material of the SARS-CoV-2 coronavirus that causes COVID-19. If the test finds that material, you have or have recently had the disease. The Cleveland Clinic has some further explanations of how PCR tests work.

PCR is usually officially called RT-PCR (RT for Reverse Transcription) and is one of a group of Nucleic Acid Amplification Tests (NAATs) that include a variety of methods—NEAR, TMA, LAMP, HDA, CRISPR, and SDA—all of which are explained well by the US Centers for Disease Control and Prevention. But all you really need to know for travel is what the relevant country you’re traveling to wants.

Use government websites to check for the latest entry requirements to your destination, or check out our Health Hub. In practice, you may need either a specific PCR or other kind of NAAT test to travel internationally. Many countries require a recent negative test in order to enter, with some even requiring testing for vaccinated travelers. Do check carefully, and either print out or screenshot the requirements so you can confirm that you’ve got it right with whoever is administering your pre-departure test.

Some countries require that tests be conducted by a healthcare provider like a doctor, nurse or pharmacist, while others are fine with the kits that let you swab yourself and mail a pack off to the lab for testing.

Some countries also require you to take another test after your arrival. You’ll want to check, but in this case the cheaper at-home, mail-off test kits might save you some money⁠—although if you have to quarantine until you get the result it’s faster to get swabbed in a healthcare setting with its own lab.

How is a PCR test different from other tests: antigen, LAMP, TMA or others?

PCR tests differ from others in what they’re testing for and how they process the sample. In many cases, the actual sample extraction from your nose, throat or saliva can be the same—it’s what’s done with it that counts.

But besides the common PCR test, some destinations accept antigen tests, which look for specific molecules on the surface of the virus. These are much faster—it might take 15–30 minutes for most of them—and come either as home test kits or in a healthcare setting like a pharmacy, test centre or doctor’s office.

By and large, only antigen tests administered by a healthcare provider, with the written documentation you’ll receive, are considered valid for travel purposes. Bring the requirements of your destination country with you when you book the test to make sure.

Read more: Everything you need to know about the EU's digital COVID-19 certificate

As more destinations introduce vaccine passes to enter cultural sites and restaurants, some countries⁠—like France and Spain⁠—also accept recent antigen tests for the Digital COVID certificate.

Where can I get a PCR—or antigen—test for travel?

Whether you’re entering a country or returning home, you may have to provide written proof of a PCR or antigen test over the last 24, 48 or 72 hours. Note that this validity window for PCR and antigen tests may well be different based on where you’re going.

Antigen tests are widely available at pharmacies, with results within 15-30 minutes, but tests for travel purposes may incur charges—and tests for public health purposes may not give you the right paperwork for travel.

PCR tests are less widely available and take longer, so you’ll want to do some more planning. In many countries you should be able to get a PCR test with documentation for travel at a pharmacy⁠—but be aware that in many places these are still quite expensive. If you’re struggling to find somewhere that provides tests, you could contact your airline and see if they can help.

Check your own country’s embassy in your destination, that country’s embassy in your own country, as well as the relevant airlines and airports to get more information on tests.

How do I get a PCR test abroad?

Since PCR tests take longer and require more equipment than an antigen test, it can be harder to find them. Given varying requirements that the test be conducted within one, two or three days, if you need a test to travel, it’s best to have one done in a healthcare setting (ideally at a lab) than using an at-home mail-in kit.

The US Department of Health & Human Services maintains a list of community-based testing sites in the US, while the UK government maintains a list for arrival tests that may also be useful for passengers departing the UK.

France, too, has a COVID test location database that allows you to search by location and to choose PCR, antigen or both. Germany does as well, broken out by region. Use a translation app or ask at your hotel for help.

For other countries, run a web search like “COVID travel test”, PCR or antigen, and the country name, but make sure you aren’t tripped up by private companies gaming the search results.

Can I take a PCR or antigen test at home for travel, or bring a test with me?

Most countries don’t accept self-administered tests for travel. That said, there are some options where you bring a test with you and book a video call with a healthcare professional who monitors you when taking the test—either then sent off to a lab for a PCR test or developed where you are for an antigen test.

On balance, with both PCR tests and antigen tests widely available in many locations, this seems like a lot of extra overhead, together with the possibility of tests going astray in the post.

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It’s many travelers’ worst nightmare: detained at the border and deported back to where they came from. With COVID-19 vaccination and testing certifications adding a new level of documentation into the mix, what happens if you’re denied entry⁠—due to coronavirus or other reasons?

When and why might I be denied entry to a country on arrival?

It’s incredibly rare for anyone to be denied entry on arrival to a country, not least because airlines are required to check that you have the right documentation before accepting you onto their aircraft. But there are a few ways in which this might occur.

First, the airline might have got it wrong, in which case you’re likely to be put straight back on their plane—and you probably have a good argument that it should be at their expense.

Second, a border guard might also have a problem with you. They might think that you’re intending to work when you’re on a visa or visa waiver programme that doesn’t permit that, or that you don’t have enough money to support yourself on vacation, or that you’re otherwise breaking (or planning to break) the rules.

Third, you might be found with something contraband that you hadn’t declared. Be especially careful when traveling with medication, even if it is over the counter in your country or if you have a prescription. Check with the embassy or foreign ministry of your destination country to ensure that, say, your decongestant, back pills or insomnia medication is permitted.

When and why might I be denied entry to a country at the airport before my flight?

It’s very rare, but there are situations when an airline checks your documentation at the airport and there’s a problem.

These days, you might not have the right COVID-19 vaccination and/or test certification. Study it carefully, especially if:

you’ve been vaccinated with the AstraZeneca, Sinopharm, Sinovac, Sputnik or Johnson & Johnson/Janssen single-shot vaccine
you got two different vaccinations: first AstraZeneca, second Pfizer or Moderna, say, perhaps because of allergic reactions or changing health authority recommendations
you only got one vaccination because you’d already recovered from COVID-19 and that’s what your national health authorities say
you might mistakenly take the wrong kind of test, or it’s outside the validity window—some countries count in hours, others in days, some from boarding and some from landing, so read the requirements carefully

You might have needed to get a visa, an electronic visa, or an electronic travel authorization, but you don’t have one, or it’s expired. If it’s an electronic travel authorization, sometimes the airline can rush you an expedited clearance, but for other options it’s more complicated.

Read more: What is a vaccine passport and do I need one to travel?

You might not have a return ticket—or, your return ticket is on another booking that the airline flying you into the country can’t see in their system, in which case you just have to show the receipts for the second booking.

Another possibility is that your passport might not have enough validity left. Many countries require it to be valid for a certain number of months after your intended date of departure, and some also require it to have been issued within the previous ten years. That latter point is only very rarely a problem, but certain countries add on any remaining validity from your previous passport to new passports—giving you, say, a passport that technically expires ten years and two months after it is issued, but which some countries won’t accept is valid longer than ten years. This has tripped up some travelers to the EU Schengen area in particular.

Do I have to buy my own return flights?

Whether or not you have to buy your own flights depends on why you were detained, and it will depend on the situation, the airline, and whoever you’re dealing with.

The range of options here include them applying your return flight to the flight on which they take you home without charging anything more, doing that but charging a change fee, or requiring you to buy a new ticket—up to and including a full-fare, one-way walk-up ticket.

What about COVID-19⁠? What happens if I tested negative before my flight, but positive when I arrive or after arrival?

This is a really unusual situation and what happens will depend on the country where you are. You’ll likely be legally required to isolate, possibly in a quarantine hotel if the country has them.

Read more: How do you choose travel insurance that covers COVID-19?

This might well be at your expense, so check your travel and travel medical insurance carefully. Try to remain calm, follow medical instructions, contact your embassy, and ride it out.

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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.

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As Milan is one of the busiest cities in Italy, it should be no surprise that its traffic can be terrible to navigate. It bustles from early morning to late at night — and that’s without mentioning the lack of parking or the many areas where there is limited traffic allowed.

This is exactly why we recommend leaving your car behind when visiting Milan and opting instead for the city’s reliable public transport. From the metro to trams to bike-sharing services, here’s what you need to know about moving around the city of the Madonnina.

The Metro

Known as the metro (short for metropolitana), the subway is one of the easiest ways to move around Milan and is used daily by locals, commuters and tourists alike, with service starting at around six in the morning and ending at around midnight. It currently has four lines (with the fifth one in construction) and it also reaches beyond Milan proper into the city’s suburbs. A single ticket is €2, but you can buy a 24-hour ticket for €7, a three-day ticket for €12 and a 10-trips pack for €18.

Passante Railway

Built following the example of S-Bahn trains in Germany, the Passante railway runs underground through the city and its suburbs. It’s a fast and efficient way to move around Milan’s most strategic points, like railway and metro stations — it doesn’t have the same capacity as the metro, but it’s fast and efficient just the same. Tickets cost the same as those for the metro.

Trams

Trams are Milan staples and they contribute not only to the city's infrastructure but also to its iconic image and cityscape with their very recognizable yellow color and distinctive noise. There are a total of eighteen lines operating within the Milan city limits, and service runs from around 4am to 2am the following day. Tickets cost the usual €2 – just like the metro and the Passante – and they can be bought on the Milanese Transport Agency’s official website or app, as well as at tabaccherie and newsagents around the city.

Bus and Filobus

Milan has both buses and filobuses lines that make up a grand total of around a hundred lines that offer a truly complete service for all urban areas of the city. They run from around 5am to half past midnight (except on holidays like Christmas Day and May Day), and tickets are the same as all other urban transportation services.

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Walking

Walking is a great way of exploring the city and catching those little corners and quirky sights you might otherwise miss by just sticking to the most famous landmarks. While it is entirely possible to stick to walking if you feel like your legs are up for it, one good solution is moving from neighborhood to neighborhood with public transport and then letting your feet take you on an adventure.

Taxi

Taxis in Milan are easily recognizable by their white color, and they can be hailed from specifically designated areas or by ordering one via call or app. The starting fare is €3.40 on weekdays and €5.60 on weekends, while the night fare starts at €6.70. There are also fixed fares for major destinations (such as airports) and the possibility of splitting the fare between a maximum of three people all going from the same starting point to the same destination.

Sharing services

An alternative to both bringing your own means of transportation and "traditional" public transport is a sharing service, whether it's a car (Milan actually has the most extensive car sharing service in the whole of Italy), a bike or a scooter. While some are cheaper than others, they all follow the same principle — you pick up your car, bike or scooter at the location closest to you and drop it off at your destination, paying for the time you have used it and avoiding the hassle of finding a parking spot.

Accessible transportation in Milan

When it comes to accessible travel, Milan is pretty much a mixed bag. Some lines and areas have prioritised accessibility and ensure smooth transit for everyone, while others, especially if they’re older, still need some major improvements.

When it comes to the subway system both Line 3 (M3) and Line 5 (M5), the two most recent ones, are equipped with elevators, tactile floor markings and panels, and accessible restrooms. As for Line 1 (M1) and Line 2 (M2), it varies from station to station and accessibility is sadly not always guaranteed.

The same goes for trams, buses and filobuses. Most stops are equipped with tactile floor markings but not all of them, especially if they’ve been built some years past and are due for a renovation. All bus lines have a ramp for wheelchair users, but only some trams and filobuses have one on board.

More detailed information and guidelines are available on Milan’s official website.

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For most international travel, you’ll have to provide proof of vaccination, a negative COVID-19 test or proof you’ve recovered from the virus in order to cross borders.

With many travelers and airlines looking for a simple way to store this information digitally, the International Air Transport Association’s (IATA) Travel Pass health information checking service is being rolled out by more and more airlines, and so are its competitors like CommonPass and VeriFLY. They’re not vaccination passports, so what are they, how do they work, who’s behind them—and should you use them?

What is the IATA Travel Pass?

The IATA Travel Pass is one of a variety of “health credential” services that some airlines are using to help them check the validity of the proof you send them of your COVID-19 status—whether that’s your vaccination, a recent test, recovery from the disease, or a combination of all three.

Read more: What is a vaccine passport and do I need one to travel?

It’s essentially an app on your phone where you take pictures of your vaccination records, a recent test or the proof you’ve recovered from COVID-19 within a certain time frame specified by the government of wherever you’re traveling to (and sometimes from). These are then checked and your airline is given either a green light or a red light for you to travel, according to the government travel rules of your destination country.

Dozens of airlines are trialling or using it—and other providers’ passes—to help them process your documentation, ideally well before you get to the airport. This helps them reduce queues and the cost of having staff members check your documents in person.

It’s different to the national or regional health pass wallets, like France’s TousAntiCovid, New York’s Excelsior Pass or the UK’s NHS COVID Pass. However, in the future, there may be links between them.

Other passes exist, with CommonPass and VeriFLY also in relatively wide use. Bear in mind that airlines may be trialling multiple pass options on different routes, so check any emails carefully and have a look at their website to confirm which you can use.

How do they work?

You take pictures of your documentation or upload an existing picture, depending on the functionality of the various apps. This is then processed by the app provider’s staff—whether the IATA Travel Pass, CommonPass, VeriFLY or whatever—who confirm whether your documentation is valid.

It can be a bit of a logistical humdinger to need to take a picture of the everyday vaccination pass or test result that lives in one app on your phone with another app on your phone. Keeping paper copies of your vaccination certificates and test results can be very helpful, but in a pinch you can always find a friend to send them to, and then take a picture of their phone.

Once the processing is done, which usually is a matter of minutes or hours, you essentially get a green light that you’re good to go, or a red light that means you can’t travel until you’ve fixed a problem.

That might be because: you’re vaccinated with a vaccine not recognised in your destination; you sent in the wrong type of test (antigen not PCR, say); your test wasn’t taken recently enough (perhaps it was taken 49 hours before you are supposed to travel, but your destination requires it to be less than 48); or simply that they weren’t able to read your documents.

Read more: PCR tests for travel: everything you need to know

Do keep an eye out for this—getting another vaccination isn’t exactly a fixable problem, but getting another test might not be the end of the world.

Who runs these passes?

IATA’s travel pass is run by an airline trade industry group, the International Air Transport Association, which is sort of a Better Business Bureau for airlines. Remember, IATA is not a governmental or intergovernmental body, it’s an airline association.

CommonPass is run by a non-profit public trust with links to the World Economic Forum (sometimes referred to as Davos, after the location of its annual meeting) and the Rockefeller Foundation. VeriFLY, meanwhile, is a product of biometric authentication software business Daon. Airlines are essentially outsourcing the verification to these apps, but in some cases, airlines are requesting that you upload the relevant information to them directly.

If you’re concerned about what happens to your data, that’s certainly a valid concern. As one example, British Airways uses VeriFLY for all flights into the UK. But its small print says: “The VeriFLY App is completely independent of British Airways and you are submitting your information directly to Daon (acting as the data controller), please check Daon’s privacy policy and terms and conditions.” However, it’s worth reading the fine print on VeriFLY to fully understand how your data will be used.

Where will I use a travel pass, is it mandatory, and should I use it?

A growing number of airlines are using them, so you’re likely to be seeing them the next time you take an international flight.

At present, they’re usually not fully required, but you can expect to receive multiple emails encouraging you to use them. You may also start seeing fast-track queues for people who have taken the time to enter their data. After all, it will take less time for an expert on these processes to check your documents remotely a day in advance than for a stressed check-in agent to try to figure out whether your vaccination certificate is valid or not.

So should you use it? Well, if you have privacy concerns, those seem valid—this technology has been developed pretty quickly, and it’s worth reading the privacy policies of the app should you have any reservations.

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Traveling with children requires a lot of planning at the best of times, and doing so during a pandemic has added a whole new set of difficulties to the permanent adventure of parenting. Traveling with kids who have not received a COVID-19 vaccine can be particularly tricky.

Kunjana Mavunda, MD, a pediatric pulmonologist and travel medicine physician at KIDZ Medical, notes that the Delta variant of the new coronavirus, which is spreading fast, “is more infectious [than previous variants], and has been infecting children more.”

How can you enjoy traveling with kids and make sure that they are safe and that their risk of infection with COVID-19 is kept at a minimum? Here are our tips.

COVID-19 vaccines and kids

The US Centers for Disease Control and Prevention (CDC) currently recommend that children and teens aged 12 and older should get the PfizerBioNTech COVID-19 vaccine, also known as Comirnaty, in order to be protected against the disease caused by the new coronavirus.

However, the vaccine is not currently available for younger children in the US—though Pfizer has requested the Food and Drug Administration (FDA) grant Emergency Use Authorization of its vaccine in kids 5 to 11⁠—and children and teens in the eligible age groups may not always be able to receive the vaccine.

Daniel Ganjian, MD, pediatrician at Providence Saint John’s Health Center in Santa Monica, CA explains that allergies may prevent some children from getting safely vaccinated.

“One contraindication for vaccines in this age group is if they have had an allergic or anaphylactic reaction to a previous dose of vaccine or any ingredient of the vaccine including PEG—polyethylene glycol,” a substance used in many medications and vaccines, including the Pfizer vaccine.

If possible, however, it is best for children who are eligible to get vaccinated. “We (and the American Academy of Pediatrics) recommend that children get the vaccine because it decreases the severity of the infection as well as the probability of getting the infection in the first place,” Dr. Ganjian notes.

Double-check international border restrictions for unvaccinated children

Planning international travel with kids can be tough⁠—and rapidly changing border rules add new complications for parents of unvaccinated children.

With many children ineligible for vaccines, countries around the world are navigating how to allow inbound travel for vaccinated parents and their unvaccinated kids. For example, France, which will only allow vaccinated US travelers for tourism purposes, requires children over 12 to present proof of vaccination, recovery or a negative COVID-19 test to take part in most tourist activities, like eating in restaurants, visiting the Louvre, the Eiffel Tower and theme parks like Disneyland Paris. Always check a country’s specific rules for children before planning any travel.

Tips for safe travel with kids

Even vaccinated kids could still become unwell if they contract SARS-CoV-2, so in order to fully enjoy your trip, it is important to plan ahead in order to keep your children safe and healthy.

1. Opt for outdoor activities

You may want to consider making plans that involve mostly outdoor settings and activities, Particularly if your kids haven’t had the COVID-19 vaccine.

Read more: How to get your kids to love the outdoors

“Plan on taking a vacation to a tropical place or another place with good weather so you can do many outdoor activities,” Dr. Ganjian advises. “Go camping, hiking or take a road trip in an RV.”

If flying, says Dr. Mavunda, try to opt for arrangements that will minimize children’s contact with other passengers.

“At boarding time, although staff suggests that families with young children and infants board the plane before the general public does, it may be safer to request a seat at the front of the plane, [and] board after everybody else has boarded,” she suggests.

“This way,” Dr. Mavunda explains, “children will have less exposure to other passengers as they go past them.”

2. Ensure all adults wear face masks

As per CDC guidelines for domestic and international travel, while traveling by public transport, adults should wear masks over the nose and mouth. This measure can help keep you, your children, and other travel companions safe. If you are traveling or sharing indoor spaces with people from outside your household or who have not been fully vaccinated against SARS-CoV-2, it is particularly important to ensure that everyone who can will be wearing a mask to prevent viral spread.

“When around people who are not part of your family or who are not or under vaccinated, make sure everybody wears their masks, maintains social distancing, and practices proper hygiene,” says Dr. Ganjian.

3. Get your own vaccinations on track

The CDC also advises adults who want to travel to make sure they are fully vaccinated against SARS-CoV-2, where possible. This is important because the COVID-19 vaccines will not only help protect you against developing severe SARS-CoV-2, but they may also help reduce the risk of spreading the new coronavirus to others, including children and teens in your household.

Remember the instruction to put on your own oxygen mask first in case of an emergency on a flight, so that you can then fit the mask on children who will need your help? It is a little like that with the COVID-19 vaccine: if you are able to receive it, it will help protect your kids too.

4. Follow best practices for hygiene and safety

Another way of keeping your children safe while traveling is by following hygiene and pandemic safety best practices, as outlined by the CDC.

Besides getting a COVID-19 vaccine and wearing a mask in indoor and crowded spaces, the CDC also recommend:

where possible, keeping a distance of 6 feet from people who do not live in your household
making sure you and your kids wash your hands thoroughly for at least 20 seconds as often as possible or, if no soap and water are available, clean your hands using sanitizer with at least 60% alcohol content
covering your mouth and nose while sneezing or coughing if you are not wearing a face mask (the same applies to children and teens)

These best practices for hygiene and safety will help minimize your and your children’s risk of infection in all settings, including while traveling and at your destination.

To motivate children to follow good hygiene practices, Dr. Mavunda suggests turning these practices into an easy routine.

“Children respond well to routines,” says Dr. Mavunda, “and during a trip, parents can continue to emphasize frequent hand washing or frequent use of hand sanitizer, remembering that children adapt well to what they are taught by their parents — and to the behaviors that they see their parents do.”

5. Keep up to date with other vaccinations

It is also important to make sure that children stay up to date with routine vaccinations, which will protect them from other communicable diseases. The World Health Organization (WHO) reports that the COVID-19 pandemic has disrupted routine childhood vaccination programmes around the world. Yet it is now as important as it has ever been to ensure that children are safe from common viral infections.

“Immunization is one of the most powerful and fundamental disease prevention tools in the history of public health,” Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, has said. UNICEF also strongly advises keeping up with routine childhood vaccinations where possible.

Making sure that children are protected against other communicable diseases will also increase their safety and decrease their health risks while traveling, especially if they are likely to come into contact with other children and adults from different households.

To sum up: vaccinate where possible, wear a mask on public transport, keep up good hygiene practices, and opt for outdoor settings if you can. Other than that, just enjoy spending quality time with your kids.

This article was medically reviewed by Dr. Debra Sullivan, Ph.D., MSN, R.N., CNE, COI.

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