MIAMI -- New Biden administration travel restrictions aimed at preventing the unvaccinated from coming to the United States will be felt particularly hard in Latin America and the Caribbean, a region where wide disparities and lack of access to covid-19 vaccines have left most of the population without protection against the virus.
The new rules, which White House covid-19 coordinator Jeff Zients said will begin in early November, could also prohibit some vaccinated travelers from entering the country if they have received shots from vaccine makers that are not recognized by the World Health Organization.
The White House said last month that it was considering banning travelers who received covid-19 vaccines that have not gotten emergency authorization from the WHO. The U.S. has authorized only three vaccines -- Pfizer, Moderna and Johnson & Johnson -- but the WHO's emergency use list includes vaccines produced by AstraZeneca and China's Sinopharm. But it currently does not include Russia's Sputnik V or Cuba's Soberana, which some countries in the region have used to augment their vaccine supplies.
A spokesperson for the U.S. Centers for Disease Control and Prevention said the agency "is actively working with vaccine experts regarding which vaccinations will be accepted."
The CDC will provide more information about the requirements in the coming weeks, she said.
Whatever decision U.S. authorities make would leave many Latin Americans and Caribbean nationals shut out of the United States at a time when visa approvals have already been backlogged over covid-19 and restrictive embassy staffing.
"It disproportionately affects the developing countries like Guyana," said Oneidge Walrond, the South American nation's minister of tourism and commerce, who fears that Sputnik will not make the U.S. approved list.
Believing vaccination was the only way out of the pandemic, Guyana this year turned to the Russian-made vaccine, purchasing 200,000 doses at $20 each after being unable to secure any of the U.S.-made vaccines. Even though it has joined a number of Caribbean countries in passing similar covid entry requirements for international visitors -- one must show proof of vaccination and negative testing within 7 days of travel -- the country believes it will now be punished by the U.S.'s new requirement after being unable to get other vaccines.
"We think it's unfair and highlights and deepens the divide between the haves and have-nots," Walrond said.
On Wednesday, the Pan American Health Organization's director, Dr. Carissa Etienne, said only 37% of the 653 million people in Latin America and the Caribbean have been vaccinated, while countries like Nicaragua have yet to reach 10%. Haiti, which has administered only about 75,220 U.S-donated Moderna shots, has less than 1% of its population vaccinated.
CALLS FOR HELP
With many people lacking access to vaccines, the U.S. this summer began shipping 40 million doses to the region, mostly through the WHO global access platform known as Covax. But tensions over the availability of shots in one of the world's hardest-hit regions have already flared even among partners like Colombia, which has already received 6 million doses donated by the U.S.
In his speech at the recent United Nations General Assembly, Colombian President Ivan Duque spoke of the "unprecedented" gaps in vaccination coverage, adding a veiled criticism of the U.S. booster-shot plan.
"While some nations acquire additional doses for six or seven times [the size of their] population and announce third booster doses, others have not applied a single dose that gives them hope," he said.
Millions of people in the region have gotten vaccines produced by Russia, China, India and Cuba that have not received WHO emergency authorization. The rules will also spotlight regional inequities, as the poorest countries struggle to vaccinate their citizens amid low supply and vaccine hesitancy, and international efforts like Covax remain slow in delivering promised doses.
"We continue to urge countries with surplus doses to share these with countries in our region, where they can have a life-saving impact," Etienne said. She said the Pan American Health Organization, which is the World Health Organization's Americas regional office, was trying to accelerate vaccinations in the Americas, including purchasing vaccines and ramping up manufacturing in the region.
Though Covax was set up to help poor and middle-income countries secure vaccine doses at lower prices, the Pan American Health Organization's assistant director, Dr. Jarbas Barbosa, said it will not meet the goal to provide enough vaccines to immunize 20% of the population of participating nations.
Cubans are in a particularly tough spot because the government declined to participate in Covax and developed its own vaccines instead. The government also has not taken the U.S. up on an offer to accept vaccine donations, two senior Biden administration officials said last week.
After a year and a half of government-imposed restrictions on foreign travel, many Cubans are looking forward to visiting family and friends abroad when airports open up in mid-November. They are likely to face a new hurdle to come to the U.S., however, as the vast majority of Cubans are receiving locally produced shots of Soberana and Abdala.
A minority of the population is getting the Chinese-manufactured Sinopharm vaccine that has WHO emergency approval. Cuban authorities said the island was leading the vaccination efforts in the region, with 80% of its 11.3 million population having received at least one dose. However, only 56% is fully immunized because Cuba's vaccination program requires three doses with several weeks between the shots.
The U.S. rule can put additional hurdles on Cuba's plans to export its vaccines. So far, the country has shipped vaccines to Venezuela and Nicaragua and signed a contract to sell 10 million doses to Vietnam.
The Finlay Institute, the Cuban state manufacturer of the Soberana vaccine, is already in contact with WHO to seek the agency's approval. Dr. Vicente Verez Bencomo, the institute's director, said the government was investing in bringing the production plant standards up to meet the requirements for export.
"We are supporting Cuba to participate in the prequalification process," Barbosa said. "We already had a meeting with WHO and vaccine producers. Our interest is that all vaccines can participate in the WHO's prequalification process, because that will expand the supply of vaccines that we can buy."
In Cuba, the Dominican Republic and other countries in the region, people have had little choice of which vaccine to get.
In countries like Argentina, there has been a patchwork of options, but not all vaccines have been available simultaneously or in all areas. More than 10 million Argentinians vaccinated with Russian Sputnik V will not be able to come to the U.S. if manufacturers do not solve issues with the production plants that have halted the WHO's approval process.
AIR-TRAVEL MANDATE WEIGHED
Amid a growing push for passengers on domestic flights to show proof of vaccination, top infectious-disease expert Dr. Anthony Fauci said he doesn't see it happening in the near future.
His statement came Sunday during an appearance on CNN's State of the Union, after anchor Dana Bash asked if he would like an air travel vaccine mandate in effect for the holidays. He said such a decision would be made with "input from a number of parts of the government."
"On the table is the issue of mandates for vaccine," said Fauci, Biden's chief medical adviser. "It's always discussable, we always wind up discussing it, but right now I don't see that immediately."
Late last month, Sen. Dianne Feinstein, D-Calif., introduced a bill that would make vaccination, a negative test or proof of recent recovery from the virus mandatory to fly domestically. Earlier in the month, Rep. Don Beyer, D-Va., proposed legislation to require proof of vaccination or a negative test for domestic air and Amtrak travelers.
Fauci said last month that he would support a vaccine mandate for domestic flights if President Joe Biden wanted to move forward with one.
During Sunday's interview, he declined to weigh in on whether he supported a mandate, saying he did not want his comments to be taken out of context.
"We have everything on the table, and it will be discussed by the medical group," he said.
Thailand, meanwhile, plans to no longer require international visitors from at least 10 low-risk nations to quarantine beginning next month if they are fully vaccinated, the prime minister said Monday.
In a televised speech, Prayuth Chan-ocha said the first group would include arrivals from the United Kingdom, Singapore, Germany, China and the United States. The list will be expanded Dec. 1 and again Jan. 1, he said.
Thailand's economy has been badly hurt by the losses suffered by its tourism industry after most foreign visitors were barred in April last year. That policy has eased, but all arrivals still faced onerous quarantine requirements.
Even now, Bangkok and other areas have a 10 p.m.-to-4 a.m. curfew and other restrictions to tame a third wave of the coronavirus that began in April.
"The time has come for us to ready ourselves to face the coronavirus and live with it as with other endemic infections and diseases, much as we have learnt to live with other diseases with treatments and vaccinations," Prayuth said.
He said he has instructed the government's Center for COVID-19 Situation Administration and the Public Health Ministry to urgently consider the plan by the end of the week. The center will also finalize which countries will be on the no-quarantine list.
All visitors will still need to show negative covid test results before embarking for Thailand and will require another test on arrival, after which they will be free to travel around the country.
Visitors from other countries will still have to quarantine and meet other requirements.
Prayuth said the authorities will also consider allowing the consumption of alcoholic beverages in restaurants as well as the operation of entertainment venues starting Dec. 1 to support the revitalization of the tourism and leisure sectors during New Year's celebrations.
"We will have to track the situation very carefully, and see how to contain and live with that situation, because I do not think that the many millions who depend on the income generated by the travel, leisure and entertainment sector can possibly afford the devastating blow of a second lost New Year holiday period," he said.
Information for this article was contributed by Nora Gamez Torres and Jacqueline Charles of the Miami Herald; by Hannah Sampson of The Washington Post; and by Chalida Ekvitthayavechnukul of The Associated Press.