When the first batch of COVID-19 vaccines went out to states in December, John and his wife assumed they would receive theirs soon.
“She’s 68. I’m 73,” said John, who lives in Virginia Beach. He didn’t want to include his last name because he fears retribution for this story.
“My wife is a heart attack survivor and a cancer survivor — two considerable preexisting conditions in our minds should have popped her to the top of the list.”
Instead, they received word it could be over a month before they got their shots. They became resigned to waiting that long, until late January when John heard that a clinic in northeastern North Carolina was giving vaccines to Virginians.
He and his wife quickly registered online and received their shots two days later.
No problem.
“It was an enormous relief,” John said. “Just the sensation of getting back into the car and going, ‘Wow, we got vaccinated.’”
With demand for vaccines outpacing supply, Virginians are crossing state lines to receive shots. They are taking advantage of a patchwork of vaccination rules and procedures across the country due to the lack of a standard national rollout process.
More than 806,000 Virginians have received at least one dose of the vaccine. The state currently prioritizes people most at risk from the coronavirus, including frontline essential workers. According to data from the Centers For Disease Control and Prevention, the commonwealth has administered a higher percentage of its shots than most other states.
Still, many Virginians are frustrated with the wait and have had better luck in North Carolina and Maryland.
“I had doubts almost until the time the needle was in my arm,” said Susan, 64, from Norfolk, who received her vaccine at a drive-thru site in Currituck County. “By the time we got in line, every time somebody came to my window I thought they were going to say, ‘You can’t be here,’ for either my age or my license plate.”
COVID-19 vaccines are a federal resource distributed to states. Therefore, North Carolina cannot restrict access to the shots based on jurisdiction, according to that state’s health officials. They did not disclose how many Virginians have received their shots in North Carolina and said they are prioritizing local residents.
Vaccine tourism, as some people call it, is occurring across the country. In Florida, more than 57,000 residents from other states have received shots. Ohio health officials also say 21,500 doses have gone to people from elsewhere.
Given the pent-up demand for the vaccine and the varying rollout approaches among states, healthcare experts aren’t surprised that people are crossing borders for shots. Some areas are giving doses out quicker than others, have fewer restrictions or a smoother booking process.
But crossing state lines raises ethical questions and challenges.
Vivian Riefberg, a University of Virginia professor studying the economics of healthcare, noted that the federal government distributes the vaccine based on state populations. States then dole out the vaccine to counties and localities.
When people receive a shot in a state that isn’t theirs, Riefberg said, “it confuses the allocation system.” It can also create the perception that people from other states are jumping the line and taking the vaccine from in-state residents.
“It could create some ill-will,” Riefberg said.
Fairness is another concern. Many people can’t travel easily or afford to take a day off from work. There is already evidence that the rollout has not been equitable, with Black and Latino residents lagging behind in getting vaccinated.
The drawbacks of vaccine tourism have prompted Virginia and Maryland officials to ask residents not to do it.
Still, Riefberg and Marissa Levine — a former Virginia health commissioner — said there are benefits to getting a vaccine in another state. The vaccine can expire and go to waste if localities receive it but cannot find enough local residents who want it. As a solution, states and localities should offer them to people from elsewhere, Levine said.
She added that the goal right now is to get as many people vaccinated as possible to end the pandemic. Crossing state borders is helping that happen.
“Anything that helps get more vaccine to more people is good,” Levine said.
In Hampton Roads, the search for the vaccine and the debate over traveling for it plays out on the neighborhood networking site, NextDoor. Residents complain about the pace of the rollout and post about their own experiences struggling to register for a shot
Some commenters suggest traveling to North Carolina. Other people discourage it.
“These vaccine chasers are just not showing their best nature,” Anna Kestenbaum said in one recent post. Kestenbaum is a member of a Norfolk neighborhood group on NextDoor.
John, the Virginia Beach resident, admits that he’s felt some guilt about possibly “taking a vaccine out of the arm of a North Carolina resident for whom it was intended.” He hopes the clinic gave him the vaccine because there weren’t enough locals who wanted it.
Despite his reservations, he’s scheduled to receive his second dose in North Carolina later in February.
“This is one of those once you start this you follow it through until the end things,” he said.