Why do vaccinated travelers still need a COVID-19 test to fly back to the US from abroad?

Candace Black Werth has traveled to Mexico four times during the pandemic.

She said she’s felt safe during her frequent trips to San José del Cabo and that the businesses and resorts she’s stayed at took precautions to keep guests and staff safe from COVID-19. However, Werth — a TPG reader — said that getting a COVID-19 test to fly back to the United States has proven to be a “stressful situation.”

“The first time we needed to test was very confusing,” Werth told TPG.

During the three times she’s taken a COVID-19 test to fly back to the U.S., she said she encountered issues verifying her passport, scheduling appointments and receiving results on time. And she thinks it’s time to revisit the policy.

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In early January, the U.S. government began requiring all international arrivals to show proof of a negative coronavirus test result. The travel industry raced to comply with the order, making it easier to test at hotels and before flights. But is it time to revisit the policy in light of the U.S.’s COVID-19 vaccination rates?

Here’s what the experts, and the science, have to say.

Ongoing requirements

In the waning days of the Trump administration, the U.S. Centers for Disease Control and Prevention (CDC) announced that all travelers flying to the U.S. need to present proof of a negative coronavirus test before boarding. The only travelers exempted from this mandate were passengers flying to U.S. territories such as Puerto Rico and the U.S. Virgin Islands and travelers arriving via a land border like Mexico or Canada.

The U.S. isn’t the only country with a COVID-19 test requirement, even for fully vaccinated travelers. Still, it is one of the few countries with higher-than-average vaccination rates that also requires travelers to prove they’ve tested negative.

For instance, Canada also requires all inbound passengers to have a negative COVID-19 to enter the country. Canada recently ramped up its vaccination effort after delays, but only two million Canadians have been fully vaccinated. In comparison, half of the U.S. population over 18 has been fully vaccinated against the novel coronavirus.

When the U.S. began requiring negative COVID-19 tests for international arrivals, few people had been inoculated against the coronavirus, and air travel was seen as particularly risky. Robert R. Redfield, who was the director of the CDC at the time, said then that testing didn’t “eliminate all risk” but noted that the mandate could make travel safer on airplanes and high-traffic locations like airports.

Travel groups praised the move and were generally amenable to the idea, mainly due to the low rate of international travel at the time. But where they drew the line was at a domestic testing mandate -- Delta Air Lines CEO Ed Bastian called that potential move a “horrible idea,” while the industry trade organization Airlines for America (A4A) called it “unwarranted.”

Monitoring the coronavirus crisis

In recent weeks, the CDC has relaxed several mask-wearing and social distancing restrictions for fully vaccinated individuals.

Fully vaccinated people no longer need to take a COVID-19 test before or after travel or quarantine if traveling in the U.S. and aren’t required to quarantine if arriving from an international destination.

The agency even expanded the testing program this month for international travel to the U.S., allowing airlines to accept at-home rapid tests that include remote supervision. Masks are still required on public forms of transportation, and that requirement was recently extended through at least Sept. 13. However, the CDC hinted that the requirement could be waived sooner.

“Right now for travel, we are asking people to continue to wear their masks,” said the CDC's current director, Dr. Rochelle Walensky. “We are going to be looking at all of our guidance and updating all of our guidance, including our travel guidance.”

Where the CDC has not waivered, however, is on requiring a negative test to fly back to the U.S.

It's important to remember that though the U.S. may be vaccinating people en masse, many other countries are lagging, and it could take them years to catch up. This could be playing a role in the agency’s decision.

And it’s not just the health agency that weighs in: Several other U.S. agencies work in tandem with the CDC on travel and health policies. The travel industry said they’re in contact with the relevant agencies.

“Industry stakeholders remain in regular communication with the CDC and federal interagency on a range of pandemic recovery issues,” A4A’s vice president for security and facilitation, Lauren Beyer, said in a statement to TPG.

“The safety and wellbeing of all passengers and employees is the top priority of the U.S. airline industry. Our primary focus for recovery is safely reopening international markets.”

A4A supported a testing requirement for international travelers in January.

Health experts expect these policies to stay in place for a while, even if other CDC policies are loosened. That’s partly because of the logistics of verifying COVID-19 vaccine credentials, said Dr. Jenny Yu, the senior manager of medical integrity at Healthline (which is also owned by TPG’s parent company, Red Ventures). There are also concerns about how even vaccinated travelers can catch the coronavirus.

“Studies are underway currently to evaluate the effectiveness of the vaccinations against the variants globally,” said Dr. Yu. “Because that data is limited, vaccinated travelers can still catch variants, and the testing is a safeguard.”

TPG reached out to the CDC for comment but did not hear back in time for publication.

Support for testing continues

Still, sentiments around travel have changed in recent months.

Over half of Americans say they are comfortable flying in a commercial aircraft, up from 36% last May, according to The Harris Poll, a market research and analytics company, which conducted a study on travel sentiments.

“We have seen a very encouraging resurgence of primarily domestic travel, and that is certainly great news for the country and for our industry in particular,” Beyer said. “I would note that international travel still remains extremely depressed.”

But that doesn't mean international travel isn't happening at all.

Travelers may be flocking to destinations such as Mexico (more than 2 million people, mostly Americans, flew to the country from the U.S. in April, according to A4A data), and hotels and resorts have responded to the surge by adding on-site testing as a perk for guests.

In fact, several hotels in international destinations Americans can travel to relatively easily (mainly the Caribbean and Mexico) provide on-site COVID-19 tests for guests, so they don’t have to derail their travel plans in fear of not complying with the U.S. testing rule.

Some travelers, however, would prefer to keep the mandate in place even with widespread vaccine access for Americans.

“There is still a pandemic happening, and some countries have it worse than others. Being vaccinated doesn't make you 100% COVID-19 proof,” said TPG reader Catherine Stevens who traveled internationally in February and got tested at her resort.

While positive cases are down in the U.S., according to a Johns Hopkins University tracker, other parts of the world still see high rates of the coronavirus.

The CDC hasn’t given much indication that it would change the policy any time soon, saying that even fully vaccinated travelers “are at increased risk for getting and possibly spreading” new COVID-19 variants.

However, if the CDC did lift or relax the testing policy for inbound international flights, Dr. Yu said the decision would be “driven by data.”

“The number of infections in hotspots [and] vaccination rates globally," she said, "all play a factor in the decision to lift the orders on masks on board and COVID-19 testing returning back to the states."

And for many travelers, the testing requirement simply feels like too little, too late.

“To start the testing process a year into the pandemic and to continue the testing now,” Werth said, “when the disease has been running rampant throughout the U.S. for over 14 months, it is akin to putting on a raincoat when the storm is starting to clear up after you have been standing in the rain for hours or days.”

“It does little good. You are already soaking wet. The raincoat won't stop that.”

Feature photo by CHANDAN KHANNA/AFP via Getty Images.