can unvaccinated travel to uk

United Kingdom Travel Restrictions

Traveler's COVID-19 vaccination status

Traveling from the United States to the United Kingdom

Open for vaccinated visitors

COVID-19 testing

Not required

Not required for vaccinated visitors

Restaurants

Not required in enclosed environments and public transportation.

United Kingdom entry details and exceptions

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Can I travel to the United Kingdom from the United States?

Most visitors from the United States, regardless of vaccination status, can enter the United Kingdom.

Can I travel to the United Kingdom if I am vaccinated?

Fully vaccinated visitors from the United States can enter the United Kingdom without restrictions.

Can I travel to the United Kingdom without being vaccinated?

Unvaccinated visitors from the United States can enter the United Kingdom without restrictions.

Do I need a COVID test to enter the United Kingdom?

Visitors from the United States are not required to present a negative COVID-19 PCR test or antigen result upon entering the United Kingdom.

Can I travel to the United Kingdom without quarantine?

Travelers from the United States are not required to quarantine.

Do I need to wear a mask in the United Kingdom?

Mask usage in the United Kingdom is not required in enclosed environments and public transportation.

Are the restaurants and bars open in the United Kingdom?

Restaurants in the United Kingdom are open. Bars in the United Kingdom are .

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United Kingdom, including England, Scotland, Wales, and Northern Ireland Traveler View

Travel health notices, vaccines and medicines, non-vaccine-preventable diseases, stay healthy and safe.

• Packing List

After Your Trip

There are no notices currently in effect for United Kingdom, including England, Scotland, Wales, and Northern Ireland.

⇧ Top

Check the vaccines and medicines list and visit your doctor at least a month before your trip to get vaccines or medicines you may need. If you or your doctor need help finding a location that provides certain vaccines or medicines, visit the Find a Clinic page.

Routine vaccines

Recommendations.

Make sure you are up-to-date on all routine vaccines before every trip. Some of these vaccines include

• Chickenpox (Varicella)
• Diphtheria-Tetanus-Pertussis
• Flu (influenza)
• Measles-Mumps-Rubella (MMR)

Immunization schedules

All eligible travelers should be up to date with their COVID-19 vaccines. Please see  Your COVID-19 Vaccination  for more information. 

COVID-19 vaccine

Hepatitis A

Consider hepatitis A vaccination for most travelers. It is recommended for travelers who will be doing higher risk activities, such as visiting smaller cities, villages, or rural areas where a traveler might get infected through food or water. It is recommended for travelers who plan on eating street food.

Hepatitis A - CDC Yellow Book

Dosing info - Hep A

Hepatitis B

Recommended for unvaccinated travelers younger than 60 years old traveling to the United Kingdom. Unvaccinated travelers 60 years and older may get vaccinated before traveling to the United Kingdom.

Hepatitis B - CDC Yellow Book

Dosing info - Hep B

Cases of measles are on the rise worldwide. Travelers are at risk of measles if they have not been fully vaccinated at least two weeks prior to departure, or have not had measles in the past, and travel internationally to areas where measles is spreading.

All international travelers should be fully vaccinated against measles with the measles-mumps-rubella (MMR) vaccine, including an early dose for infants 6–11 months, according to  CDC’s measles vaccination recommendations for international travel .

Measles (Rubeola) - CDC Yellow Book

Dogs infected with rabies are not commonly found in the United Kingdom.

If rabies exposures occur while in the United Kingdom, rabies vaccines are typically available throughout most of the country.

Rabies pre-exposure vaccination considerations include whether travelers 1) will be performing occupational or recreational activities that increase risk for exposure to potentially rabid animals and 2) might have difficulty getting prompt access to safe post-exposure prophylaxis.

Please consult with a healthcare provider to determine whether you should receive pre-exposure vaccination before travel.

For more information, see country rabies status assessments .

Rabies - CDC Yellow Book

Tick-borne Encephalitis

Avoid bug bites

Learn more about tick-borne encephalitis at your destination .

Tick-borne Encephalitis - CDC Yellow Book

Avoid contaminated water

Leptospirosis

How most people get sick (most common modes of transmission)

• Touching urine or other body fluids from an animal infected with leptospirosis
• Swimming or wading in urine-contaminated fresh water, or contact with urine-contaminated mud
• Drinking water or eating food contaminated with animal urine
• Avoid contaminated water and soil
• Avoid floodwater

Clinical Guidance

Airborne & droplet.

• Breathing in air or accidentally eating food contaminated with the urine, droppings, or saliva of infected rodents
• Bite from an infected rodent
• Less commonly, being around someone sick with hantavirus (only occurs with Andes virus)
• Avoid rodents and areas where they live
• Avoid sick people

Tuberculosis (TB)

• Breathe in TB bacteria that is in the air from an infected and contagious person coughing, speaking, or singing.

Learn actions you can take to stay healthy and safe on your trip. Vaccines cannot protect you from many diseases in the United Kingdom, so your behaviors are important.

Eat and drink safely

Food and water standards around the world vary based on the destination. Standards may also differ within a country and risk may change depending on activity type (e.g., hiking versus business trip). You can learn more about safe food and drink choices when traveling by accessing the resources below.

• Choose Safe Food and Drinks When Traveling
• Water Treatment Options When Hiking, Camping or Traveling
• Global Water, Sanitation and Hygiene | Healthy Water
• Avoid Contaminated Water During Travel

You can also visit the  Department of State Country Information Pages  for additional information about food and water safety.

Prevent bug bites

Although the United Kingdom is an industrialized country, bug bites here can still spread diseases. Just as you would in the United States, try to avoid bug bites while spending time outside or in wooded areas.

What can I do to prevent bug bites?

• Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
• Use an appropriate insect repellent (see below).
• Consider using permethrin-treated clothing and gear if spending a lot of time outside. Do not use permethrin directly on skin.

What type of insect repellent should I use?

• FOR PROTECTION AGAINST TICKS AND MOSQUITOES: Use a repellent that contains 20% or more DEET for protection that lasts up to several hours.
• Picaridin (also known as KBR 3023, Bayrepel, and icaridin)
• Oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD)
• 2-undecanone
• Always use insect repellent as directed.

What should I do if I am bitten by bugs?

• Avoid scratching bug bites, and apply hydrocortisone cream or calamine lotion to reduce the itching.
• Check your entire body for ticks after outdoor activity. Be sure to remove ticks properly.

What can I do to avoid bed bugs?

Although bed bugs do not carry disease, they are an annoyance. See our information page about avoiding bug bites for some easy tips to avoid them. For more information on bed bugs, see Bed Bugs .

For more detailed information on avoiding bug bites, see Avoid Bug Bites .

Stay safe outdoors

If your travel plans in the United Kingdom include outdoor activities, take these steps to stay safe and healthy during your trip:

• Stay alert to changing weather conditions and adjust your plans if conditions become unsafe.
• Prepare for activities by wearing the right clothes and packing protective items, such as bug spray, sunscreen, and a basic first aid kit.
• Consider learning basic first aid and CPR before travel. Bring a travel health kit with items appropriate for your activities.
• If you are outside for many hours in the heat, eat salty snacks and drink water to stay hydrated and replace salt lost through sweating.
• Protect yourself from UV radiation : use sunscreen with an SPF of at least 15, wear protective clothing, and seek shade during the hottest time of day (10 a.m.–4 p.m.).
• Be especially careful during summer months and at high elevation. Because sunlight reflects off snow, sand, and water, sun exposure may be increased during activities like skiing, swimming, and sailing.
• Very cold temperatures can be dangerous. Dress in layers and cover heads, hands, and feet properly if you are visiting a cold location.

Stay safe around water

• Swim only in designated swimming areas. Obey lifeguards and warning flags on beaches.
• Do not dive into shallow water.
• Avoid swallowing water when swimming. Untreated water can carry germs that make you sick.
• Practice safe boating—follow all boating safety laws, do not drink alcohol if you are driving a boat, and always wear a life jacket.

Keep away from animals

Most animals avoid people, but they may attack if they feel threatened, are protecting their young or territory, or if they are injured or ill. Animal bites and scratches can lead to serious diseases such as rabies.

Follow these tips to protect yourself:

• Do not touch or feed any animals you do not know.
• Do not allow animals to lick open wounds, and do not get animal saliva in your eyes or mouth.
• Avoid rodents and their urine and feces.
• Traveling pets should be supervised closely and not allowed to come in contact with local animals.
• If you wake in a room with a bat, seek medical care immediately.  Bat bites may be hard to see.

All animals can pose a threat, but be extra careful around dogs, bats, monkeys, sea animals such as jellyfish, and snakes. If you are bitten or scratched by an animal, immediately:

• Wash the wound with soap and clean water.
• Go to a doctor right away.
• Tell your doctor about your injury when you get back to the United States.

Reduce your exposure to germs

Follow these tips to avoid getting sick or spreading illness to others while traveling:

• Wash your hands often, especially before eating.
• If soap and water aren’t available, clean hands with hand sanitizer (containing at least 60% alcohol).
• Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
• Try to avoid contact with people who are sick.
• If you are sick, stay home or in your hotel room, unless you need medical care.

Avoid sharing body fluids

Diseases can be spread through body fluids, such as saliva, blood, vomit, and semen.

Protect yourself:

• Use latex condoms correctly.
• Do not inject drugs.
• Limit alcohol consumption. People take more risks when intoxicated.
• Do not share needles or any devices that can break the skin. That includes needles for tattoos, piercings, and acupuncture.
• If you receive medical or dental care, make sure the equipment is disinfected or sanitized.

Know how to get medical care while traveling

Plan for how you will get health care during your trip, should the need arise:

• Carry a list of local doctors and hospitals at your destination.
• Review your health insurance plan to determine what medical services it would cover during your trip. Consider purchasing travel health and medical evacuation insurance for things your regular insurance will not cover.
• Carry a card that identifies, in the local language, your blood type, chronic conditions or serious allergies, and the generic names of any medicines you take.
• Bring copies of your prescriptions for medicine and for eye glasses and contact lenses.
• Some prescription drugs may be illegal in other countries. Call the United Kingdom’s embassy to verify that all of your prescription(s) are legal to bring with you.
• Bring all the medicines (including over-the-counter medicines) you think you might need during your trip, including extra in case of travel delays. Ask your doctor to help you get prescriptions filled early if you need to.

Many foreign hospitals and clinics are accredited by the Joint Commission International. A list of accredited facilities is available at their website ( www.jointcommissioninternational.org ).

Select safe transportation

Motor vehicle crashes are the #1 killer of healthy US citizens in foreign countries.

Be smart when you are traveling on foot.

• Use sidewalks and marked crosswalks.
• Pay attention to the traffic around you, especially in crowded areas.
• Remember, people on foot do not always have the right of way in other countries.

Riding/Driving

Choose a safe vehicle.

• Choose official taxis or public transportation, such as trains and buses.
• Make sure there are seatbelts.
• Avoid overcrowded, overloaded, top-heavy buses and minivans.
• Avoid riding on motorcycles or motorbikes, especially motorbike taxis. (Many crashes are caused by inexperienced motorbike drivers.)
• Choose newer vehicles—they may have more safety features, such as airbags, and be more reliable.
• Choose larger vehicles, which may provide more protection in crashes.

Think about the driver.

• Do not drive after drinking alcohol or ride with someone who has been drinking.
• Consider hiring a licensed, trained driver familiar with the area.
• Arrange payment before departing.

Follow basic safety tips.

• Wear a seatbelt at all times.
• Sit in the back seat of cars and taxis.
• When on motorbikes or bicycles, always wear a helmet. (Bring a helmet from home, if needed.)
• Do not use a cell phone or text while driving (illegal in many countries).
• Travel during daylight hours only, especially in rural areas.
• If you choose to drive a vehicle in the United Kingdom, learn the local traffic laws and have the proper paperwork.
• Get any driving permits and insurance you may need. Get an International Driving Permit (IDP). Carry the IDP and a US-issued driver's license at all times.
• Check with your auto insurance policy's international coverage, and get more coverage if needed. Make sure you have liability insurance.
• Avoid using local, unscheduled aircraft.
• If possible, fly on larger planes (more than 30 seats); larger airplanes are more likely to have regular safety inspections.
• Try to schedule flights during daylight hours and in good weather.

Helpful Resources

Road Safety Overseas (Information from the US Department of State): Includes tips on driving in other countries, International Driving Permits, auto insurance, and other resources.

The Association for International Road Travel has country-specific Road Travel Reports available for most countries for a minimal fee.

Traffic flows on the left side of the road in the United Kingdom.

• Always pay close attention to the flow of traffic, especially when crossing the street.
• LOOK RIGHT for approaching traffic.

Maintain personal security

Use the same common sense traveling overseas that you would at home, and always stay alert and aware of your surroundings.

Before you leave

• Research your destination(s), including local laws, customs, and culture.
• Monitor travel advisories and alerts and read travel tips from the US Department of State.
• Enroll in the Smart Traveler Enrollment Program (STEP) .
• Leave a copy of your itinerary, contact information, credit cards, and passport with someone at home.
• Pack as light as possible, and leave at home any item you could not replace.

While at your destination(s)

• Carry contact information for the nearest US embassy or consulate .
• Carry a photocopy of your passport and entry stamp; leave the actual passport securely in your hotel.
• Follow all local laws and social customs.
• Do not wear expensive clothing or jewelry.
• Always keep hotel doors locked, and store valuables in secure areas.
• If possible, choose hotel rooms between the 2nd and 6th floors.

Healthy Travel Packing List

Use the Healthy Travel Packing List for United Kingdom for a list of health-related items to consider packing for your trip. Talk to your doctor about which items are most important for you.

Why does CDC recommend packing these health-related items?

It’s best to be prepared to prevent and treat common illnesses and injuries. Some supplies and medicines may be difficult to find at your destination, may have different names, or may have different ingredients than what you normally use.

If you are not feeling well after your trip, you may need to see a doctor. If you need help finding a travel medicine specialist, see Find a Clinic . Be sure to tell your doctor about your travel, including where you went and what you did on your trip. Also tell your doctor if you were bitten or scratched by an animal while traveling.

For more information on what to do if you are sick after your trip, see Getting Sick after Travel .

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Americans and Europeans can travel to Britain without quarantining from August

Jul 28, 2021 • 4 min read

England has updated its rules for quarantine-free international travel © Bloomberg/Getty Images

Britain is set to further ease travel restrictions by dropping quarantine requirements for arrivals who have been vaccinated in the US and the European Union—if they are traveling to England , Wales , and Scotland  from amber list countries.

From August 2, most of the UK will no longer require fully vaccinated travelers from EU countries and the US to quarantine for 10 days upon arrival if they are coming from an amber or mid-risk country. Until now, only UK residents returning to England who had been "fully vaccinated with an NHS administered vaccine in the UK" could bypass quarantine, but now the doors are open for arrivals who have been fully jabbed with US- and EU-approved vaccines —as well as travelers from these countries who have recovered from the virus.

Most countries are categorized as amber under the UK's traffic light system, including holiday hotspots like Italy , Greece , Spain , mainland Portugal  and the US.  France is also on the amber list, but passengers returning from there are still required to quarantine for 10 days due to the concern over the spread of the Beta variant in the country.

But there are still some requirements people need to consider before planning a trip. In addition to a pre-travel test, travelers coming from amber countries must take a PCR test on the second day of their arrival, transport secretary Grant Shapps confirmed. Children will also be required to take a PCR test on the second day, and unvaccinated and even partially vaccinated travelers will still be required to quarantine for 10 days when arriving from an amber country.

For now the rules only apply to people who are traveling to England, Scotland and Wales; the situation remains unchanged in Northern Ireland .

We're helping reunite people living in the US and European countries with their family and friends in the UK 👪 From 2nd August at 4am people from these countries will be able to come to the England from an amber country without having to quarantine if they're fully vaxxed 💉 — Rt Hon Grant Shapps MP (@grantshapps) July 28, 2021

There are no changes to the rules for arrivals coming from green list countries – destinations where infection rates are low and vaccination rates are high. They're also required to take a PCR before and after travel but they don't have to quarantine.

Arrivals from red list or high-risk countries will continue to be required to undergo mandatory hotel quarantine at their own expense. You can see a detailed breakdown of travel rules here .

Meanwhile, England has reopened the nation, dropping almost all domestic COVID-19 rules, despite the ongoing surge in cases due to the Delta variant. While the British Medical Association (BMA) has called for continued face mask use , the government's mask mandate is now removed, along with social distancing guidelines. Entertainment and hospitality sectors fully reopened on July 19 for the first time since last March without restrictions; gigs and festivals are returning; sporting games are permitted to operate at full capacity; and life has more or less return to pre-pandemic times.

In London, however, masks are still mandatory on public transport including the Tube, bus, tram, DLR, Overground and TfL Rail. Passengers will continue to wear a face covering in transport stations and for the duration of their journey.

In a tweet announcing the news , London's mayor Sadiq Khan said: "there is overwhelming evidence that face masks reduce the transmission of COVID. Face masks will stay compulsory on services—to protect vulnerable Londoners and give everyone the confidence to travel."

In Scotland, officials have downgraded COVID-19 restrictions to their lowest level, but the mandatory use of face masks will remain in place for "some time", the country's first minister Nicola Sturgeon has said as she urged citizens to continue to "stick to limits on gatherings, observe appropriate distance, wear face coverings, ventilate rooms and wash hands".

Like England, Wales dropped COVID-19 restrictions on July 19 but masks will continue to be required on public transport and in health and social care settings. While in Northern Ireland, masks are required in public, and social distancing will apply in most public settings.

This article was originally published on May 7, 2021 and updated on July 28, 2021.

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What are the latest UK testing rules for unvaccinated travellers?

No more tests for unvaccinated people from 18 march, article bookmarked.

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Sign up to Simon Calder’s free travel email for expert advice and money-saving discounts

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Your travel to-do list changes once again this month, following the UK government’s January announcement that it will scrap all remaining Covid-19 travel restrictions on 18 March.

Announcing the end to measures such as the passenger locator form, transport secretary Grant Shapps described travellers enjoying “greater freedom in time for Easter”, saying “You can travel just like in the good old days”.

However, many destinations outside the UK still demand proof of vaccination, a negative test result, or both, to cross their borders, while others have banned unvaccinated visitors outright.

So what paperwork, testing and other travel admin do you need before leaving or entering the UK?

Here’s everything you need to know for travel, before and after the March rule change.

Do unvaccinated travellers need a Covid test to leave and enter the UK?

As of 4am on 18 March, you no longer have to take any tests either side of travel to the UK. The passenger locator form will be abolished at that time , as will the travel testing formerly required for unvaccinated people by the UK government.

You no longer need to quarantine once in the UK.

As for testing before leaving for your holiday, that is specific to your destination. Several places, such as the Dominican Republic and the UAE, require unvaccinated arrivals to present a negative result from a PCR test taken in the two or three days before travel.

Others, such as Croatia and Greece, will accept a lateral flow test instead of a PCR test for vaccinated travellers, but give a shorter time frame for taking it (usually 24 or 48 hours). Some destinations such as Cyprus and Israel also require a test on arrival.

Meanwhile, countries including the USA, Spain and France have barred unvaccinated tourists outright.

Your best bet is to check the individual country-by-country rules and entry advice on the Gov.uk Foreign Office website right up until your departure date - rules can change at short notice.

Do unvaccinated travellers need to quarantine?

No. Before 11 February, unvaccinated people had to self-isolate for 10 days on arrival into the UK (although in England this could be shortened to five days if a traveller opted to pay for an extra “day five” PCR test). Since 11 February, unvaccinated travellers have not been required to quarantine unless they test positive, in which case they should follow the latest guidance for self-isolation .

Do unvaccinated travellers need a Passenger Locator Form?

As of 4am on 18 March, you no longer have to fill in the UK’s arduous online form - it will be abolished from this time .

This applies to all travellers, regardless of vaccination status.

Is hotel quarantine still a possibility?

Hotel quarantine has not been employed by the UK for some months. The red list has been empty since January, and ministers announced on 14 March that hotel quarantine “will be fully stood down from the end of March, putting the UK as one of the first major economies to end all Covid-19 international travel rules”.

While the 14 March announcement appeared to cover a “final” removal of all restrictions during March 2022, ministers have reserved the right to reintroduce measures in the case of a worrying new variant of Covid.

Health secretary Sajid Javid said: “We will continue monitoring and tracking potential new variants, and keep a reserve of measures which can be rapidly deployed if needed to keep us safe.”

Are the travel rules likely to change again for unvaccinated people?

Though there was a note of finality to Grant Shapps’ announcement on 14 March, he took care to say that although he wants to “keep international travel moving”, rules were being removed only because they are currently deemed unnecessary.

He said: “I said we wouldn’t keep travel measures in place for any longer than necessary, which we’re delivering on today - providing more welcome news and greater freedom for travellers ahead of the Easter holidays.

“I look forward to continuing to work with the travel sector and partners around the world to keep international travel moving.”

UK testing rules were simplified to some extent last autumn, between the Delta variant of Covid-19 spiking cases in the UK and the arrival of the Omicron variant, before being tightened again in late November and early December 2021.

This shows that rules can change at short notice. However, ministers have moved to a “learning to live with Covid-19” approach due to the lower number of deaths and hospitalisations during the Omicron variant surge, ending the stricter “Plan B” guidance introduced during winter.

There is a chance that testing could be reintroduced for unvaccinated people if a concerning new variant is detected in the UK or elsewhere, with some experts pointing to the importance of genomic sequencing using PCR tests. More likely is that countries abroad may be added to the red list - currently empty, but kept on standby in case of new variants - with some stricter restrictions attached to travel there.

Simon Calder, travel correspondent of The Independent , says: “While claims by the transport secretary, Grant Shapps, that the UK is ‘world-beating’ in abolishing restrictions are wide of the mark, the abolition of the passenger locator form and testing rules will spur international travel.

“But with concern about Russia’s brutal invasion of Ukraine foremost in people’s minds, a sudden rebound on rules is unlikely.

“However, it remains to be seen how much lasting damage has been done to the outbound travel industry – previously the best in the world – and the UK’s reputation as a good destination for inbound visitors.”

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Can you travel to the UK without Covid-19 vaccine?

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The United Kingdom has had one of the largest Covid-19 deaths globally, resulting in several lockdowns throughout the country.

Most legal coronavirus restrictions in England, Scotland, Wales, and Northern Ireland have now been lifted. However, there are still some restrictions across the United Kingdom regarding international travel , and some countries have retained specific domestic measures that were previously in place. Below are some of the information you need before travelling to the United Kingdom. 

The Covid-19 Vaccine you should take

There are different types of Covid-19 vaccine in the world. But, not all are accepted in the UK. Here are the approved Covid-19 vaccines in the UK:

- Moderna Vaccines

- Pfizer and BioNTech

- Oxford University and AstraZeneca

- Janssen (available later this year)

In most cases, you will not be able to choose which vaccine you will receive. When you make a reservation, you will only be offered appointments for vaccines that are appropriate for your needs. The COVID-19 vaccines are available to the majority of people; however some persons are only administered particular vaccines under certain circumstances.

If you are pregnant or under the age of 40, you will be offered appointments for the Pfizer/ BioNTech or Moderna vaccine. In the case of a minor under the age of 18, you will only be offered the Pfizer/BioNTech vaccine. Unless you have substantial side effects (such as a severe allergic response) after your first dosage, you should receive the same vaccine for both doses of the vaccine.

What are the Covid-19 Rules for Visiting the UK?

According to official sources in the United Kingdom, the new guidelines will discriminate between recipients of COVID-19 immunizations not based on the vaccine received but rather on the region in which these vaccines were administered.

The additional measures required by travelers whose immunization is not recognized depend on the country where they obtained the vaccines. These additional precautions include two additional tests (pre-departure and "day 8 tests") as well as a ten-day quarantine period. The limits will consequently apply to anyone who has received vaccines through the COVAX program.

The United Kingdom is one of the principal backers, having donated more than USD 700 million in funding and 80 million vaccine doses to the program in the past. As of this writing, COVAX supplies account for about half of the total number of COVID-19 vaccinations distributed on the African continent.

There are no longer any nations on the UK's travel blacklist. Therefore no one has to pay for hotel quarantine when they arrive in the UK.

Before visiting the United Kingdom, all countries must be removed from the travel warning list. Passengers fully vaccinated and are traveling to the United Kingdom no longer need to take a Covid test before leaving. This includes vaccinated persons in the United Kingdom, the European Union, the United States, and dozens of other nations, including Brazil, Hong Kong, India, Pakistan, South Africa, and Turkey. Before traveling, you must be able to show proof that you have been completely vaccinated.

The modifications apply to anyone below 18 years who lives in one of these nations, whether or not they have been vaccinated.

Upon Arrival

After completing the Covid-19 passport application , travelers who have been fully vaccinated must complete a lateral flow test two days after arriving in the UK. Before they arrive, they should order and pay for a test kit privately; they cannot use NHS kits.

If they ordered a home testing kit, they would almost always be required to send a photo to validate the outcome. Even if they are merely passing through, all visitors to the UK must fill out a passenger locator form, which they must complete 48 hours or fewer before their trip.

After one year, all countries and territories will be removed from the red list. The red list policy will continue to be followed, and the list will be reviewed every three weeks after that. Countries may be added at any moment, and travel restrictions to protect the public health of the United Kingdom may be imposed at any time.

Completely vaccinated travelers coming to England from countries that are not on the red list can opt to have their "on arrival" test performed using antigen-lateral flow device (ALFD) technology rather than the traditional polymerase chain reaction (PCR).

All children below 18 who arrive in England from countries not on the Red List are now treated as fully vaccinated at the border. This implies that children under 17 do not have to be quarantined upon arrival in England, and they are exempt from day eight testing. Children from age 5 to 17 years do not need to take a COVID-19 test before traveling to England, but they must do so on or before the second day of their arrival in the country (arrival day is day 0).

They must ensure they get the correct information from the immigration lawyer before travelling. Children under the age of four do not need COVID-19 travel tests or COVID-19 health examinations.

Travelers with children should check the rules in the nation from which they are departing, as some countries may need children to take a test before being allowed to enter the United Kingdom.

Children who have traveled to a nation on the red list within the previous ten days of their arrival in England are subject to different rules. Other restrictions may apply to persons who arrive in Wales, Scotland, and Northern Ireland.

Final Thoughts

Covid-19 vaccination is compulsory if you must go to the UK. But, entering will be very easy only if you are coming from a country that is not on the UK red list.  So, before you hit the road, ensure you check if the country you are coming from is not on the red list. Remember to go for the approved vaccines and not just anyone as it is compulsory you are vaccinated appropriately.

Above all, follow the UK immigration law and Covid-19 precautions to the core. This will save you from running into the quagmire.

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The countries you can travel to without a vaccine

Travel around the world is easier now, particularly for those who are fully vaccinated with an approved Covid vaccine – but some countries are allowing unvaccinated travellers to enter. Yet with restrictions constantly changing, how do the latest rules affect those who aren't fully vaccinated, and which countries are allowing tourists to enter if they're unvaccinated?

Where can I travel unvaccinated?

There are currently a number of countries that will allow visitors who have not been vaccinated to enter. A few of them are in Europe , and the others are slightly farther afield. We recommend always closely following UK health guidance, including having your Covid vaccine and booster if you are able to. Before travelling, you should regularly check government guidelines both for the country you might be considering visiting and for the UK when you return.

You can find the full list of countries allowing people to enter without a vaccine below:

Since 1 May 2022, unvaccinated travellers are able to visit the country without proof of a negative PCR or rapid antigen test. Passenger locator forms are also no longer required.

Arrivals may, however, be required to undergo a rapid Covid test on arrival. If you test positive on arrival in Greece, you (and those you are travelling with) will have to self-isolate for at least five days, either at home or in a hotel (this will be paid for by the Greek state). If you have no symptoms on day five you will be allowed to leave quarantine.

For holiday inspiration, see our guide to the best Greek Islands to visit .

Read the rules on travel to Greece .

2. Portugal and Madeira

Portugal ’s mainland and Madeira are open to travellers who have not been vaccinated, as long as they can prove they don't have coronavirus when they enter the country. To enter mainland Portugal, you will be required to show proof of a negative PCR test taken within 72 or an antigen test taken within 24 hours of departure for the country as well as complete and submit a traveller questionnaire before departure for the country. Self-administered tests are not accepted. Your temperature will also be screened on arrival.

To enter Madeira, you must register on the Madeira Safe travellers platform and download a QR code to present to airport staff on arrival. You must provide proof of a negative antigen test taken within 48 hours of departure that has been administered by a trained healthcare professional.

Your airline may deny boarding if you cannot show one of these documents when you check in for your flight. Check with your airline before you travel.

Read the rules on travel to Portugal .

Unvaccinated adult travellers can enter Spain if they are able to show proof of a negative test taken before entering the country. Previously, only fully vaccinated travellers aged 12 and over could enter Spain from the UK, but the destination has relaxed rules slightly, so it is now accepting negative PCR tests taken in the 72 hours before departure for the country or negative antigen tests taken in the 24 hours before departure for the country in lieu of full vaccination in adults. However, those who cannot meet either criteria will not be able to enter.

As of 1 February, you need to have received your second jab between 14 and 270 days before travel to Spain and the Canary Islands to be classed as fully vaccinated. Children aged 12-17 no longer need to show proof of a vaccine, but will need a negative PCR test to enter.

Read the rules on travel to Spain .

Unvaccinated travellers can enter Croatia without showing proof of a vaccine or negative test. The requirement to fill out a passenger locator form also no longer exists.

Read the rules on travel to Croatia .

Unvaccinated travellers to  Cyprus  must provide proof of a negative PCR test taken within 72 hours before departure for the country or an antigen test taken in the 24 hours before departure for the country. Travellers over 12 may then be asked to take another PCR test upon arrival at Larnaca or Paphos airports, and remain in isolation until the result comes back (this should take roughly three hours). This costs €15–€19 and must be paid for by the traveller.

Read the rules on travel to Cyprus .

If you are unvaccinated and over 12 years old, you must provide a negative PCR test result taken within 72 hours or an antigen test result taken within 48 hours pre-departure for entry to France.

Read the rules on travel to France .

7. Maldives

All travellers to the Maldives must fill in a Traveller Declaration form in the 72 hours prior to departure. A PCR test is no longer required regardless of vaccination status.

Read the rules on travel to the Maldives .

Unvaccinated tourists entering Italy from the UK must show a negative PCR test taken within 48 hours before entering, or a negative lateral flow test taken within 48 hours before entering. The requirement to fill in a passenger locator form has now been lifted.

Read the rules on travel to Italy .

9. Dubai and United Arab Emirates

You do not have to be fully vaccinated to visit the UAE. Unvaccinated arrivals to the Emirates must present evidence of a negative PCR test taken 48 hours before departure. Unvaccinated travellers from the UK to Dubai may be required to have a Covid-19 PCR test on arrival.

Read the rules on travel to Dubai .

10. Slovenia

Unvaccinated British travellers to Slovenia must provide a Digital Passenger Locator Form, but are not required to show proof of a negative test or vaccination to enter.

You do not need to be fully vaccinated to visit Turkey, but you must be able to show proof of a negative PCR test (taken no more than 72 hours before entry), rapid antigen test (taken no more than 48 hours before entry), or proof of a recent recovery from Covid-19 within the last six months. Arrivals into the country should also show an online form completed 72 hours before travel and will be subject to a medical evaluation for symptoms of coronavirus, including temperature checks. Arrivals may be subject to random PCR testing on arrival.

You must wear a face mask at all times while in an airport and for the duration of all flights, to and from Turkey.

Read the rules on travel to Turkey .

Mexico  does not currently require visitors to show a negative PCR test or quarantine on arrival. Resorts are also able to request guests fill in a health questionnaire on arrival.

Read the rules on travel to Mexico .

13. Ireland

If you are travelling to Ireland as of Sunday 6 March 2022, you do not need to show any proof of vaccination, proof of recovery, negative test or passenger locator form.

Read the rules on travel to Ireland .

As of Friday 1 April 2022, UK travellers visiting Sweden are no longer required to present a negative Covid-19 test or proof of vaccination.

15. Seychelles

Travellers are able to enter Seychelles regardless of vaccination status, but must present a negative PCR test taken within 72 hours prior to departure for the country or a rapid antigen test done within 24 hours. There is no requirement to quarantine on arrival, but travellers must stay in approved accommodation.

16. Bahamas

Unvaccinated travellers aged 12 and over must show a negative PCR test taken no more than 72 hours prior to the date of arrival to The Bahamas. All visitors of any age must submit a Bahamas Travel Health Visa Trip application. Seventeen-year-olds and under must be included in a parent or guardian’s profile.

All travellers to Egypt must complete a declaration form before entering the country. Unvaccinated travellers are required to show either a negative PCR test, taken no more than 72 hours before arrival in Egypt, or a rapid antigen test. Proof of Covid-19 recovery will not be accepted.

18. Cape Verde

You do not need to be fully vaccinated to enter Cape Verde, but you do need to be able to prove that you don't have Covid, either with a negative PCR test taken 72 hours before departure for the country or a lateral flow test taken 48 hours, when you check-in for your flight to Cape Verde.

19. Iceland

On 25 February 2022 all Covid restrictions were removed, including domestic rules. This means you do not need to test or show proof of vaccination status to enter the country.

20. Luxembourg

All travellers to Luxembourg need to fill in a passenger locator form before their flight. Those who are not vaccinated need to show proof of a negative PCR test taken no more than 48 hours before their flight, or a negative lateral flow test taken no more than 24 hours before. If you’re not fully vaccinated but have tested positive for Covid in the last year you can show proof of recovery to enter.

The travel restrictions upon entry into Norway have been lifted, which means that the same rules as before the pandemic now apply.

Read the rules on travel to Norway .

22. Sri Lanka

Covid travel insurance is mandatory for all visitors, and unvaccinated travellers need to show proof of a negative PCR test taken no more than 72 hours before their flight, or a negative lateral flow test taken no more than 48 hours before – be aware that self-swab tests are not recognised.

23. South Africa

Travellers to South Africa must present proof of a negative PCR test taken no more than 72 hours before departure for the country. You may be screened on arrival.

Read the rules on travel to South Africa .

Unvaccinated travellers to Belize must present a negative PCR test taken within 72 hours before arrival, or a negative antigen test taken in the 48 hours before arrival. You may also opt to take a rapid test at the airport, at a cost of BZ$100 or US$50 (which must be paid in cash). If you test positive, you will be required to quarantine at your own cost. Foreign tourists are required to pay BZ$36 (US$18) for Belize Travel Health Insurance – this is mandatory even if you already have personal travel insurance and helps protect against incurred medical and non-medical expenses should you test positive for Covid during your stay in Belize.

There are no direct flights from the UK to Belize, so it's important to check the rules of the country you will be transiting through too.

25. Costa Rica

Since 1 April 2022 there have been no requirements for entry to Costa Rica in regards to coronavirus. However, the government acknowledges that these may be brought back at short notice, in which case travellers should always check guidance before their trip.

Since 6 April 2022, there have been no requirements for travellers from the UK to show either a Covid vaccination or Covid test when entering Cuba. However, random testing is still being carried out at airports, and anyone who tests positive will be moved to quarantine in a designated government health centre, at their own expense.

27. Denmark

There are no Covid-related requirements regarding test or self-isolation when entering Denmark.

Read the rules on travel to Denmark .

You do not need to show proof of vaccination to enter Monaco, however travellers over the age of 16 who are not fully vaccinated will need to provide either a negative result of a PCR or antigen test taken within the last 24 hours, or a certificate showing proof of recovery from Covid-19 (a positive PCR or antigen test, taken more than 11 days before arrival and within the last six months).

Do I have to quarantine when returning to the UK?

No. On 18 March 2022 all Covid travel rules within the UK were removed – which means that travellers do not need to test, quarantine or even fill in a passenger locator form , regardless of their vaccination status, upon return to the country.

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• International travel, immigration and repatriation during COVID-19

UK travel update: government waives quarantine for arrivals fully vaccinated from Europe and USA while also confirming international cruise restart

The latest steps towards reopening international travel make it easier for people vaccinated in Europe or the USA to travel to England.

Read the guidance on testing and quarantine for amber list countries

• passengers fully vaccinated with vaccines authorised by the EMA and FDA in Europe and the USA will be able to travel to England from amber countries without having to quarantine on arrival from 4am 2 August
• part of the second Global Travel Taskforce review, these latest changes will boost economy and make it easier for those vaccinated in Europe or USA to return to the England and unite with family and friends
• updates include restart of international cruise sailings and bespoke testing programmes for certain groups of workers

The UK government has today (28 July 2021) announced that passengers arriving from amber countries who have been fully vaccinated in Europe ( EU Member States, European Free Trade Association countries and the European microstate countries of Andorra, Monaco and Vatican City) and the USA will not have to quarantine when entering England, as part of a range of new measures designed to continue to drive forward the reopening of international travel, set out as part of the second Global Travel Taskforce checkpoint review .

From 4am 2 August 2021, passengers who are fully vaccinated in the EU with vaccines authorised by the European Medicines Agency ( EMA ) or in the USA with vaccines authorised by the Food and Drug Administration ( FDA ), or in the Swiss vaccination programme, will be able to travel to England without having to quarantine or take a day 8 test on arrival.

Amber arrivals who have been fully vaccinated in the USA and European countries will still be required to complete a pre-departure test before arrival into England, alongside a PCR test on or before day 2 after arrival. Separate rules will continue to apply for those arriving from France . Those vaccinated in the US will also need to provide proof of US residency. Passengers from all countries cannot travel to the UK unless they have completed a passenger locator form .

Following the close monitoring of epidemiological evidence, gained through the restart of the domestic cruise industry earlier this year, the UK government has also confirmed the go ahead for international cruise sailings to restart from England in line with Public Health England guidance. International cruise travel advice will be amended to encourage travellers to understand the risks associated with cruise travel and take personal responsibility for their own safety abroad.

To further support the safe restart of international cruise travel, the government and cruise industry have signed a breakthrough memorandum of understanding ( MOU ) to help the industry build back from COVID-19 while protecting British nationals from future pandemic-related disruption.

Transport Secretary Grant Shapps said:

We’ve taken great strides on our journey to reopen international travel and today is another important step forward. Whether you are a family reuniting for the first time since the start of the pandemic or a business benefiting from increased trade – this is progress we can all enjoy. We will of course continue to be guided by the latest scientific data but thanks to our world-leading domestic vaccination programme, we’re able to look to the future and start to rebuild key transatlantic routes with the US while further cementing ties with our European neighbours.

Health and Social Care Secretary Sajid Javid said:

Our vaccination programme is building a wall of defence against this virus so we can safely enjoy our freedoms again, with 7 in 10 adults in the UK now double jabbed. By reopening quarantine-free travel for travellers who have been fully vaccinated in European countries and the USA , we’re taking another step on the road to normality which will reunite friends and families and give UK businesses a boost.

We are also relaxing the testing requirements for certain critical workers, who by the nature of their work do not mix with the public or leave their vehicles helping free up running times by removing undue burdens.

All measures announced today will be kept under review and be guided by the latest data. Public health remains our top priority, and we will not hesitate to act should the data show that countries risk ratings have changed.

Travel continues to be different this summer, and while some restrictions remain in place passengers should expect their experience to be different and may face longer wait times than they are used to – although the government is making every effort to speed up queues safely. We will continue to rollout upgrades to our e-gates over the summer to automate checks for health requirements, with many e-gates already in operation and more to be added over the coming months to increase automated checks on passengers at airports.

If travelling abroad, you should continue to take the steps to keep safe and prepare in case things change before you go or while you are there. Check the booking terms and conditions on flexibility and refunds and subscribe to FCDO travel advice updates to understand the latest entry requirements and COVID-19 rules at their destination.

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NEWS... BUT NOT AS YOU KNOW IT

Where can you travel unvaccinated? 64 destinations you can visit

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As spring and summer swoop in, the urge to travel abroad might be bubbling up inside you.

But if you haven’t been vaccinated against Covid-19 , your holiday destination options do slim down some.

Some places just won’t let you visit full stop – while others might require you to be fully-vaccinated to step off the plane and roam free without a lengthy quarantine period.

So, where can you actually go if you’re an unjabbed Brit? And what will you be expected to do?

Here’s what you need to know.

Where can you travel if you’re unvaccinated?

Countries that currently allow UK passengers to travel unvaccinated

• Bosnia and Herzegovina
• Costa Rica 
• Dominican Republic
• El Salvador 
• Guinea-Bissau
• Mozambique 
• North Macedonia
• São Tomé and Príncipe
• Saudi Arabia
• Seychelles 
• South Africa
• St Vincent and the Grenadines

Countries that the FCO advises against travelling to (but do allow unvaccinated people)

What will you need to provide to travel unvaccinated.

In a few cases, nothing. Iceland , for example, has no Covid restrictions for travellers.

Most countries will require proof of a negative Covid test result – often (but not always) a PCR test (taken within 72 hours) or an antigen test (within 24 hours) in order to enter the country.

A few will require you to test on arrival. Cyprus , for example, will have you test at the airport (at your cost) and then self-isolate at your hotel until the result comes back.

Other countries, such as Costa Rica , may ask unvaccinated people to book specific insurance in order to visit – while Nepal requires unvaccinated folks to apply for a special visa.

Sri Lanka lets unvaccinated people in after testing, but once there you’ll need to stay in a Tourism Bio Bubble.

Some places won’t require a test if you can prove, via the NHS Covid Pass, that you’ve recovered from Covid within a certain time frame.

Czech Republic and Spain will NOT typically allow someone unvaccinated in for tourism purposes – unless they can provide necessary documentation to show they’ve recently recovered from Covid.

Although Spain had planned to allow in unvaccinated travellers from the UK, this decision has now been reversed – the only exception to the rule being 12-17-year-olds who can show a negative PCR test taken not more than 72 hours before arrival.

To put it simply: the rules vary for each country, so check the FCO website for the exact entry requirements for your desired destination before you book, and again before you set off.

It’s wise to check the country’s own government website, too.

And though this list is up to date at the time of writing, keep in mind that travel rules can still change at any time.

What do I need to do to return to England?

If you manage to escape for a holiday, you’ll be pleased to know there’s nothing for you to sort for your return to England.

As of March 18, 2022, all Brits returning home to England won’t need to test or fill in a passenger locator form anymore.

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Yep, that includes passengers who are unvaccinated, too.

MORE : Best places to travel in 2022 – according to experts

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COVID-19: Remaining restrictions for travel to UK scrapped - including tests and passenger locator forms

Previously only fully vaccinated people were able to enter the UK without the need for tests - and a passenger locator form had to be completed within 72 hours of travel.

By Alexa Phillips, news reporter

Friday 18 March 2022 08:22, UK

All remaining COVID travel measures, including the Passenger Locator Form and tests for unvaccinated arrivals, have now ended in the UK.

A range of "contingency measures" will be kept in reserve so ministers can take "swift and proportionate action" if needed to tackle new variants, according to the Department for Transport.

It is understood that these include targeted testing from a country where a new variant has been detected.

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The plans would only be enacted "in extreme circumstances", the department said.

Previously only fully vaccinated people were able to enter the UK without the need for tests.

All arrivals were also required to fill in a passenger locator form within 72 hours of travel, sharing their address, phone number, passport and flight details.

The forms were launched two years ago, when arrivals had to quarantine at home, to help check if travellers were following the rules.

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'Greater freedom ahead of Easter' despite rising COVID cases

Transport Secretary Grant Shapps said: "I said we wouldn't keep travel measures in place for any longer than necessary, which we're delivering on today - providing more welcome news and greater freedom for travellers ahead of the Easter holidays."

Aviation minister Robert Courts said the lifting of restrictions was due to "sacrifices made by the whole country", adding that he hopes to "never see a day" when the rules are re-introduced.

The decision was made despite rising COVID-19 cases in all four UK nations since the end of January, according to the Office for National Statistics.

Infections in the UK have risen by 43.9% in the last seven days, with another 534,747 people testing positive.

The number of people hospitalised with the virus has increased 22% in the last week - a total of 11,580 patients in the last seven days.

In England hospital admissions remain well below the peaks reached during the Omicron and previous waves, while in Scotland the figure was close to the record peak seen in January last year, according to data from ZOE and King's College London.

Health Secretary Sajid Javid said the lifting of travel restrictions was possible due to the success of the vaccine rollout and said the government would continue to monitor potential new variants.

'A final game-changer'

Tim Alderslade, the chief executive of Airlines UK - the industry body representing UK carriers, welcomed the changes, saying "the time to return to the skies is now".

"People want to go away, and there is a real air of positivity within the sector now," he said.

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Derek Jones, chief executive of Kuoni, a tourism company, said: "The removal of all travel restrictions is the final game-changer - people can now go on holiday or visit family and friends overseas without all of the stress that comes with testing before they return home.

"Finally, we've seen the back of the unpopular and ineffective passenger locator forms, which were always a hassle to complete.

"Travel has been in turmoil for two years but now it's back."

He said bookings have risen in the last few months for destinations like the Maldives, Mauritius, the Caribbean and Europe.

Travel Abroad: When Can We Leave?

• Last updated Jul 01, 2024
• Difficulty Advanced

• Category Travel

As of 15 January 2021, more than 50 countries were welcoming US leisure travellers, including the UK, Ireland, Turkey, Jamaica, the United Arab Emirates, and more. However, this was during the COVID-19 pandemic, and the rules around travel were rapidly changing. As of the same date, the US still had border closures in place with Europe, Mexico, and Canada. In the UK, the first key date for travel in Boris Johnson's post-lockdown roadmap was 29 March 2021, when the stay at home message was scrapped in favour of stay local in England. The prime minister announced that recreational international travel could restart from 17 May at the earliest.

What You'll Learn

International travel restrictions, vaccination requirements, testing requirements, quarantine requirements, country-specific travel advice.

As of May 2021, international travel restrictions due to the COVID-19 pandemic are still in place in many countries. However, with the rollout of vaccines and the development of rapid coronavirus testing, several countries have begun to reopen their borders to international travellers.

United Kingdom

In the UK, Prime Minister Boris Johnson announced a "roadmap" for easing lockdown restrictions, including key dates for the resumption of international travel. The earliest date given for the restart of international leisure travel was 17 May 2021, although this was subject to certain conditions being met. These conditions included the continuation of the vaccination programme, evidence of vaccine effectiveness, stable or reduced hospitalisations, and no changes in risk assessment due to new variants.

United States

The United States had imposed a Level 4 travel advisory worldwide due to the pandemic, but this was lifted on 6 August 2020, and the country returned to a previous system of country-specific levels of travel advice. As of 26 January 2021, all international passengers flying into the US, including returning US citizens, were required to provide proof of a negative COVID-19 test before boarding.

Outbound travellers from the US may face health screenings upon arrival in other countries and may be required to quarantine for 14 days, regardless of whether they are symptomatic or not. The CDC recommends that travellers get tested for COVID-19 1-3 days before their flight and 3-5 days after their return, even if they are fully vaccinated.

Other Countries

Several countries and regions, such as the European Union and the European Schengen zone, have implemented their own versions of vaccination passport schemes to facilitate safer travel within their borders.

As of January 2021, more than 50 countries were welcoming US leisure travellers, including Albania, Ireland, Turkey, the United Kingdom, the United Arab Emirates, and several Caribbean and Central and South American nations. However, border closures remained in place between the US and Europe, as well as with Mexico and Canada, until at least 21 January 2021.

It is important to note that travel restrictions can change rapidly, and travellers should refer to official sources for the most up-to-date information.

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The U.S. Centers for Disease Control and Prevention (CDC) categorizes travel vaccinations into three categories: routine, recommended, and required. Routine vaccinations are those that are normally administered during childhood in the United States, such as immunizations against Haemophilus influenzae type b and human papillomavirus. It is important to ensure that these vaccinations are up to date before travelling internationally, as many conditions that are rare in the U.S. due to immunity may be more common in other countries.

Recommended vaccinations are those that protect travellers from illnesses that occur routinely in other parts of the world. Doctors determine which recommended vaccines are necessary on an individual basis, taking into account factors such as your destination, whether you will be visiting rural areas, the season of travel, your age, and your overall health status. Examples of recommended vaccinations include rabies, typhoid fever, and Japanese encephalitis.

The only vaccine classified as "required" by International Health Regulations is the yellow fever vaccination for travel to certain countries in sub-Saharan Africa and tropical South America. However, other countries may have their own specific vaccination requirements, so it is important to check the regulations for your destination.

In addition to the vaccines themselves, it is also important to be aware of the timing of your vaccinations. Some vaccines, like hepatitis A, can provide partial protection after just one dose, while others may be given on an "accelerated schedule" with doses administered over a shorter period of time. It is recommended that you get vaccinated at least a month before you travel, and that you see your doctor as soon as you start planning your trip, as some vaccines may require multiple doses or may not be readily available at your doctor's office.

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As of 18 March 2022, travellers entering the UK no longer need to take any COVID tests, nor do they need to quarantine or fill out a passenger locator form. Similarly, Canada and Britain have lifted their COVID testing requirements for vaccinated visitors. However, the US still requires air travellers, regardless of vaccination status, to present a negative COVID test before boarding a flight to the country. This has caused frustration among travellers and the US travel industry, with many people concerned about the prospect of testing positive and being unable to return home.

The standard test is the PCR test, which involves a nose or mouth swab that detects the genetic material of the virus. The rapid antigen test, or lateral flow test, is another option. This involves taking a swab and mixing it with a solution on a paper strip and can be done at home. The price of COVID tests varies, but it is important to use a government-approved provider. In the UK, expect to pay at least £60 for one PCR test and between £18 and £30 for a rapid antigen or lateral flow test.

Many countries now require travellers to take a test before entering, so it is important to check the coronavirus travel advice for your destination country. Testing requirements may include showing results produced within a certain timeframe before departure, such as 48, 72, or 96 hours. Some countries may also accept proof of full vaccination or relevant COVID-19 antibodies instead of a negative test. It is recommended to plan carefully and book tests in advance to ensure that you meet the testing requirements for your destination.

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As of May 2024, the UK has removed most of its COVID-19 restrictions for vaccinated travellers. Fully vaccinated travellers (those with two doses) and under-18s no longer need to take any COVID-19 tests or quarantine when entering England, Scotland, Wales, or Northern Ireland. Non-UK travellers must have received their vaccination in a country or territory with "approved proof of vaccination", which currently covers most countries.

For unvaccinated travellers, different rules are still in force. Those who are unvaccinated and travelling to the UK must show proof of a negative COVID-19 test taken two days before departure and take a post-arrival PCR test two days after arrival. This test must be booked before travelling to the UK and bought privately from a government-approved list of providers. If this test is positive, the traveller must self-isolate. Additionally, unvaccinated travellers must complete a passenger locator form before departure.

Digital COVID passes showing vaccination status can be downloaded to your phone, whether you are in England, Scotland, Wales, or Northern Ireland. Test results can be in the form of a printed document or an email or text message on your phone. They must be in English, French, or Spanish. European Union residents can use the EU Digital COVID Certificate to show their vaccination status or test results.

The Top Winter Travel Destinations in China

The UK's Prime Minister, Boris Johnson, announced a "roadmap" for the easing of lockdown restrictions in England, with key dates for travel. From 29 March, the "stay at home" rule was replaced with "stay local," and people were allowed to meet outdoors in groups of up to six people or two households. From 12 April, trips to self-contained accommodation within England were allowed for one household, including second homes, holiday homes, and campsites without shared facilities. All domestic travel restrictions in England were lifted on 17 May, and international recreational travel was allowed from this date, subject to a review by the Global Travel Taskforce.

The Welsh First Minister confirmed that from 27 March, residents could stay in self-contained holiday accommodation within Wales, but only with their own household or support bubble. People from outside Wales were not permitted to cross the border for holidays. The "stay local" rule was also lifted, allowing unrestricted travel within Wales.

Scotland took a phased approach to reopening, with the "stay at home" rule replaced by "stay local" from 2 April, retaining local authority-based travel restrictions for at least three weeks. Domestic travel and tourist accommodation reopened on 26 April, and travel within mainland Scotland was permitted. Scotland's First Minister, Nicola Sturgeon, expressed caution about reopening international travel, citing concerns about new cases being imported.

The U.S. Department of State, in coordination with the CDC, lifted the Global Level 4 travel advisory on 6 August 2020, reverting to a previous system of country-specific levels of travel advice. As of January 15, 2021, over 50 countries were welcoming U.S. leisure travellers, including the United Kingdom, Ireland, Turkey, the United Arab Emirates, and several Caribbean islands. From 26 January 2021, all international passengers flying into the U.S. were required to provide proof of a negative COVID-19 test before boarding.

Greece, particularly the island of Crete, is mentioned as a potential travel destination by AFAR. Delta offers quarantine-free travel to Italy and the Netherlands, which have strict entry requirements. Citizens and residents of the European Union and the Schengen zone, as well as students and those travelling for work, health, or emergencies, are permitted to enter Italy.

The Difference Between Membership Number and Known Traveler Number

Frequently asked questions.

The earliest date that has been set for the restart of international travel is 17 May.

In England, trips to self-contained accommodation could restart from 12 April for one household. All domestic travel in England should be possible from 17 May.

Most outbound travellers from the United States face health screenings on arrival in international countries. They may also face a 14-day quarantine, symptomatic or not.

All international passengers flying into the United States need to provide proof of a negative COVID-19 test prior to boarding.

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Suggestions

Bias-driven travel bans are an ineffective response to variants.

• February 1, 2022

By Linda Weaver, travel communications specialist

JOHANNESBURG, South Africa, 1st February 2022-/African Media Agency (AMA)/- The knee-jerk travel bans imposed late last year in response to Omicron were inconvenient for many – particularly given the holiday season. But they were also deeply destructive: separating families and loved ones; undercutting businesses and livelihoods; and causing further economic losses. While most countries have lifted the restrictions, the ripple effects will continue to be felt for months to come. And it is important that we understand the costs, so that we exercise greater care as we deal with future variants.

South African resident, Nonye Mpho Omotola, was one of millions of people who were affected. 

“I live in Johannesburg and had been hoping to travel to Nigeria to see my father, who was ill earlier in 2021, before the discovery of the Omicron variant. However, my plans to see him were scuppered when travel between Nigeria and South Africa was banned. Unfortunately, my father, whom I was very close to, has since passed away.”

Omotola, who is fully vaccinated, also tried to get to the UK to visit her mother who suffers from dementia and lives in a care home. “Trying to explain to her that I can’t visit her due to a global pandemic and because the UK placed South Africa on a ‘red’ travel list was very difficult,” she admits. 

The personal losses are only compounded by the economic ones. Prior to the pandemic, South Africa’s tourism sector supported approximately 800 000 jobs and contributed more than R130 billion to the country’s economy. Covid-19 and its variants decimated the sector. When Omicron was discovered – by South African scientists, no less! – the red-listing of South Africa by more than 70 countries exacerbated the damage. The Tourism Business Council of South Africa estimates that the South African tourism sector lost approximately R26 million for every day that it remained on the UK’s red list. Prior to that, the discovery of the Beta variant resulted in South Africa being placed on the UK’s red list for almost 10 months and cost the South African economy an estimated R8 billion  in lost tourism spend .

We now know that  Omicron  and  Beta  were already circulating in many parts of the world before South African scientists identified them.  Omicron was in the UK  at least four days before South Africa raised the alarm to the World Health Organisation (WHO). It was  in the Netherlands  a week before and i n Canada’s Nova Scotia wastewater  several weeks before. Yet South African travellers were among the most restricted travellers globally in the first half of 2021. 

The costs of travel bans are wide-ranging, with multiple human and economic dimensions. As tourism, hospitality and adjacent sectors are affected, it costs jobs and livelihoods. South Africa’s commercial film production sector, for example, lost more than 100 projects valued at an estimated R500 million leaving local freelance crew, models and actors without an income. 

These costs are not necessary. The World Health Organisation and Africa CDC  have been clear  that blanket travel bans do not prevent the spread of the virus. Countries must make this a part of the careful calculus that goes into the difficult decisions around how to contain the virus. 

“Rather than imposing a knee-jerk travel ban, countries need to have a proper rationale for imposing a travel ban; particularly if travellers are fully vaccinated,” agrees Weaver. “It’s a different debate when unvaccinated travellers are concerned. All indications are that it is going to become increasingly difficult to travel if you are unvaccinated.”

This article is part of a series on Covid-19 in Africa brought to you by Africa CDC in partnership with the Mastercard Foundation under the Saving Lives and Livelihoods initiative. To learn more, visit The saving lives and livelihoods page or  https://africacdc-comm.org/ .

  Distributed by  African Media Agency .

Media contact: Carême Kouamé [email protected]

The post Bias-driven travel bans are an ineffective response to variants appeared first on African Media Agency .

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• Published: 25 June 2024

Short- and long-term neuropsychiatric outcomes in long COVID in South Korea and Japan

• Sunyoung Kim 1   na1 ,
• Hayeon Lee   ORCID: orcid.org/0009-0000-2403-6241 2 , 3   na1   na2 ,
• Jinseok Lee   ORCID: orcid.org/0000-0002-8580-490X 2 ,
• Seung Won Lee   ORCID: orcid.org/0000-0001-5632-5208 4 ,
• Rosie Kwon 3 ,
• Min Seo Kim   ORCID: orcid.org/0000-0003-2115-7835 5 ,
• Ai Koyanagi 6 ,
• Lee Smith   ORCID: orcid.org/0000-0002-5340-9833 7 ,
• Guillaume Fond   ORCID: orcid.org/0000-0003-3249-2030 8 ,
• Laurent Boyer 8 ,
• Masoud Rahmati   ORCID: orcid.org/0000-0003-4792-027X 8 , 9 , 10 ,
• Guillermo F. López Sánchez   ORCID: orcid.org/0000-0002-9897-5273 11 ,
• Elena Dragioti 12 , 13 ,
• Samuele Cortese 14 , 15 , 16 , 17 , 18 ,
• Ju-Young Shin 19 ,
• Ahhyung Choi 19 ,
• Hae Sun Suh 20 , 21 ,
• Sunmi Lee 22 ,
• Marco Solmi   ORCID: orcid.org/0000-0003-4877-7233 23 , 24 , 25 , 26 ,
• Chanyang Min 3 ,
• Jae Il Shin   ORCID: orcid.org/0000-0003-2326-1820 27 , 28   na2 ,
• Dong Keon Yon   ORCID: orcid.org/0000-0003-1628-9948 3 , 20 , 21 , 29   na2 &
• Paolo Fusar-Poli 30 , 31 , 32 , 33  

Nature Human Behaviour ( 2024 ) Cite this article

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• Epidemiology
• Risk factors

We investigated whether SARS-CoV-2 infection is associated with short- and long-term neuropsychiatric sequelae. We used population-based cohorts from the Korean nationwide cohort (discovery; n  = 10,027,506) and the Japanese claims-based cohort (validation; n  = 12,218,680) to estimate the short-term (<30 days) and long-term (≥30 days) risks of neuropsychiatric outcomes after SARS-CoV-2 infection compared with general population groups or external comparators (people with another respiratory infection). Using exposure-driven propensity score matching, we found that both the short- and long-term risks of developing neuropsychiatric sequelae were elevated in the discovery cohort compared with the general population and those with another respiratory infection. A range of conditions including Guillain-Barré syndrome, cognitive deficit, insomnia, anxiety disorder, encephalitis, ischaemic stroke and mood disorder exhibited a pronounced increase in long-term risk. Factors such as mild severity of COVID-19, increased vaccination against COVID-19 and heterologous vaccination were associated with reduced long-term risk of adverse neuropsychiatric outcomes. The time attenuation effect was the strongest during the first six months after SARS-CoV-2 infection, and this risk remained statistically significant for up to one year in Korea but beyond one year in Japan. The associations observed were replicated in the validation cohort. Our findings contribute to the growing evidence base on long COVID by considering ethnic diversity.

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Long COVID prevalence and impact on quality of life 2 years after acute COVID-19

Features of acute COVID-19 associated with post-acute sequelae of SARS-CoV-2 phenotypes: results from the IMPACC study

A nationwide questionnaire study of post-acute symptoms and health problems after SARS-CoV-2 infection in Denmark

Data availability.

The datasets analysed during the current study are available from the NHIS, South Korea ( https://nhiss.nhis.or.kr/bd/ab/bdaba000eng.do ) and the JMDC, Japan ( https://www.jmdc.co.jp/en/jmdc-claims-database/ ). This protects the confidentiality of the data and ensures that information governance is robust. Applications to access health data in South Korea should be submitted to the NHIS, South Korea. Information can be found at https://nhiss.nhis.or.kr/bd/ab/bdaba000eng.do . Applications to access health data in Japan should be submitted to the JMDC, Japan. Information can be found at https://www.jmdc.co.jp/en/jmdc-claims-database/ .

Code availability

This study did not generate new or customized code or algorithms. The statistical analyses were performed using SAS (version 9.4; SAS Institute Inc.) for big-data analysis. The code used in the analysis is available from the corresponding author upon request.

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Acknowledgements

This study used the database of the KDCA and the NHIS for policy and academic research. The research number of this study is KDCA-NHIS-2022-1-632 in South Korea and PHP-00002201-04 in Japan. This research was supported by a grant from the National Research Foundation of Korea funded by the Korean government (MSIT; no. RS-2023-00248157; D.K.Y.) and the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (no. HI22C1976; D.K.Y.). The research was supported by a grant (no. 21153MFDS601; D.K.Y.) from the Ministry of Food and Drug Safety in 2024. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. S.C., NIHR Research Professor (NIHR303122) is funded by the NIHR for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care. S.C. is also supported by NIHR grants NIHR203684, NIHR203035, NIHR130077, NIHR128472, RP-PG-0618-20003 and by grant 101095568-HORIZONHLTH- 2022-DISEASE-07-03 from the European Research Executive Agency.

Author information

These authors contributed equally: Sunyoung Kim, Hayeon Lee.

These authors jointly supervised this work: Hayeon Lee, Jae Il Shin, Dong Keon Yon.

Authors and Affiliations

Department of Family Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea

Sunyoung Kim

Department of Biomedical Engineering, Kyung Hee University, Yongin, South Korea

Hayeon Lee & Jinseok Lee

Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea

Hayeon Lee, Rosie Kwon, Chanyang Min & Dong Keon Yon

Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea

Seung Won Lee

Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA

Min Seo Kim

Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain

Ai Koyanagi

Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK

Research Centre on Health Services and Quality of Life, Assistance Publique-Hôpitaux de Marseille, Aix Marseille University, Marseille, France

Guillaume Fond, Laurent Boyer & Masoud Rahmati

Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran

Masoud Rahmati

Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran

Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain

Guillermo F. López Sánchez

Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden

Elena Dragioti

Research Laboratory Psychology of Patients, Families and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece

Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK

Samuele Cortese

Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK

Solent NHS Trust, Southampton, UK

Child Study Center, Hassenfeld Children’s Hospital at NYU Langone, NYU Langone, New York, NY, USA

Department of Precision and Regenerative Medicine and Jonic Area, University of Bari ‘Aldo Moro’, Bari, Italy

School of Pharmacy, Sungkyunkwan University, Suwon, South Korea

Ju-Young Shin & Ahhyung Choi

Department of Regulatory Science, Kyung Hee University Graduate School, Seoul, South Korea

Hae Sun Suh & Dong Keon Yon

Institute of Regulatory Innovation through Science, Kyung Hee University College of Pharmacy, Seoul, South Korea

Department of Applied Mathematics, Kyung Hee University, Yongin, South Korea

Department of Psychiatry, SCIENCES lab, University of Ottawa, Ottawa, Ontario, Canada

Marco Solmi

On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, Ottawa Hospital, Ottawa, Ontario, Canada

Ottawa Hospital Research Institute Clinical Epidemiology Program, University of Ottawa, Ottawa, Ontario, Canada

Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany

Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea

Jae Il Shin

Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, South Korea

Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea

Dong Keon Yon

Early Psychosis: Interventions and Clinical-Detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

Paolo Fusar-Poli

Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy

Outreach and Support in South-London Service, South London and Maudlsey NHS Foundation Trust, London, UK

Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University of Munich, Munich, Germany

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Contributions

D.K.Y. had full access to all of the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. All authors approved the final version before submission. Study concept and design: S.K., H.L., C.M., J.I.S. and D.K.Y. Acquisition, analysis or interpretation of data: S.K., H.L., C.M., J.I.S. and D.K.Y. Drafting of the paper: S.K., H.L., C.M., J.I.S. and D.K.Y. Critical revision of the paper for important intellectual content: S.K., H.L., J.L., S.W.L., R.K., M.S.K., A.K., L.S., G.F., L.B., M.R., G.F.L.S., E.D., S.C., J.-Y.S., A.C., H.S.S., S.L., M.S., C.M., J.I.S., D.K.Y. and P.F.-P. Statistical analysis: S.K., H.L., C.M., J.I.S. and D.K.Y. Study supervision: D.K.Y. and P.F.-P. P.F.-P and D.K.Y. are the senior authors. H.L., J.I.S. and D.K.Y. contributed equally as corresponding authors. S.K. and H.L. contributed equally as first authors. D.K.Y. is the guarantor for this study. The corresponding authors attest that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

Corresponding authors

Correspondence to Hayeon Lee , Jae Il Shin or Dong Keon Yon .

Ethics declarations

Competing interests.

M.S. received honoraria or has been a consultant for AbbVie, Angelini, Lundbeck and Otsuka. P.F.-P. is supported by #NEXTGENERATIONEU, funded by the Ministry of University and Research, National Recovery and Resilience Plan, project MNESYS (PE0000006)—A Multiscale Integrated Approach to the Study of the Nervous System in Health and Disease (DN. 1553 11.10.2022). S.C. has declared reimbursement for travel and accommodation expenses from the Association for Child and Adolescent Central Health (ACAMH) in relation to lectures delivered for ACAMH, the Canadian AADHD Alliance Resource, the British Association of Psychopharmacology, and from Healthcare Convention for educational activity on ADHD, and has received honoraria from Medice. The other authors declare no competing interests.

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Kim, S., Lee, H., Lee, J. et al. Short- and long-term neuropsychiatric outcomes in long COVID in South Korea and Japan. Nat Hum Behav (2024). https://doi.org/10.1038/s41562-024-01895-8

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Australian Journal of General Practice

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July 2024 correspondence

The views expressed by the authors of articles in the Australian Journal of General Practice are their own and not those of the publisher or the editorial staff and should not be quoted as such.

Should we now discuss possible COVID-19 vaccine negative effectiveness?

Commendations are due to AJGP and Professor Robert Tindle for their recent article published in the April 2024 issue, including the bold statement: ‘Because COVID-19 vaccines were approved without long-term safety data and might cause immune dysfunction, it is perhaps premature to assume that past SARS-CoV-2 infection is the sole common factor in long COVID’. 1 The possibility that long COVID could be related to the vaccines is important, but the focus here is on the notion that the vaccines could cause some sort of immunosuppression, especially, as noted by Professor Tindle, since the spike protein ‘exhibits pathogenic characteristics’ – to say nothing of the ‘class switch to IgG4 antibodies’, which Professor Tindle thinks could lead to autoimmunity and cancer. I have speculated as much, noticing many data sets indicating that not only does COVID-19 vaccine effectiveness appear to decline very rapidly (varyingly for infections, hospitalisations and even deaths), it can reach zero (no effectiveness), and beyond (negative effectiveness).

For example, a recent The Lancet Regional Health paper states: ‘Compared to a waned third dose, fourth dose VE [vaccine effectiveness] was 13.1% (95% CI 0.9 to 23.8) overall; 24.0% (95% CI 8.5 to 36.8) in the first two months post-vaccination, reducing to 10.3% (95% CI −11.4 to 27.8) and 1.7% (95% CI −17.0 to 17.4) at two to four and four to six months, respectively’. 2 Given the wide confidence intervals, these latter figures could be negative. A study by Shrestha et al found each vaccine dose was associated with a higher number of infections, with those on zero doses faring best. 3 A study published in the New England Journal of Medicine found vaccine effectiveness dropping dramatically, including for severe COVID, with the previously infected and unvaccinated having lower infection rates than the never-infected double dosed. 4 And a British study revealed the effectiveness of one to two doses of AstraZeneca and Pfizer vaccines dropping to zero, and turning negative, after only two to three months. 5 There is much more in the literature; word count prevents me from listing all such evidence.

Relatively few articles dare to explicitly discuss the phenomenon of perceived COVID-19 vaccine negative effectiveness, though Monge et al at least acknowledged it and tried to explain it away with a hypothesis around some selection bias. 6 A British Medical Journal (BMJ) rapid response listed some of the evidence for this disturbing phenomenon, and called for further research. 7 Furthermore, an unofficial ‘series’ of four articles, involving Peter Doshi, in the Journal of Evaluation in Clinical Practice , the last of which was published this year, indicates that issues with counting windows have likely led to exaggerations of COVID-19 vaccine effectiveness and safety estimates, for both the clinical trials and later observational studies. 8 Finally, in contrast to Monge et al, a new Czech study by Fürst et al found strong evidence for the healthy vaccinee effect; 9 this also seems to be evident in the recent and much-publicised Australian study promoting booster shots, which revealed an uncharacteristically high unvaccinated rate in elderly Australian aged care residents. 10

All this makes it plausible that the COVID-19 vaccines have always had an effectiveness that was very low, zero, or even negative, with inadequate methods allowing for a highly exaggerated effectiveness initially – an exaggeration that is lessened with time. It is, as Professor Tindle noted, possible that the vaccines could be causing immunosuppression. With the ubiquitousness of the vaccines, and the fact that some vaccine mandates are still in place, to say nothing of the upcoming Senate inquiry into excess mortality, 11 I suggest we investigate this further.

Raphael Lataster BPharm, PhD, Associate Lecturer, FASS, University of Sydney, Sydney, NSW

Competing interests: None.

• Tindle R. Long COVID: Sufferers can take heart. Aust J Gen Pract 2024;53(4):238–40. doi: 10.31128/AJGP-07-23-6896 .
• Kirwan PD, Hall VJ, Foulkes S, et al; SIREN Study Group. Effect of second booster vaccinations and prior infection against SARS-CoV-2 in the UK SIREN healthcare worker cohort. Lancet Reg Health Eur 2023;36:100809. doi: 10.1016/j.lanepe.2023.100809 .
• Shrestha NK, Burke PC, Nowacki AS, Simon JF, Hagen A, Gordon SM. Effectiveness of the coronavirus disease 2019 bivalent vaccine. Open Forum Infect Dis 2023;10(6):ofad209. doi: 10.1093/ofid/ofad209 .
• Goldberg Y, Mandel M, Bar-On YM, et al. Protection and waning of natural and hybrid immunity to SARS-CoV-2. N Engl J Med 2022;386(23):2201–12. doi: 10.1056/NEJMoa2118946 .
• Kerr S, Bedston S, Bradley DT, et al. Waning of first- and second-dose ChAdOx1 and BNT162b2 COVID-19 vaccinations: A pooled target trial study of 12.9 million individuals in England, Northern Ireland, Scotland and Wales. Int J Epidemiol 2023;52(1):22–31. doi: 10.1093/ije/dyac199 .
• Monge S, Pastor-Barriuso R, Hernán MA. The imprinting effect of covid-19 vaccines: An expected selection bias in observational studies. BMJ 2023;381:e074404. doi: 10.1136/bmj-2022-074404 .
• Lataster R. We need proper explanations for apparent COVID-19 vaccine negative effectiveness. BMJ 2023;381. Available at www.bmj.com/content/381/bmj-2022-074404/rr-0 [Accessed 24 May 2025].
• Lataster R. How the adverse effect counting window affected vaccine safety calculations in randomised trials of COVID-19 vaccines. J Eval Clin Pract 2024;30(3):453–58. doi: 10.1111/jep.13962 .
• Fürst T, Bazalová A, Fryčák T, Janošek J. Does the healthy vaccinee bias rule them all? Association of COVID-19 vaccination status and all-cause mortality from an analysis of data from 2.2 million individual health records. Int J Infect Dis 2024;142:106976. doi: 10.1016/j.ijid.2024.02.019 .
• Lin L, Demirhan H, P Johnstone-Robertson S, Lal R, M Trauer J, Stone L. Assessing the impact of Australia’s mass vaccination campaigns over the Delta and Omicron outbreaks. PLoS One 2024;19(4):e0299844. doi: 10.1371/journal.pone.0299844 .
• Parliament of Australia. Excess mortality. Parliament of Australia, 2024. Available at www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/ExcessMortality47 [Accessed 24 May 2024].

We read with interest Professor Robert Tindle’s recent Viewpoint article published in the AJGP April 2024 issue that rightly draws attention to the plight of long COVID sufferers, and the need to better understand the condition’s aetiology, clinical course, management and to tailor care. 1 However, we write to provide evidence to counter the unsubstantiated assertions that COVID-19 vaccination is causally associated with long COVID.

COVID-19 vaccination has saved millions of lives and reduced morbidity and mortality from SARS-CoV-2 worldwide, including in Australia. 2–4 Additionally, COVID-19 vaccine boosters continue to provide protection against serious disease and death, particularly in people at highest risk such as the elderly. 5,6 Like any vaccine, there are expected and common self-resolving side effects, such as muscle aches, fatigue and fever in some recipients; such events have been extremely well studied in the largest body of clinical trials ever seen and continue to be closely monitored using active surveillance in Australia. 7

Importantly, to understand whether vaccines cause any adverse event, detailed epidemiological studies of association, as well as biological plausibility, are needed. To date, extensive studies of a range of potential adverse events have shown only a few very rare types of events are linked to COVID-19 vaccines. These include myocarditis following mRNA vaccines, pericarditis following mRNA and adjuvanted protein subunit vaccines, and vaccine-induced thrombosis thrombocytopenia syndrome following viral vector vaccines that are no longer used in Australia. 8–10 Multicountry studies, involving hundreds of thousands of people, continue to be conducted to examine a range of health outcomes. 11

Professor Tindle’s discussion failed to cite the extensive body of evidence demonstrating that vaccination protects against long COVID. This includes at least four systematic reviews of more than 40 individual studies. 12–15 Further, more recently published studies 16–19 using primary care electronic health records to ascertain long COVID diagnoses were conducted across five countries (UK, Spain, Norway, Estonia, USA) during circulation of SARS-CoV-2 pre-Omicron and Omicron variants. These studies included more than 25 million adults and over one million children. Collectively, the systematic reviews and other high-quality publications indicate that COVID-19 vaccination reduces the risk of long COVID and post-COVID-19 conditions by approximately 30–50%. Protection is evident for both primary vaccination and boosters. Although the precise mechanism by which SARS-CoV-2 infection leads to long COVID is not known and the condition is likely multifactorial, the prevention of post-COVID‑19 conditions by vaccination might occur through either or both of prevention of infection and mitigating the impact and severity of breakthrough infection.

Alongside Professor Tindle, we fully support the need for further high-quality data collection and research into long COVID, as recommended by the Australian Parliamentary Inquiry. 20 We also appreciate the importance of conducting and transparently sharing surveillance and vaccine safety data; however, we emphasise that great responsibility is needed for all healthcare professionals to draw on the most robust scientific evidence available.

General practitioners (GPs) and practice nurses are critical partners in vaccination, distilling complex information into guidance for their patients on the benefits and risks of specific vaccines during shared decision making. With misinformation and vaccine hesitancy increasing globally and locally, 21 we suggest that trusted clinical guidelines developed by expert groups, such as those contained in the Australian Immunisation Handbook, are relied upon by GPs in their quality practice. 22

Bette Liu MBBS, MPH, DPhil, Associate Director, National Centre for Immunisation Research and Surveillance, Sydney, NSW; Clinical Professor, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW; Associate Professor, School of Population Health, UNSW, Sydney, NSW

Penelope Burns BMed, MPHTM, PhD, Associate Professor, Academic Department of General Practice, The Australian National University, Canberra, ACT; Conjoint Senior Lecturer, School of Medicine, Western Sydney University, Sydney, NSW; General Practitioner, Northern Beaches Hospital Medical Centre, Northern Sydney, NSW

Shireen Durrani MBChB, MPP, MSc, FAFPHM, Senior Medical Officer, National Centre for Immunisation Research and Surveillance, Sydney, NSW

Nicholas Silberstein FRACGP, MFam Med, DTM&H, General Practitioner, Thorneharbour Health, Melbourne, Vic; General Practitioner, Turn the Corner Medical Clinic, Melbourne, Vic

Ben Smith BMedSci, MBBS, DCH, FRACP, Senior Medical Office, National Centre for Immunisation Research and Surveillance, Sydney, NSW; Clinical Lecturer, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW

Kristine Macartney MBBS (Hons), BMedSci, Dip Paeds, MD, FRACP, FAHMS, Director, National Centre for Immunisation Research and Surveillance, Sydney, NSW; Professor, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW; Infectious Diseases Specialist Clinician, The Children’s Hospital Westmead (CHW), Sydney, NSW

Competing interests: KM works for the National Centre for Immunisation Research and Surveillance Australia (NCIRS). NCIRS is funded by the Australian Government Department of Health and Aged Care and Department of Foreign Affairs and Trade. She also receives grant funding from the National Health and Medical Research Council (NHMRC) and the Medical Research Future Fund (MRFF), has been a past expert witness for in-court proceedings brought against two Australian state health departments on public health pandemic response measures, has received past funding (<$5000) from independent conference organisations for travel/registration for vaccine conferences (no pharmaceutical funding accepted) and is a past Data Safety and Monitoring Board member for vaccine trials sponsored by The University of Melbourne and by PATH. BL received grant funding from the NHMRC and MRFF for research into the post-acute sequelae of COVID-19. All other authors have no competing interests to declare.

• Tindle R. Long COVID: Sufferers can take heart. Aust J Gen Pract 2024;53(4):238–40. doi: 10.31128/AJGP-07-23-6896.
• The WHO European Respiratory Surveillance Network. Estimated number of lives directly saved by COVID-19 vaccination programs in the WHO European Region, December 2020 to March 2023. medRxiv 2024. doi: 10.1101/2024.01.12.24301206.
• Liu B, Stepien S, Dobbins T, et al. Effectiveness of COVID-19 vaccination against COVID-19 specific and all-cause mortality in older Australians: A population based study. Lancet Reg Health West Pac 2023;40:100928. doi: 10.1016/j.lanwpc.2023.100928.
• Link-Gelles R, Ciesla AA, Mak J, et al. Early estimates of updated 2023-2024 (Monovalent XBB.1.5) COVID-19 vaccine effectiveness against symptomatic SARS-CoV-2 infection attributable to co-circulating Omicron variants among immunocompetent adults - Increasing community access to testing program, United States, September 2023-January 2024. MMWR Morb Mortal Wkly Rep 2024;73(4):77–83. doi: 10.15585/mmwr.mm7304a2.
• UK Health Security Agency. COVID-19 vaccine surveillance report: Week 4. UK Health Security Agency, 2024. Available at https://assets.publishing.service.gov.uk/media/65b3c8a3c5aacc000da683d3/vaccine-surveillance-report-2024-week-4.pdf . [Accessed 15 April 2024].
• AusVaxSafety, An NCIRS led collaboration. COVID-19 vaccine safety data. NCIRS, Kids Research, 2024. Available at https://ausvaxsafety.org.au/ [Accessed 15 April 2024].
• Karlstad Ø, Hovi P, Husby A, et al. SARS-CoV-2 vaccination and myocarditis in a nordic cohort study of 23 million residents. JAMA Cardiol 2022;7(6):600–12. doi: 10.1001/jamacardio.2022.0583 .
• Dag Berild J, Bergstad Larsen V, Myrup Thiesson E, et al. Analysis of thromboembolic and thrombocytopenic events after the AZD1222, BNT162b2, and MRNA-1273 COVID-19 vaccines in 3 nordic countries. JAMA Netw Open 2022;5(6):e2217375. doi: 10.1001/jamanetworkopen.2022.17375 .
• National Academies of Sciences, Engineering, and Medicine. Evidence review of the adverse effects of COVID-19 vaccination and intramuscular vaccine administration. The National Academies Press, 2024. Available at https://nap.nationalacademies.org/catalog/27746/evidence-review-of-the-adverse-effects-of-covid-19-vaccination-and-intramuscular-vaccine-administration [Accessed 23 April 2024].
• Faksova K, Walsh D, Jiang Y, et al. COVID-19 vaccines and adverse events of special interest: A multinational Global Vaccine Data Network (GVDN) cohort study of 99 million vaccinated individuals. Vaccine 2024;42(9):2200–11. doi: 10.1016/j.vaccine.2024.01.100 .
• Marra AR, Kobayashi T, Callado GY, et al. The effectiveness of COVID-19 vaccine in the prevention of post-COVID conditions: A systematic literature review and meta-analysis of the latest research. Antimicrob Steward Healthc Epidemiol 2023;3(1):e168. doi: 10.1017/ash.2023.447 .
• Watanabe A, Iwagami M, Yasuhara J, Takagi H, Kuno T. Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis. Vaccine 2023;41(11):1783–90. doi: 10.1016/j.vaccine.2023.02.008 .
• UK Health Security Agency. The effectiveness of vaccination against long COVID. UK Health Security Agency, 2022. Available at https://assets.publishing.service.gov.uk/media/65020e0097d3960014482e47/The-effectiveness-of-vaccination-against-long-COVID-a-rapid-evidence-briefing.pdf [Accessed 15 April 2024].
• Byambasuren O, Stehlik P, Clark J, Alcorn K, Glasziou P. Effect of covid-19 vaccination on long covid: Systematic review. BMJ Med 2023;2(1):e000385. doi: 10.1136/bmjmed-2022-000385 .
• Català M, Mercadé-Besora N, Kolde R, et al. The effectiveness of COVID-19 vaccines to prevent long COVID symptoms: Staggered cohort study of data from the UK, Spain, and Estonia. Lancet Respir Med 2024;12(3):225–36. doi: 10.1016/S2213-2600(23)00414-9 .
• Trinh NTH, Jödicke AM, Català M, et al. Effectiveness of COVID-19 vaccines to prevent long COVID: Data from Norway. Lancet Respir Med 2024;12(5):e33–34. doi: 10.1016/S2213-2600(24)00082-1 .
• Lundberg-Morris L, Leach S, Xu Y, et al. Covid-19 vaccine effectiveness against post-covid-19 condition among 589 722 individuals in Sweden: Population based cohort study. BMJ 2023;383:e076990. doi: 10.1136/bmj-2023-076990 .
• Razzaghi H, Forrest CB, Hirabayashi K, et al; RECOVER CONSORTIUM. Vaccine effectiveness against long COVID in children. Pediatrics 2024;153(4):e2023064446. doi: 10.1542/peds.2023-064446 .
• Parliament of Australia. Sick and tired: Casting a long shadow. Report – April 2023. Parliament of Australia, 2023. Available at www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/LongandrepeatedCOVID/Report [Accessed 15 April 2024].
• Larson HJ, Gakidou E, Murray CJL. The Vaccine-hesitant moment. N Engl J Med 2022;387(1):58–65. doi: 10.1056/NEJMra2106441 .
• Australian Government, Department of Health and Aged Care. The Australian Immunisation Handbook. Australian Government, Department of Health and Aged Care, 2024. Available at https://immunisationhandbook.health.gov.au/ [Accessed 26 May 2024].

I am grateful for the valuable insights shared by Professor Robert Tindle in his article ‘Long COVID: Sufferers can take heart’, published in the AJGP April 2024 issue. 1 Of most importance is the understanding of the pathogenic nature of the COVID-19 spike protein – found both in the COVID-19 vaccines and the COVID-19 virus. This view is also supported by other Australian academics and has been termed ‘spikeopathy’. 2

Professor Tindle’s concerns about ‘Long Vax(x)’ very much echo conditions I have observed working as a general practitioner. I have seen patients present with long COVID symptoms post COVID-19 vaccine without prior COVID-19 infection. I have also observed patients with long COVID that has been acquired post COVID-19 infection, who have experienced a worsening of their symptoms post COVID-19 vaccination. This is consistent with studies that have shown a worsening of symptoms in 21% 3 to 31% 4 of long COVID sufferers post COVID-19 vaccination. Although the remainder of patients in these trials experience either improvement or no change in their long COVID symptoms, it leaves the patient in a Russian roulette-type scenario when they are already barely functioning.

Although Professor Tindle lauded the availability of antivirals, more recently, access to antiviral treatments was tightened. 5 Access to early antiviral therapy might help prevent long COVID cases and assist long COVID sufferers’ worsening in the setting of repeat infections; however, the Pharmaceutical Benefit Scheme (PBS) criteria do not include this vulnerable group. Many long COVID sufferers struggle to work and cannot afford the $1000 non-PBS fee.

I have personally suffered from a COVID-19 vaccine injury leading to dysautonomia, small fibre neuropathy, thyroiditis and mast cell activation syndrome (MCAS). Subsequent COVID-19 infections worsened these conditions and contributed to Epstein–Barr Virus (EBV) reactivation. These personal challenges have given me insights I would not have otherwise had into the numerous immunological effects of the manufactured vaccine spike protein.

I do take heart in the growing awareness of the complications of COVID-19 infection and vaccination, and the role that spike protein plays in both. Understanding of ‘spikeopathy’ will assist with safer vaccines and more effective treatments for long COVID and vaccine injuries.

Lucia Murnane MBBS, FRACGP, MReproMed, DCH, GradDipBioethics, General Practitioner, Melbourne, Vic

• Parry PI, Lefringhausen A, Turni C, et al. ‘Spikeopathy’: COVID-19 spike protein is pathogenic, from both virus and vaccine mRNA. Biomedicines 2023;11(8):2287. doi: 10.3390/biomedicines11082287 .
• Tsuchida T, Hirose M, Inoue Y, Kunishima H, Otsubo T, Matsuda T. Relationship between changes in symptoms and antibody titers after a single vaccination in patients with Long COVID. J Med Virol 2022;94(7):3416–20. doi: 10.1002/jmv.27689 .
• Scherlinger M, Pijnenburg L, Chatelus E, et al. Effect of SARS-CoV-2 vaccination on symptoms from post-acute sequelae of COVID-19: Results from the nationwide VAXILONG study. Vaccines (Basel) 2021;10(1):46. doi: 10.3390/vaccines10010046 .
• Australian Government Department of Health and Aged Care. Eligibility for oral COVID-19 treatments. Australian Government Department of Health and Aged Care, updated 2024. Available at www.health.gov.au/health-alerts/covid-19/treatments/eligibility [Accessed 1 May 2024].

My viewpoint article, published in the AJGP April 2024 issue, 1 addresses aspects of long COVID involving medical practitioners, health administrators, support systems and sufferers. I thank the three correspondents, (hereafter designated as Drs Lataster, Liu et al and Murnane), for their insightful comments.

Vaccine efficacy

The correspondents address the efficacy of COVID-19 vaccines for primary SARS-CoV-2 infection and disease, long COVID and putative vaccine adverse effects.

The fact that Drs Lataster and Liu et al differ in their perspectives of vaccine efficacy reflects the unease felt in sectors of the medical and scientific community. It is undeniable that there is a persuasive counternarrative to the ‘safe and effective’ 2 mantra that has accompanied the promulgation of COVID-19 mRNA and adenovirus DNA vaccines.

The perspective that primary doses of nucleic-acid vaccines encoding the SARS-CoV-2 spike protein have been effective in reducing hospitalisation and deaths during the COVID-19 pandemic is confounded by postulated overstating of the results due to selection bias, and case counting window concerns, 3,4 as Dr Lataster notes.

The threat of a prescient COVID-19 pandemic drove the acceptance of only short-term, placebo-controlled trial data as being sufficiently reliable to mass vaccinate (major pharmaceutical companies producing COVID-19 vaccines eventually vaccinated almost all placebo subjects, ostensibly for fear of COVID-19 infection, and lost their control groups 5 ). The shortcomings to scientific integrity are now recognised. 6

Other studies have indicated a negative effect of supernumerary vaccine dosing in the event of a new strain (Omicron) arising. 7 Efficacy waned until it was lower among those receiving a booster than those with only primary immunisation, likely due to immunological imprinting gearing the immune response to a pre-Omicron challenge. 7

A proper explanation is needed for purported limitations in COVID-19 vaccine effectiveness. All-in-all, a ‘back-to-first principles’ analysis of vaccine efficacy is apposite.

Do vaccines protect against long COVID?

In view of the association of COVID-19 vaccination with postural orthostatic tachycardia syndrome (POTS) onset, it is appropriate that Drs Liu et al draw to attention the evidence derived from a meta-analysis of large datasets suggesting vaccination protects against long COVID (refer to references 10–13 in the letter by Drs Liu et al). However, Edwards and Hamilton 8 commenting on the review by Byambasuren et al, 9 which lists 17 observational studies, 12 looking at the effect of vaccination before COVID-19 infection and five looking at the effect after COVID-19 infection, noted ‘many studies used symptoms coded by the International Classification of Diseases, 10th revision (ICD-10), rather than patient-reported symptoms of long COVID’. Although this approach allows large datasets to be analysed remotely, we cannot assume that an ICD-10 code reflects the lived experience of patients with long COVID. Another limitation was inconsistency in the long COVID definition between the studies, and whether a definition was provided at all. Differing duration of symptoms of long COVID can represent a different disease syndrome to that captured in the World Health Organization’s definition. 10 Additionally, as with many observational studies on vaccination, the study had clear potential confounders, with those patients who take up vaccination being generally healthier than those who do not (the so-called healthy vaccine effect)’. The lack of consensus diagnostic criteria or standardised outcome measures are exacerbated by the recent determination of long COVID heterogeneity defined by serum proteomic profiles and specific inflammatory pathways. 11 Similar concerns pertain to the other dataset reviews cited by Drs Liu et al in support of vaccination preventing long COVID.

The salient point is that a resolution of the issues around vaccine efficacy remains paramount.

Vaccine adverse effects

Drs Liu et al point to evidence derived largely from multicountry, meta-analysis of data that vaccination with COVID-19 vaccines has few serious pathological sequelae (myocarditis, pericarditis, thrombosis with thrombocytopenia syndrome [TTS]) (refer to references 7–9 in the letter by Drs Liu et al). This approach to demonstrate relative safety raises concerns. It involves heterogeneity in data collection, quality and reporting standards across participating countries, varied vaccination strategies, differing prioritisation of vaccine recipients and difference in pre-existing health conditions. In lumping together vaccine recipients of all ages, safety signals are ignored or underreported in some subgroups (eg in men aged <40 years receiving two or more doses of vaccine). 12 Adverse events do not affect all populations equally. Subclinical adverse events might not appear in electronic records, or adverse events might be misinterpreted in an absence of intensive investigation. 13

Meanwhile, spike protein pathogenicity, whether originating from vaccine nucleic acid or from SARS-CoV-2 infection, is being unravelled by molecular biology and pathophysiology investigations. 13 Studies support ‘unprecedented high rates of adverse events’ and cite ‘evidence for widespread harms of… COVID-19 mRNA and adenovector DNA vaccines’. 14

Adverse event data from official pharmacovigilance databases underestimate the rates of serious adverse events (SAE) five- to 100-fold. 15

A re-analysis of the of the Pfizer and Moderna phase III trials (posted at www.clinicaltrials.gov ) showed the vaccines caused serious adverse events in comparison to a placebo. 16

A Food and Drug Administration (FDA)–Pfizer report derived via freedom of information showed high rates of, and multiple organ systems affected by, toxicity issues not taken into account in deliberations culminating in market approval of the genetic vaccines ostensibly because they were treated as conventional vaccines (ie protein/peptide + adjuvant) and not as prodrugs. 14

In light of these conflicting views, it is encouraging that a deep dive into the pathological and immunological sequelae of long-term persistence of spike protein mRNA and its protein products continues to gather pace (summarised in reference 14).

Recent studies are particularly relevant. Patterson et al report that the S1 and S2 spike proteins persist for many months in SARS-CoV-2-negative, post-COVID-19 vaccine recipients with post-acute sequelae of COVID-19 (PASC). 17 The amount of spike protein from the vaccine is likely many fold greater than that from infection with virus because of stability mutations introduced into the vaccine mRNA, and the tissue penetrance of spike protein mRNA into a far more diverse set of tissues than infection. 18

Spike protein toxicity has been demonstrated in multiple studies, 19 and damage occurs in various tissues (primarily neurological, cardiovascular and reproductive).

Binding of the S1 spike protein to sialylated glycan-rich erythrocytes, platelets and endothelial cells triggers blood clotting and related morbidities. 20 Prolonged exposure predisposes to clonal deletion or anergy of cognate immune response CD4 and CD8 T-cells and underlies the IgG1-to-(non-neutralising) IgG4 antibody class switch, which also induces immune tolerance through various pathways including induction of immunosuppressive cytokines and perturbation of complement function. 21 Spike protein is a novel intracellular ‘foreign antigen’ processed through the major histocompatibility complex class 1 pathway for ‘non-self’ recognition, ergo, autoimmunity.

The carrier for synthetic mRNA vaccines, lipid nanoparticles, itself can be toxic and can translocate across cellular barriers allowing access to multiple tissues including the brain. 22

As it is becoming clear that the SARS-CoV-2 spike protein is pathogenic, whether derived from the virus or derived from the mRNA and adenovector DNA vaccine, one might be persuaded that the ‘more-is-better’ approach applied to traditional peptide/protein vaccines might be quintessentially flawed when applied to boosting with nucleic acid vaccines.

Overall, there are lingering concerns that a sober evaluation of COVID-19 vaccine effectiveness and safety has not been made. On both these issues, informed opinions are poles apart, and there is scant evidence of a continuum between them. The issue will not be resolved until the science is understood. This is a less-than-satisfactory scenario in which to recommend COVID-19 vaccination for everyone eligible for prevention of primary SARS-CoV-2 infection and disease, and for its application to long COVID.

Concerns among health providers and sufferers

Dr Murnane expresses one GP’s concerns about vaccination and spike protein-associated pathologies. Similar concerns have been echoed by other GPs in response to the Viewpoint article. For example,

(Long COVID is…) a huge problem and one for which the GP cohort has little to offer apart from supportive measures. Even the special Long COVID clinics are limited in the assistance they can provide to sufferers. The toll on lives and families is nothing short of a tragedy. I have no doubt now, having witnessed it, that long COVID can be a side effect of the COVID vaccination. (GP, Melbourne, Vic; R. Tindle pers. obs.)

…….. I had my alarm bells going from the very start but now you (and others) have confirmed what I knew. It is really making an impact amongst my patients who are alerting me to it as well as my colleague GPs… (GP, Sydney, NSW; R. Tindle pers. obs.)

Persecution of health practitioners by the Australian Health Practitioner Regulation Agency (AHPRA) for challenging the official governmental position on the COVID-19 pandemic response is alarming. As are the anecdotal reports of doctors under-reporting COVID-19 vaccine adverse events to the Database of Adverse Events Notifications (DAEN) for fear of reprisal (R. Tindle, pers. obs).

A rigorous qualitative analysis of the lived experiences of the large number of sufferers (including general practitioners [GPs] and other health professionals) on digital long COVID support platforms 23–25 reporting post-vaccination symptoms, which transcend the ‘few rare types of events … linked to COVID-19 vaccines (see the letter by Drs Liu et al)’ might add traction in the debate. Many sufferers report that their GPs had advised of a possible ‘Long Vax(x)’ aetiology of their condition (note that, until recently, posts implicating COVID-19 vaccines were removed by the site moderators).

A way forward

Open discussion, the very stuff of scientific enquiry, is stultified. It can only do harm to a timely understanding of how best the COVID-19 situation should be handled, of genetic vaccines, and of response to putative future pandemics.

Drs Lataster, Liu et al and Murnane contribute in important ways to this discussion.

Should trends in the emerging data persist, it is reasonable to ask whether the benefits of the current strategy for repetitive COVID-19 vaccination outweighs its risks for individual informed consent and for public policy. Not every age group demonstrates net harm (eg the elderly derive net benefit). But to recommend doing net harm in certain age groups (eg young men) is a questionable practice. It might be appropriate that the Federal Government’s proposal of repetitive vaccination for such groups 26 be revisited.

It is pertinent that in a parliamentary debate on 18 April 2024 in the UK House of Commons (in which the Viewpoint article 1 was cited), the motion was carried by the House for a ‘COVID-19 enquiry into vaccines and therapeutics as soon as possible’. It would be appropriate were the vaccine issue addressed in the forthcoming Commonwealth Government COVID-19 Response Inquiry 27 and/or by the proposed Australian Senate COVID-19 Royal Commission.

Robert Tindle PhD, Director (retired), Clinical Medical Virology Centre, Royal Children’s Hospital, Brisbane, Qld; Emeritus Professor in Immunology, Faculty of Science, University of Queensland, Brisbane, Qld

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