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Guam is offering COVID-19 vaccinations to American expats in Japan and other Asian countries, where vaccine rollouts are lagging behind the U.S. and most developed nations.

But if they are expecting a relaxing vacation that comes with vaccination, they may be disappointed. Travelers to the Pacific island, which has travel alerts in place and a rising number of coronavirus cases, will face challenges including quarantine protocols.

Launched earlier this month, the vaccination program — called “Air V&V,” using the initials of vaccination and vacation — aims to encourage Americans in Asia who may not have the same access to vaccines as those back home to visit Guam to get their COVID-19 shots.

Japan’s slow vaccination rollout has prompted many foreign residents to get shots in their home countries, where vaccines are more widely available. In Guam, authorities are aiming to vaccinate 80% of all eligible residents by July 21.

The Air V&V program applies to all Americans, including adolescents, with valid residency in Japan, Taiwan, Hong Kong and several other Asian countries.

Expatriates who travel to Guam can get any vaccine approved for use in the U.S. for free — Moderna, Pfizer-BioNTech and Johnson & Johnson — in line with the U.S. Centers for Disease Control (CDC) guidelines.

“This is about the best thing that could happen to Guam right now, with our proximity — we’re three-and-a-half hours away from Japan, Taiwan, Hong Kong. The Philippines, believe it or not, have 350,000 … expats there,” Guam Visitors Bureau (GVB) President Carl Gutierrez was quoted by local media outlets as saying on May 7. “Let’s get that market going, fill up the hotel rooms here, get the restaurants going.”

In the future, Guam is planning to introduce “vaccine tourism” — or allowing foreign tourists to be inoculated on the island.

Nevertheless, the Air V&V program is still being conducted on a small scale and was launched with an initial allotment of 1,500 doses.

Moreover, the expatriates will still be subjected to Guam’s quarantine policy upon arrival to the island, according to the GVB.

Under the existing policy, all incoming travelers need to quarantine at a government facility for 10 days. However, those who test negative for COVID-19 on the sixth day will only need to quarantine for seven days.

Travelers with proof of inoculation with vaccines authorized by the U.S. Food and Drug Administration will be exempt from the quarantine process.

The GVB is currently working with the island’s medical experts to enable travelers to get vaccinated while in quarantine, to shorten their time of stay.

The program was introduced before the CDC raised its travel advisory for the island to its most restrictive and highest, Level 4, warning Americans not to travel. According to the CDC, a Level 4 warning is issued when the incidence rate of COVID-19 cases is greater than 100 in the past 28 days and daily new cases have increased in that time frame.

In fact, visitors are advised to get fully vaccinated before traveling to the island.

Local media have reported that broader vaccine tourism would involve non-U.S. citizens getting inoculated at their own expense at private clinics.

Guam’s recovery task force has reportedly said that at least 50,000 doses will be required to allow for the vaccination of non-American tourists. Details are still under discussion, with the growth in infections in the region possibly adding to uncertainties.

After getting the jab, travelers would still need to self-quarantine for 14 days when they come back to Japan.

In Japan, vaccinations have started for older people and health-care workers but not yet for the general population.

As a result, U.S. citizens in Japan have been inquiring into the possibility of getting inoculated at U.S. military bases across Japan.

American Citizens Abroad, an advocacy group, has argued they should have the same rights to a vaccine as citizens back home, and they have requested that the government send surplus COVID-19 shots to embassies overseas.

While U.S. President Joe Biden has pledged to provide coronavirus vaccinations to every eligible American, it would be a logistical challenge to allocate vaccine doses to civilians overseas and would go against U.S. policy that such individuals rely on their local health system for medical care.

“We have not historically provided private health care for Americans living overseas, so that remains our policy,” White House Press Secretary Jen Psaki said last week. “But I don’t have anything to predict in terms of what may be ahead.”

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