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Can I go on a cruise if I'm not vaccinated?

Specific vaccine requirements vary cruise to cruise, but setting sail in 2021 without a COVID-19 shot is tricky business.

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Like many other businesses attempting to regain shape as we close out year two of a global pandemic, cruise lines have started setting sail again -- with some strict health measures put in place. That's because cruise ships, with their tight quarters, buffet-style living and international travel, can be a breeding ground for the coronavirus. As is true for most travel restrictions these days, your ability to book a cruise may depend on your vaccination status. If you chose not to get a COVID-19 vaccine, can you still go on a cruise?

Probably not, if you're an adult in the US, unless you're one of the few people with a medical exemption, or if you're not vaccinated for religious reasons (and whether or not you'll be offered an exemption depends on the cruise line). If your kid can't get a coronavirus vaccine right now, whether they'll be able to come along also depends on what cruise you want to take. 

Before you book -- and especially if you're looking at cruises setting sail months ahead -- it's important to consider the COVID-19 spread in countries or ports where your ship will stop, regardless of your vaccination status. It's also important to consider who's coming with you. For children under age 12 especially, the vaccine requirement for taking a cruise may change in the months ahead as Pfizer has asked the US Food and Drug Administration to authorize its vaccine in children ages 5 to 11. It is also possible, months from now, that cruise lines could lighten their COVID-19 measures and stop requiring proof of vaccination in passengers. Presently, many US-based cruise lines say they're following the regulations put forth by the US Centers for Disease Control and Prevention, which are subject to change as the coronavirus pandemic does.

But right now, here's what we know about cruising unvaccinated. 

What does 'fully vaccinated' mean?

It seems most cruise lines are following the CDC's definition of fully vaccinated, which means two weeks have passed since your second dose of a messenger RNA vaccine (Pfizer or Moderna) or two weeks have passed since your one-dose Johnson & Johnson shot. Some cruise lines say they will accept a mixed series of mRNA vaccine (one shot of Moderna, one shot of Pfizer) but fewer are likely to accept one shot of a viral vector vaccine, such as AstraZeneca, and one shot of an mRNA vaccine. This isn't likely to be an issue in the US, though, where the "mix and match" approach to COVID-19 vaccines hasn't been approved yet. But it's something to consider if you've been vaccinated in another country that allows a mixed series. 

Some cruise lines, such as Royal Caribbean and Norwegian Cruise Line, accept vaccines recommended or approved by the World Health Organization as well as the CDC. This includes vaccines such as AstraZeneca and Sinovac. See the full list of vaccines approved by the WHO here

Bottom line: If you've been vaccinated against COVID-19 outside of the US, check with your cruise line to make sure they accept your vaccine before putting any money down. Also, you don't need a booster or third dose of a COVID-19 vaccine to be considered fully vaccinated. 

Unvaccinated adults and vaccine exemptions

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All guests, regardless of vaccination status, should expect to be tested for COVID-19 prior to boarding a cruise ship. 

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Major cruise lines including Royal Caribbean, Princess, Disney, Carnival, Celebrity and Norwegian Cruise Line require COVID-19 vaccines for all people aged 12 and older. Everyone age 12 and older in the US, with limited exceptions, is able to get a COVID-19 vaccine right now. (Pfizer is authorized for kids ages 12 and up.) 

Some cruise lines state they'll accept medical exemptions, while others do not and it also might depend on the port. Carnival, for example, says it will accept some vaccine exemptions from those ages 12 and younger, as well as adults who have "written confirmation from their medical provider" that they can't be vaccinated at their Florida, Texas, Louisiana and Maryland ports until the end of the year. COVID-19 vaccine exemptions at Carnival's Long Beach, California port will only be accepted for kids under age 12 and when "required by US federal law" because of religious beliefs or medical reasons.

How long will the vaccine requirement be in place for cruise passengers? That's hard to say, because it depends on the state of the pandemic at any given time, as well as rules for cruise ships, including those from the CDC as well as other territories. Royal Caribbean, for example, says all guests aged 12 and older who are departing from Florida must be vaccinated because it's required by The Bahamas and St. Thomas governments. That requirement is planned to remain in effect until Nov. 1, 2021. 

Booking a cruise months out in the hope that cruise lines will lift their COVID-19 vaccine requirements might be risky, however. Norwegian Cruise Line, for example, explicitly says it won't give guidance for vaccines for cruises departing January 2022 because it's "premature" to offer guidance right now. 

"We will continue to evaluate our health and safety protocols and rely on science and our expert council as we make decisions and evolve our policies and procedures," Norwegian's website says. 

Putting it all together: If your cruise line is even accepting medical exemptions around a COVID-19 vaccine, presenting valid proof of the exemption to the cruise line is critical. So before you book, contact the cruise line to see if they'll accept an exemption and also look into the local laws of the land you'll be visiting if you're able to get off the ship for an excursion. Chances are, if you're unvaccinated, you'll need to book a specific tour with the cruise line, such as Carnival's "bubble tour" for unvaccinated guests, which is mostly families whose children are too young to be vaccinated. 

You also might need to purchase travel insurance with emergency evacuation coverage, if you have an unvaccinated guest in your party and you're departing from a Florida or Texas port. Unvaccinated people are now over 10 times more likely to get hospitalized with COVID-19 and over 10 times more likely to die from the disease than fully vaccinated people, according to a September report from the US Centers for Disease Control and Prevention. If you're able, getting a COVID-19 vaccine before your cruise is not only more cost effective, but it could save your life. 

The testing and masking requirement specifics may vary by cruise or the length of sail, but everyone age 2 and older should be prepared to be tested for COVID-19 before boarding, or during the journey when applicable, regardless of vaccination status.

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What if I have a certificate of recovery? 

Some countries issue "certificates of recovery" if someone has been infected with COVID-19 and recovered, issuing a certificate that proves a positive COVID-19 test and recovery, instead of vaccination as someone's proof of immunity. The European Union's Digital COVID Certificate, for example, includes certification of recovery from COVID-19.

For guests departing outside of the US who are cruising with Royal Caribbean, they may present a certificate of recovery. If you're not in the US and have a certificate of recovery, contact your desired cruise line before purchasing the cruise. 

The US doesn't issue certificates of recovery at this time and telling the cruise line you already had COVID-19 won't get you a vaccine exemption.

Cruising with unvaccinated kids 

Children may or may not be able to cruise, depending on the ship. Norwegian Cruise Line doesn't allow children under the age of 12 to cruise, for example, because they can't get vaccinated yet. In the specific event that you have a child turning 12 during the voyage, check in with your cruise line before buying a ticket. 

Looking for a family cruise on Disney's cruise line? The Disney Magic will start sailing again on Oct. 28 and children under the age of 12 who aren't able to be vaccinated are able to come along but will still need to follow the cruise line's testing requirements, as with all major cruise lines. For the Disney Magic cruise, all guests aged 12 and older will need to be vaccinated. 

One example of vaccine exemptions varying based on cruise destination is Disney's Panama Canal Voyage, which requires all guests be vaccinated, regardless of age. So you'll need to leave your younger kids home for this one. 

It's important not to book a cruise before you're confident that you have a valid vaccine exemption (because a refund of your money probably isn't likely if you're denied). You may want to hold off on buying a cruise for children between the ages of 5 to 11, because Pfizer's COVID-19 vaccine is expected to be authorized in this age group in the coming months, which could prompt cruise lines to lower the vaccine requirement from age 12 to age 5. The vaccine could be authorized as early as the end of October for younger kids. So if you're not sure if you'll vaccinate your child that could be eligible for a COVID-19 vaccine in the future, it might be best to be confident in the cruise line's refund policy before booking.

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The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.