Like many 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 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 your favorite cruise vacation?
If you're an adult in the US, the answer is probably not, unless you're one of the few people with a medical or religious exemption (and whether you'll be offered an exemption depends on the cruise line).
Before you book -- and especially if you're looking at cruises months ahead -- it's important to consider the spread of COVID-19 in countries or ports where your ship will stop, and that's regardless of your vaccination status. It's also important to consider who's coming with you. Children as young as age 5 are now able to get vaccinated, so your ability to cruise may depend on whether you've chosen to get your child vaccinated.
It's also possible that cruise lines could ease up on their pandemic measures in the near future and stop requiring proof of vaccination for passengers. Many US-based cruise lines say they're currently following the regulations put forth by the US Centers for Disease Control and Prevention, and those are subject to change as the coronavirus pandemic does.
Here's what we know about cruising unvaccinated for now.
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 shot of Pfizer or Moderna, or since your one-dose Johnson & Johnson shot. It's possible a cruise line may accept one shot of a viral vector vaccine, such as AstraZeneca, and one shot of an mRNA vaccine, but this practice of mixing for a COVID-19 vaccine primary series isn't authorized yet in the US. (The only "mix and match" approach to COVID-19 vaccines in the US applies to boosters.)
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. It's also important to know that while all adults in the US are now eligible for boosters, the definition of "fully vaccinated" hasn't changed and you don't need an extra shot to be considered fully vaccinated.
Unvaccinated adults and vaccine exemptions
Most major cruise lines require proof of vaccination for all passengers age 12 and up, and some require them for kids as young as 5 years old (Pfizer's vaccine was authorized for kids ages 5 to 11 at the beginning of November). Last week, Disney Cruise Line became the first cruise line to require passengers as young as 5 to be vaccinated for sailings starting Jan. 13.
While some cruise lines state they'll accept medical exemptions, others do not, and it also might depend on the port. Carnival, for example, says it'll 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 -- but only at their Florida, Texas, Louisiana, Maryland, South Carolina and Alabama ports until the end of March 2022. 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" due to 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. It also varies based on different rules for cruise ships or territories, and evolving guidance from the CDC.
Putting it all together: If your cruise line is even accepting medical exemptions around a COVID-19 vaccine, presenting valid proof of the exemption is critical. Before you book, contact the cruise line to see if it'll accept an exemption and also look into the local laws of where you'll be visiting if and when you 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 with children who 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 CDC report. Getting a COVID-19 vaccine before your cruise is not only cost effective, but it could save your life.
The testing and masking requirement specifics may differ by cruise or 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.
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, so 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 5 to cruise, for example, because they can't get vaccinated yet. In the specific event that you have a child turning 5 during the voyage, check in with your cruise line before buying a ticket.
Looking for a family cruise on Disney's cruise line? Disney Cruise Line became the first cruise line to require passengers as young as 5 to be vaccinated for sailings starting Jan. 13.
While other cruise lines may not officially require vaccinations for kids that young yet, they may in the future. If you're not comfortable vaccinating your child under 12, hold off on buying them a ticket or get confirmation on a timeline for requirements from your desired cruise line. Remember: Vaccine exemptions and refunds are not guaranteed.
Watch this: How do I get the COVID-19 vaccine? Your questions answered
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.