Alec Goldman, an American educator who has made a life in Bangkok, wants to get vaccinated.
Right about now would be a good time as COVID-19 cases in Thailand have been spiking since early April, fueled by the highly transmissible variant B.1.1.7, first detected here just before the four-day Thai New Year holiday that began April 12.
Goldman worries about the health risks posed by long international flights. He said a trip would strain his finances.
To get a shot in the United States, Goldman, who runs a personalized learning startup in Bangkok, would have to spend at least 20 hours at airports and on airplanes. Depending on vaccine availability, it might take another week to a month to get fully vaccinated.
Then the 51-year-old New York native would need permission from Thai authorities to return to Thailand, where, after landing, he would be required to pay to stay at a private hotel for the mandatory 14-day quarantine, even with a vaccination certificate.
Although all Americans 16 and older in the U.S. are eligible to receive the vaccine, and about 44% of adults 18 and above in the U.S. are now fully vaccinated, some 9 million Americans live outside the U.S., and many are struggling to get a shot in their host countries.
Now a coalition of Thailand-based American organizations is leading an appeal to the U.S. government to deliver vaccines to tens of thousands of Americans in Thailand as a pilot project that could later be expanded globally, according to Paul Risley, chairperson of Democrats Abroad Thailand and a United Nations consultant.
The call by American expatriates is becoming more urgent as more contagious and virulent variants of the coronavirus emerge.
"Americans who live abroad need to be vaccinated for the same reasons that Americans who live in the United States need to be vaccinated," Risley told VOA Thai. "Because it's the only way to stop COVID-19."
Expatriate Republicans echo the Democrats' concern.
"In this particular case, all of us are on board," Tony Rodriguez, vice president of Republicans Overseas Asia, told VOA. "Obviously, there's plenty of vaccines in America. Just get them on a plane and fly them over."
The two groups, along with the Veterans of Foreign Wars, Post 12074, and American Women's Club, on May 6 signed a joint letter asking Washington to get vaccines approved by the U.S. Food and Drug Administration (FDA) — namely Pfizer, Moderna and Johnson & Johnson vaccines — into the arms of overseas Americans as soon as possible.
In the letter, they asked "that our government now continue to fulfill the pledge made by President (Joe) Biden to make coronavirus vaccines available to all Americans."
Expatriates propose pilot
Addressing U.S. Secretary of State Antony Blinken, the groups also proposed that Thailand, with its robust health infrastructure, "could serve an ideal testbed for a pilot project for the U.S. Government to deliver approved and effective vaccines to the tens of thousands of private U.S. citizens living here, and then ultimately replicate that effort for the large number of other Americans living overseas."
"Would the logistics of such a project be challenging?" the letter asks. "Perhaps, but Americans excel at dealing with precisely these sorts of challenges, especially via the public and private sector partnerships which could undoubtedly be brought to bear."
The Thailand campaign is gaining support from Republicans Overseas headquarters.
"You have to treat U.S. citizens equally, no matter where they are. If American citizens stateside are getting free vaccines, overseas Americans should be getting the same kind of deal," said Solomon Yue Jr., vice chair and CEO of Republicans Overseas, which is estimated to have about 3.6 million members worldwide.
Democrats Abroad, in a global resolution in March, called on Biden to direct the Department of State to work with vaccine manufacturers and health authorities worldwide to ensure availability of vaccinations to Americans, regardless of where they live.
American Citizens Abroad, a nonpartisan nonprofit group based in Washington, D.C., wrote the State Department and Congress about vaccinating Americans overseas on April 12.
When asked about the Thai letter, a State Department spokesperson told VOA on background that the department did not comment on correspondence, adding, "The Department continues to proactively communicate travel advice and warnings to U.S. citizens amidst the ongoing COVID-19 pandemic. The Department does not provide direct medical care to private U.S. citizens abroad. We are committed to providing all possible consular assistance to U.S. citizens in need overseas, including by providing information on local medical resources when appropriate."
The U.S. is expected to have a surplus of 500 million to 1 billion doses by the end of this year, depending on its vaccine strategy, according to estimates by Brookings Institution.
Many Americans in Thailand show little, if any, vaccine hesitancy. About 98% of nearly 1,000 Americans in Thailand who responded to an online survey by Democrats Abroad Thailand said they would choose to be vaccinated if U.S.-approved vaccines became available.
Limited options
U.S. private citizens in Thailand interviewed by VOA are taking a variety of approaches to protect themselves against COVID-19. While some are trying to ride out the current surge, others are planning to go wherever they can to get vaccinated.
For some, "going to the U.S. would be the last resort," Goldman said.
As many Americans in Thailand who spoke with VOA see it, they, like all U.S. expats, are required to pay U.S. taxes, and if they can vote in U.S. elections why can't they get vaccinated where they live?
Aaron Frankel, a 54-year-old American businessman, plans to fly this summer with his two teenage children to California, where his sister lives, to get shots.
This means paying thousands of dollars for plane tickets and a private hotel quarantine for three people during "the hardest year" of his life and for his company, which sells maps and souvenirs at airport outlets.
"I look forward to (getting vaccinated)," Frankel said, but added that he felt frustrated at being left out of the U.S. government's vaccine program.
"I'm a little bit jealous that (Americans in the U.S.) were able to get vaccines already and we're still under lockdown and don't know when or where these vaccines will come from," he told VOA.
Thailand's vaccine supply
Only AstraZeneca and China-made Sinovac vaccines are currently available in Thailand.
Since February, the country has administered 1.8 million doses to its nearly 70 million people. About 513,000 Thais — or 0.73% — have been fully vaccinated as of May 6, according to Thailand's Department of Disease Control.
Since the onset of the pandemic, the country has reported 85,005 cases and a death toll of 421 as of Monday, according to the Johns Hopkins University Coronavirus Resource Center. The U.N. estimates the population of Thailand is 69,929,000.
After sending mixed messages about the vaccine eligibility of expats, Thailand's Public Health Ministry said on May 6 that everyone residing in the country is eligible to get a vaccine, including about 3 million foreign residents in the country.
While that is a relief for some, Americans interviewed by VOA said they prefer the three vaccines approved by the U.S. FDA.
"My husband is diabetic and I'm immunocompromised. For us, which vaccine we get is extremely important," Goldman said. "We want something that will have a good chance not only of working against the U.K. variant but against the Indian variant that's emerging right now that seems really serious."
New studies published by the New England Journal of Medicine and The Lancet showed that the Pfizer-BioNTech vaccine has a real-world effectiveness against COVID-19 variants B.1.1.7 and B.1.351, first identified in the U.K. and South Africa. Moderna also said its early trial results show that its booster shot generated increased immunity against variants first found in Brazil and South Africa.
Many Thais have expressed their wariness about the efficacy of the country's two available vaccines, saying they prefer those approved by the U.S. authorities. Some have traveled to cities in the U.S. for a free jab, and Thai travel agencies are even starting to sell COVID-19 "vaccine tours."
U.S. private citizens on their own
The U.S. State Department delivered COVID-19 vaccines to all its eligible workforce stationed overseas in late April and expects its entire workforce to have been fully vaccinated by mid-May, according to Reuters.
The program has not been extended to U.S. private citizens abroad.
Nikki Fox, spokesperson of the U.S. Embassy in Bangkok, said in an email to VOA that the State Department does not provide direct medical care to private citizens abroad. The State Department's current guidelines recommend that Americans overseas check whether they are eligible for a vaccine with local authorities.
Some U.S. expats, however, remember when U.S. government personnel inoculated American expats.
When Gary Suwannarat first moved to Thailand in the 1980s, she and her family were vaccinated against hepatitis B, a major public health concern in Asia at the time, on the grounds of the U.S. Consulate in the northern Thai city of Chiang Mai.
Last month, the 73-year-old vice chair of the Democrats Abroad Thailand wrote to President Joe Biden, urging him to restore the program to make vaccines available for Americans abroad.
"I think it would be really important for the U.S. government to go back and look at, OK, how did we do it then, let's do it now," said Suwannarat.
Washington has been under pressure to share excess doses with other parts of the world. The Biden administration committed to sending 60 million doses of AstraZeneca vaccine to hard-hit countries beginning this month.
"I'm not quite sure how it would work for Thailand if there were lines of Americans waiting outside the embassy for vaccination," Rodriguez said. "Still, I do think it's an important service that the embassy should be able to provide to Americans."
Cindy S. Spang contributed to this report.