A nurse administers a shot to an elderly man wearing a white T-shirt and black pants at his home.

COVID-19

Dual citizens in Mexico seek vaccine options in the US as rollout lags

Mexico's vaccine rollout has been slow and cumbersome. Mexican residents with US citizenship, permanent residency or valid visas are starting to take matters into their own hands.

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Nurse Ana Arteaga prepares to administer a shot of the AstraZeneca coronavirus vaccine to Juan Manuel Herrera Espinosa, 63, inside a rural home in Porto Las Cruces, Cuajimalpa, on the outskirts of Mexico City, Feb. 18, 2021. Mexico City's health department is sending teams of medical workers to give in-home vaccinations to seniors unable to reach vaccination centers.

Credit:

Rebecca Blackwell/AP

Keeping up with Mexico's COVID-19 news means watching lots of videos of high-ranking officials receive vaccine shipments on airport tarmacs. But the attention given to vaccine arrivals contrasts with rollout logistics. 

Related: Mexico’s COVID-19 wards are full. Many patients who can’t get oxygen die at home.

Thousands of public-sector medical workers have been waiting longer than the advised 21 days for their second dose of the Pfizer vaccine, and many in private practice continue to wait at the back of the line. 

Mass vaccinations of people over the age of 60 started last week, but the process has been slow and haphazard. Mexican residents with US citizenship, permanent residency or valid visas are starting to take matters into their own hands.

“Both of my parents are doctors,” said Alfonso, who asked to use his first name only to protect his parents’ identities.

His parents live in a city that borders California, and his mother, who has diabetes, is now watching for when the age eligibility limits drop on the other side. 

At 62, his mom should qualify now in Mexico based on her age, but the federally managed vaccines aren’t available nationwide. Meanwhile, she stopped seeing patients in March to reduce her risk of exposure. 

“My mom … she works for the Simi Pharmacies, which are these medical consultations next to these very popular generic pharmacies. And she hasn’t received any notices of her vaccine.”

Alfonso, whose mother seeks a vaccine for the coronavirus

“My mom … she works for the Simi Pharmacies, which are these medical consultations next to these very popular generic pharmacies. And she hasn’t received any notices of her vaccine.”

Alfonso’s father lucked out. He works at ISSSTE, a public institution, and received his first dose more than a month ago. He is scheduled to get his second dose on Tuesday.

But many others are not so lucky. 

“I know of two neighbors on my block in Mexicali that have crossed the border into the US to get the vaccine,” Alfonso said. “They’re both older than 65, and they were both able to do it because they’re either US citizens or green card holders. Right now, the land border is closed for Mexicans, but US citizens and US green card holders can cross.”

The contrast in vaccine rollout speeds between the two nations can be especially striking along the border. About 2 million people have completed their two-dose vaccine regimens in the state of California, dwarfing the total number of vaccine doses applied nationwide in Mexico.

“I think that, contrary to what’s happening in other countries, a problem that we have in Mexico is that the application of vaccines is very centralized."

Alejandro Cano, an independent data analyst

“I think that, contrary to what’s happening in other countries, a problem that we have in Mexico is that the application of vaccines is very centralized,” said Alejandro Cano, an independent data analyst who keeps a close eye on Mexico’s pandemic response.

He said with vaccine shipments coming in, the bottleneck is due to the clunky bureaucratic rollout. 

“One of the things that is most maddening about the way they’re doing things in Mexico is that right now, it’s not possible to forecast when your turn is going to be to be vaccinated,” Cano said.

Unlike other countries, Mexico’s federal government hasn’t delegated authority to the states or tapped into preexisting structures used for other vaccination campaigns. 

Cano said the selection of vaccination sites further complicates the effort because “rather than vaccinating everybody above a certain age nationwide, they have chosen to only vaccinate in only a few municipalities," which adds to the overall uncertainty.  

Related: Experts concerned Mexico not taking enough COVID-19 precautions

Mexico-based US citizens and green card holders are also contemplating vaccine-motivated travel beyond the US-Mexico border. 

Mexico is home to the largest population of US citizens living abroad with an estimated 1 million. Many live in the interior and are members of binational families.

“My mom is originally from Florida, and my parents met in college in Florida, and later moved back to Mexico,” said Sofia Diaz.

Her family visits Florida frequently, where they also own a home and pay taxes. Her parents hadn’t really thought about getting vaccinated in the US until a chance opportunity arose during her grandfather’s vaccination appointment in Miami.

“He had the last appointment of the day,” Diaz said. “And my mom was waiting for him in the waiting room and a nurse came out and said, ‘If any of you here without an appointment would like a vaccine, we have some doses left over that we cannot keep.’”

Her mother raised her hand, got vaccinated and returned to Mexico. When Diaz’s mother had to return to Florida for her second dose, her father went along to get vaccinated there, as well.

“We did want to take advantage of this opportunity, first of all, because we weren’t sure when we were going to get the vaccine here in Mexico,” she said. “Second of all, we didn’t know which vaccine we were going to get.”

Mexico has started using AstraZeneca to vaccinate persons over 60 and plans to incorporate other brands as they become available. A SinoVac shipment recently arrived — complete with an airport tarmac ceremony — and the government has also made agreements to obtain millions of doses of the CanSino and Sputnik V vaccines from China and Russia. None of those brands have emergency approval in the US.

Related: South Africa changes course on vaccine rollout after disappointing study

Residency requirements for vaccine eligibility vary across states. Texas Gov. Greg Abbott has said that vaccines there are for Texans only, while California and Arizona have been more flexible. Florida has recently moved to require proof of residency at vaccine sites. But many dual citizens, green card holders and even vacation homeowners can point to valid US addresses and show in-state driver's licenses. 

Diaz said that while the increased availability in the US may lead to some degree of medical tourism, most people weighing the option are US taxpayers or frequent travelers.

“I do think that at least the large majority of the people that are crossing over to get vaccinated are people that have a lot of interaction with the US,” she said. “It’s in the best interests of the US to have those people vaccinated to the medical standard of the US.”

The Biden administration seems to have reached a similar conclusion and is working with its foreign counterparts to vaccinate foreign-born essential workers at consulates. 

After all, it’s a basic tenet of herd immunity theory — mass vaccination of individuals is an investment in the protection of society at large. Plus, the pandemic has already shown that viruses don’t stop at international borders.

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