Royal Caribbean's Policy of Testing the Vaccinated Will Further Erode Confidence in the COVID-19 Vaccine

So before boarding the Royal Caribbean ship, travelers were required to provide a negative COVID-19 test and proof of vaccination. Exceeding the CDC guidelines by not letting travelers serve themselves at the buffet is one thing, but exceeding the CDC guidelines on testing will do nothing but decrease confidence in vaccines and create problems where there should be none.

Here is what the CDC says about testing vaccinated individuals for COVID-19:

Fully vaccinated people can:

• Resume activities without wearing masks or physically distancing, except where required by federal, state, local, tribal, or territorial laws, rules and regulations, including local business and workplace guidance
• Resume domestic travel and refrain from testing before or after travel or self-quarantine after travel
• Refrain from testing before leaving the United States for international travel (unless required by the destination) and refrain from self-quarantine after arriving back in the United States
• Refrain from testing following a known exposure, if asymptomatic, with some exceptions for specific settings
• Refrain from quarantine following a known exposure if asymptomatic
• Refrain from routine screening testing if feasible

Guess what happens if the vaccine effectively blocks an infection? The same thing. It may not persist for 90 days, but viral RNA can still be present after a typical and effective immune response following a COVID-19 exposure. This is why the CDC does not recommend testing asymptomatic vaccinated individuals and recovered patients, even after a known exposure. A perfectly effective vaccine would look pretty darn ineffective if it required repeated testing for the virus.

Commercial tests also utilize a much higher threshold to determine if a test is negative than the CDC does to investigate and document reinfections. Under a EUA from the FDA, PCR tests may use anywhere from 35-40 cycles before determining a test is negative. The CDC uses 28 or fewer to investigate reinfections. At a minimum, tests for fully vaccinated travelers should use the CDC standard. However, if they are without symptoms, it is not clear why the cruise company would require testing for vaccinated individuals.

As of April 30, 2021, out of approximately 101 million shots, there were 10,262 breakthrough cases reported. That was during a period of much higher transmission than the U.S. is experiencing now. Even then, a reasonably large number of vaccinated patients were testing positive on routine hospital testing and were admitted or died from an unrelated cause. Since then, the CDC has moved to monitor only hospitalized patients and COVID-19 deaths among the vaccinated.

Royal Caribbean stated that passengers are required to get a COVID test before disembarking at the end of the trip. If this is a requirement from the CDC, it is a departure from their other recommendations. The closest they come is recommending a test 3-5 days after a vaccinated person returns from international travel, not before they embark. It remains to be seen if this news causes the cruise industry to take another hit just as they are getting ready to launch again. Royal Caribbean has eliminated its proof-of-vaccination requirement for ships departing from Florida and Texas as of June 7.