mabt

13 hours ago, MR_T said:

You are correct, now you mention it I do remember somewhere in the booking procedure it did have a box to tick if you didn’t have a medical card… 

 

i just took a look and if you click the box it does say other forms of ID will be required for proof of eligibility 

Good to know.  Big question is whether a non-resident is considered "eligible" for a third dose.  I might just break down and try.  Now that RCCL has clarified the same-manufacturer interval issue, I get the sense that they feel like they've sorted everything out and it's all fine now.  Not so confident that the remaining issue with extended intervals of mixed doses will be addressed.

Thanks again!

6 hours ago, Russ Lomas said:

 

As the individual who started this thread, I would like to post one final time to close this thread.

 

The answer above is the one we were all seeking.  Several people have posted Tweets here and on Facebook from Michael Bayley himself with the answer - thanks to all of you who have done this.

 

I too received the same letter yesterday that is posted above.  Personally, I feel much better and confident now though that I have a personal letter addressed directly to me from the CEO's executive office stating I am considered FULLY VACCINATED and welcoming me aboard.  Twelve days until we fly from Toronto to Fort Lauderdale and 15 days until we board the Odyssey of the Seas. 

 

Thank you to everyone who participated in this thread and especially those who reached out to RCCL directly to help resolve this issue.

 

I wish it was closed.  There are still a great many of us who can't sail under the current requirements, even with this clarification.

Genuinely glad it has been resolved for you though!

4 hours ago, MR_T said:

So to answer your first question above this post and this one we had to show our Quebec medical card which was imprinted onto the paper document we received so I guess it would only be available to Quebec residents unfortunately, 

 

As for the record we got an additional paper with the details on, nothing fancy just the imprint of our medical card and our name with the dose of vaccine we received, it’s a standard paper which only has space for 2 doses so for the 3rd we were just given a an additional paper, however they just crossed out the 2nd dose an hand wrote 3rd next to it so I’m doubting it would be good enough for check in. 
 

In regards to official documentions they do send out proof that has each vaccine with all the details on in English with a scannable section so I’m hoping this will be good enough 🤞🏻 Obviously it does show all 3 but they are in date order so it shows our last 2 shots we’re both Phizer. 
 

hope you can get something done soon to enable you to cruise without concerns, or ultimately they change the requirements etc to enable any double dose to be accepted 🤞🏻

Interesting.  Remains to be seen whether they will vaccinate non-residents or not.  I agree that it's not a given.  BUT, every province for sure has a process to vaccinate someone who doesn't have provincial health coverage - new or temporary residents, people who lost their cards and never replaced them, illegal immigrants, etc.  They still want everyone vaccinated.  So I wouldn't assume that no health card necessarily means no vaccine.

Thanks very much for the information!

3 minutes ago, ace2542 said:

What about people who have had the same vaccine but 12 weeks apart?

Open question.  Short answer is that different people are getting different information, depending on who they ask.  When escalated, typically the response is that the 42-day interval requirement applies to all mRNA combinations, same manufacturer or otherwise.

I suggest reading through one of these threads, or at least the last few pages:

https://boards.cruisecritic.com/topic/2792370-is-royal-caribbean-trying-to-get-all-canadians-to-cancel-their-planned-cruises/

https://boards.cruisecritic.com/topic/2790972-passengers-who-have-used-mixed-vaccination-protocols-will-not-be-considered-to-be-fully-vaccinated-per-rci-faqs/

13 hours ago, mabt said:

Okay, well if you're right about that, then the CDC is clearly in violation of the FDA's "absolute authority" in their administrative guidance.

 

I don't know how you square that circle, but I won't argue it further.  My assessment was based on first principles and logic.  What you're saying might be right, but it's not logically consistent.

So, not that I particularly want to reopen debate on this topic, but I like things to make sense, and this just... didn't.  So I went and had a look at the Emergency Use Authorization for Pfizer.  For those who are interested in this sort of thing:

Under "Scope of Authorization", it stipulates:

"The Pfizer-BioNTech COVID‑19 Vaccine covered by this authorization will be
administered by vaccination providers and used only to prevent COVID-19 in
individuals ages 12 and older"

Under "Conditions of Authorization", section R, page 9, it says:

"Vaccination providers will administer the vaccine in accordance with the
authorization and will participate and comply with the terms and training required by
CDC’s COVID-19 Vaccination Program."

There are various other conditions mainly relating to handling, reporting, and documentation requirements.  However, there is nothing additional in the authorization itself relating to the specific terms of administration, aside from the statement above.

So the FDA kicks the issue of administration terms back to the CDC.  And the CDC's "COIVD-19 Vaccination Program" includes the Clinical Considerations document that has been referenced here several times, which recommends against, but ultimately allows for, both mixed mRNA doses and extended dosing intervals.

The Moderna letter of authorization is very similar.

52 minutes ago, Iamcruzin said:

We are talking about boosters and the poor Canadians can't even get two doses of the same vaccine.

Well, we could probably get the same dose now.  But that's a very recent development, like in the last week or two, and most of us were already fully vaccinated by then.

We're actually kind of swimming in vaccines at this point, much like the US.  The problem was that much of the supply came all at once, especially Moderna.  Most people had Pfizer for the first dose, because we were getting a reasonably steady supply of Pfizer from Europe all along.  But when the US finally relaxed export controls, we got a huge supply of Moderna in a very short window, and that happened to coincide with a temporary disruption in the Pfizer supply.  So Moderna was what we had, and here we are.

Your point is still very valid though.  In much of the world people still can't get one dose, let alone three.

3 hours ago, MR_T said:

As mentioned... in Quebec, hope you guys get the opportunity soon 🤞🏻 

Curious, what kind of documentation do you end up with?

Digital proof for those with Quebec health insurance, I know.  Is each shot just documented individually?  As opposed to the Ontario record stating the number of "valid doses"?

I think I also read that in Quebec they give a paper record on-site; does that look valid enough to be accepted by a cruise line?  I know you can't possibly know what the cruise lines will or will not accept; I'm just trying to get a sense of what is provided.  And will they provide it in English?  (Not for my sake; I can read enough French to get by, but the check-in guy at the port probably can't.)

6 hours ago, Brownezes72 said:

Where did you get your third?? I am in ontario and looking for same

6 hours ago, Airbalancer said:

They are in PQ 

wait a month , the policy will change 

A month is too late for some of us.  🙁  The policy changed three times in less than two weeks though, so it might not take that long.  😉   I like to think that the current delay in clearing this up is because they're actually trying to get it right this time.

I might try Gatineau if they haven't sorted this out by this time next week.  Not sure if they'll give it to a non-resident, but for the sake of a short drive, it doesn't hurt to try.  If we get to that point, I'll report back on how it goes.

8 minutes ago, DeanD said:

I tend to look at these things big picture.  While the CDC has said to consider those with mixed doses as fully vaccinated, they also say "Any currently FDA-authorized COVID-19 vaccine can be used when indicated; ACIP does not state a product preference. However, COVID-19 vaccines are not interchangeable" as well as "The safety and efficacy of a mixed-product series have not been evaluated. Both doses of the series should be completed with the same product.".  One has to realize that anything outside the FDA approval, which means within the stated time frame with the same mRNA vaccine, is simply a compromise.  It would appear that RCL has decided to avoid the compromise situations at least for now.

IMO that's not "big picture", it's cherry picking.  Yes, the CDC gives lots of reasons to support their recommendation of single-manufacturer doses, and then goes on to conclude that under certain circumstances deviation from the recommendation is justified, and that deviation still results in "full vaccination".

Incidentally, the situation in Canada was exactly the exception case that the CDC outlines: namely, the temporary unavailability of a second dose from the same manufacturer, resulting in a dosage interval of greater than 42 days.

But we're going around in circles now.  You are welcome to maintain your opinion that RCCL's position on this is rational and justified, and I will stick to my assessment that it is non-sensical, unsupported by either the available evidence (limited as it may be) or the documented position of the governing bodies involved, and inconsistent with the decision of every other cruise line operating in the same jurisdiction.  Agree to disagree.

3 minutes ago, not-enough-cruising said:

Sorry but you are incorrect, and as you stated earlier you were unclear on the inner workings of government health agencies. Under the EUA window, which we are still in, the FDA dictates FULLY how these substances must be used; their authority during the EUA "window" is absolute.  The CDC must abide by this authority, and declare any situation outside of the parameters as "void"

Okay, well if you're right about that, then the CDC is clearly in violation of the FDA's "absolute authority" in their administrative guidance.

I don't know how you square that circle, but I won't argue it further.  My assessment was based on first principles and logic.  What you're saying might be right, but it's not logically consistent.

Just now, not-enough-cruising said:

Perhaps (obviously) I did not make my point clear (a recurring problem for me and the written word). Let me try again.

 

A large portion of the FDA EUA approval for these vaccines was a very specific, tested, dosing regimen; to include acceptable timing of the 2 doses.  Doses given outside of these studied parameters (not to mention mixing manufacturers) were never granted approval, therefore are not considered (by the appropriate governing body) to be a successful vaccination dose.

I don't think you were unclear; we just disagree.  🙂

The CDC is the "appropriate governing body" in this case, and they are very clear that these scenarios, while not recommended, still result in a person being "fully vaccinated", and that no additional dose should be administrated.

Have you read the CDC document?  It's here: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html

See the sections on "Vaccine Administration" (specifically "Interval between mRNA doses"), "Interchangeability of COVID-19 vaccine products", and the table in "Appendix A. Vaccine administration errors and deviations", specifically under "mRNA vaccines only".

Again, the FDA doesn't dictate how an approved substance must be used.  (Or that's my understanding, anyway.)  They approve a substance based on manufacturer's recommended use, supported by the manufacturer's studies.  It is then up to the medical experts to follow the guidelines, or not.  And deviating from manufacturer's guidelines is (again, to my understanding) very, very common.

1 hour ago, Russ Lomas said:

Well, here is your daily update.  The person I know sailing this Saturday from Florida just received a call after he was told this morning they were meeting to discuss the matter.  They just told him (again) now that for this weekend's cruise HE IS considered UNVACCINATED because his Pfizer shots were more than 42 days apart.  They say talks with the CDC are still ongoing.

 

Just when I thought we were getting somewhere after Michael Bayley himself said that we are considered fully vaccinated, this happens...

😡

Someone upthread (or in a different thread on the same topic) said that the cruise lines were "stepping in their own do-do and tracking it around the room".

That's the best description I've seen so far.  At least where RCCL is concerned.

1 hour ago, not-enough-cruising said:

BUT the CDC requires a WHO or FDA EUA approved vaccine.  Mixed doses are not EUA approved by either health agency, therefore accepting them opens one up to a litany of liability, the way the CSO is currently worded.

So admittedly I'm not an expert in the US drug administration system, or any other country's, for that matter.  But I think people are mixing up the concept of "FDA approval" of a substance with the subsequent use of that substance.

ALL of the vaccines in question here are approved for use by the WHO and EUA.  The mRNA vaccines are also approved for use by the FDA.  Again, not an expert, but my understanding is that a drug is either approved for use, or it's not.  The approval will come with manufacturer's guidelines on how it should be used,  but drugs are used off-label all the time.  The FDA doesn't dictate that the drug must be used according to the manufacture's label.  It is approved, with guidelines, and then it's up to medical professionals to follow those guidelines, or not.  If this wasn't true, drugs would never be used in combination - because they're not approved that way.

The very existence of the CDC's clinical considerations document suggests, to me, that at least in the case of vaccines, it's up to the CDC to advise on appropriate use and how to proceed with off-label use, deliberate or otherwise.  That has already been done, and they are very clear that both mixed mRNA doses and mRNA doses administered outside of the manufacturers' recommended intervals are considered fully vaccinated.

Not to mention the inherent inconsistency of the idea that the CDC would define mixed doses and non-standard intervals as fully vaccinated in general, but then disregard their own guidelines in the case of cruise ships.  That's just non-sensical.

4 hours ago, DeanD said:

One is that of the most stringent interpretation, that of the FDA approval.  IMO the emotions don't play into it from a decision making standpoint.  It will change over time but the CDC is not known for making changes quickly.

But this is where your argument is going wrong.  You talk about RCCL following FDA guidelines, but then expect the CDC to resolve the situation.  Except that the CDC has already issued guidelines, at least on the topic of mRNA doses, and they are unambiguous.

And again, this is not an emotional argument.  Your logic doesn't add up.

2 hours ago, CruisinCanuck63 said:

I don’t see this as a problem of Royal’s interpretation of any directive from the CDC or FDA guidelines.  As written, the policy seems rather clear that the 42 day limit applies to mixed doses.  
 

What we have here, and to no surprise, is a problem with Royal’s differing interpretations of their own policy. 

Yes and no.  Definitely they need to get their story straight on whether or not the 42 day policy applies to a same-dose series as well.

But the mixed dose policy is a problem for many of us too, and drawing a line between mixed doses and same-manufacturer doses, at least where mRNA intervals are concerned, is completely arbitrary.  Nobody else draws this distinction, including the CDC.  Royal appears to have made it up themselves.  And this is, most likely, exactly why there is confusion over the same-manufacturer situation, because there's no rational reason to apply to one and not the other.  It's inconsistent.

I will be happy for others if the same-dose interval issue is resolved, and it would clear my husband to cruise.  But I had Pfizer / Moderna at 44 days, so if the mixed dose policy stands, we still don't sail.

And even if my problem is solved, that still leaves anyone who got AstraZeneca in the lurch.

So suggesting that there is no problem except that RCCL can't make up their minds about the same-dose mRNA interval is maybe a little short-sighted.  😉

5 minutes ago, DHLuCruise said:

 

I know you're genuine at heart and trying to be helpful. That's sincerely appreciated. What you are seeing is frustration that people are continually correcting Canadians and others as if we don't know how to read the regulations. We do. 

 

The point I think everyone can agree upon is this is an INTERPRETATION of the regulation. What Canadians are concerned about is that the interpretation isn't consistent with the reality of efficacy on the ground.

 

We're not saying RC is evil here, we're trying to ask them to take a second look. Which it seems that they are. That's all we can ask.

If I could give this multiple "likes", I would.

3 minutes ago, DeanD said:

Still, the interpretation by RCL is a reasonable one at present given the situation.

Well, that's obviously a matter of opinion.  But the bigger question is, why is RCCL trying to impose their own "interpretation" at all?  I rather doubt that they have experts in immunology on staff.

There is literally no other organization imposing this restriction.  Not the CDC, not the destination countries, not other cruise lines - even the ones owned by the same holding company.

And yes, the subject is emotionally charged for some, but this isn't an emotional response.  You can play devil's advocate if you want, but the argument really doesn't hold up to scrutiny.

28 minutes ago, Russ Lomas said:

In the words of Regis Philbin from who wants to be a millionaire, “Michael Bayley, CEO of RCCL, is that your final answer?

Yeah, problem is that we've heard that answer before, haven't we?

Wouldn't actually help me much, because my mRNA doses *are* mixed (and outside 42 days), but I would be happy for you if it sticks.  Also puts my husband in the clear.

I did hear back from the executive office just now.  She said (I am paraphrasing): "sit tight".

I think there will be some policy revision announced soon.

ETA: Just realized that came directly from Michael Bayley, so that does seem promising!

12 hours ago, Russ Lomas said:

Thanks for sharing that with me.  I love it when people on CruiseCritic are helpful and courteous like you and do not just argue and insult each other.  You are right.  The credit can now be claimed up til August 31st.  It used to be July 31st and I took a screen shot to prove it if they question me if I applied for it.  

Aw, thanks.  Your posts have been super helpful to me too!

Still nothing from RCCL's executive office, but I'm actually taking that to be a good sign.  There would be little point in replying just to say "yeah, nothing has changed".  I'm choosing to believe that they are waiting until they have positive news to report.

Either that, or they're just ignoring me now.  😂

3 minutes ago, Russ Lomas said:

Our Air Canada tickets out of Toronto can get that credit as well, but you have to apply for that credit prior to July 31, so as of Sunday, they become non-refundable tickets.  Our tickets back home are with Delta and were significantly cheaper, thus non-refundable.

Are you sure?  I admit that I'm wary, but the currently stated policy seems to be that tickets can be cancelled for credit up to two hours prior to departure.

See "terms and conditions" here: https://www.aircanada.com/ca/en/aco/home/book/travel-news-and-updates/2020/covid-19.html

It changes all the time, so might have changed since you booked?

Also it looks like they've extended that policy now to August 31, so that might give you (and me!) some breathing space.  Doesn't help with your return tickets, of course, but if you do end up having to cancel you should at least get the Air Canada credit.

I really am optimistic that this will be sorted out before your sail date.  But it is really hard to hold on when you have money on the line, and the prospect of no vacation at all if it doesn't pan out.

16 minutes ago, Russ Lomas said:

Thank you so much for your kind words.  It angers me that they are doing things like this that are fully within their realm to decide upon.  They are the only cruise line doing this.  Not even their sister-brand Celebrity is making any mention of this.  I know others will argue that it is their ship and they can do as they like, but to spring something like this on us days before the cruise is....

 

My two oldest daughters have already been granted 2 weeks off work that they would have been working to help pay for their university.  We have thousands invested in non-refundable air travel.  Our youngest kids did not want the shots but agreed to get them so they could go on this summer cruise.  UGGGHHH

It's a mess, for sure.  I feel for you.  And everyone else in this situation.

If I hear anything before you do, I'll be certain to tag you!

12 minutes ago, Russ Lomas said:

Unfortunately, we have sunk thousands of dollars into non-refundable flights about 10 days ago since it appeared that everything was going ahead for us.  We can get an airline credit for one of our flights if we cancel it in the next 3 days, but then if we do that and we are told we can go on the ship, we would have to repurchase flights and they now cost double what I got them for 10 days ago.

 

I emailed the CDC directly today to ask them if they consider me as double vaccinated since my two doses of Pfizer were administered just beyond 42 days apart.  If they get back to me and I can show that directly to RCCL that the CDC acknowledges me as being fully vaccinated, I do not understand how RCCL can say I am not according to what the CDC says.

I totally hear you on the flights.  I have a couple thousand dollars tied up in flights from Montreal to New York that I hope not to take, whether or not we go ahead with the cruise.  Those are on Air Canada, and the way I understand their policy is that they are cancellable for non-expiring credit, which is good enough for me.  We'll use them eventually.

I was about to pull the trigger on non-refundable flights from New York to Nassau on Friday, and then I saw the policy change.  I could buy refundable tickets, but it would cost a lot more, and I'm not sure I'm willing to pay it.  Especially if we aren't able to drive to New York and have to use those Montreal flights.  So I wait, and watch, and hope that the current price holds.

I think the CDC policy is pretty clear that the 42 day thing is recommended - even strongly recommended - but ultimately not required.  It would be helpful if you can get unambiguous confirmation for your specific circumstance though.

I have my fingers crossed for both of us!

25 minutes ago, Russ Lomas said:

We are hearing all this data saying that delaying the 2nd shot gives you more protection, but we moved our kids' 2nd doses up so that we could go on this cruise.  The kids got their 2nd shots at 45 days and they are considered unvaccinated.  The frustration, anger, and tears that will come out of this and the way it is being handled is agonizing.  I can't imagine how the kids are going to take it either when they find out if RCCL does not change this policy.

This is my thing too.  If it were just my husband and me, I probably would have given up and cancelled by now.  My kids are fully aware of the situation, so it won't come as a big shock to them if we can't go, but they will still be very disappointed.  It's been a long year and a half, and of course they are looking forward to a vacation.

My kids are actually just under the line (41 and 38 days), but it's not like they can go without us.

Thanks for the update.  That is terrible news for your friend.  How frustrating.  🙁   I responded last night to the lady from the executive office that replied yesterday.  I stressed that since RCCL is the only organization drawing this 42-day line, it would appear to be within their control to change it, and that for some of us, time is of the essence.  If we're not going to be able to go, I'd rather cut my losses in time to plan a consolation vacation.  I've not yet had another response, but if I hear anything useful I will report back.

4 minutes ago, Russ Lomas said:

We are in the exact same situation as you, other than using the different email.  This is really turning out to be very poor customer service on their part.  What does it say when you can pay extra for testing and be limited to where you can go if you never received a single dose of the vaccine, but those who did get 2 doses (either mixed or just one type) are considered fully unvaccinated if they did not get them within 42 days.  Once again, money talks.

Yeah, I'm sure that extra two days (in my case) makes all the difference.  Clearly, I am a danger to myself and others.  🙄

It's a tough situation.  I'll hold on until I can't, in hopes that they come around in time.  I do think they will change the policy (again), because they seem to be the only organization drawing this 42-day line.  Even the CDC doesn't require it.  They have made it up themselves, and they're going to lose business over it.  But every day I wait, I am running the risk that the flights I need will spike.  And if that happens, I'll probably throw in the towel.

Here's my take on possible options, with varying likelihoods of success.  You can make your own decisions on ethics and what lengths you are personally willing to go to.

• Outside of Quebec, no province has said - yet - that they will offer third doses for travel purposes.  (Ontario has taken the decisive approach of asking the federal government to "work with international bodies" to sort it out - as if they're not already trying.)  But it's not clear if giving third doses is explicitly disallowed in other jurisdictions, or just undefined.  At least one poster in another thread was told by a local pharmacist in Ontario that she could get a third dose.  There was one report of someone getting a third dose at a pharmacy in Calgary.  I asked (hypothetically) at two pharmacies in Ottawa yesterday; at one the assistant pharmacist didn't bother to follow up with someone who could actually make a decision on whether or not to administer the dose.  She just said that she "never heard of it", and I didn't push the matter.  At the other pharmacy the pharmacist tried to find an answer, came up blank, and told me to ask again when the pharmacy manager was on duty.
• Other provinces have no access to your medical records.  If you show up to a vaccination clinic or pharmacy, tell them that you are temporarily residing in the province, that you have only gotten one dose (or none), and ask for another, I suspect they would give it to you.  You may need to be able to give a "temporary address", although I doubt they would have any way to verify it.  Again, the ethics of this approach are for you to decide for yourself.
• You could fly to another country.  I hear vaccines are easy to come by in most places in the US.

In any of these scenarios, it is unclear what documentation you would end up with.  However, all provinces are giving vaccines to people who are not covered by local health insurance and can't be tracked in their provincial systems.  Presumably, they issue some sort of written proof at the time of vaccination.  Whether or not that would be accepted by the cruise line(s) is an open question.

6 minutes ago, K_e_short said:

Quebec is allowing 3rd dose of Moderna or Pfizer ONLY if you got AZ as your first dose.

This is unclear.  CBC originally reported that it applied only to AstraZeneca mixes, but have since clarified that they misreported:

"This is a corrected story. A previous version stated that Quebec was offering the extra dose only to recipients of AstraZeneca vaccine." - https://www.cbc.ca/news/health/quebec-third-dose-covid-vaccine-travel-1.6117954

Quebec's website uses the AZ situation as an example of a situation that may require an additional dose for travel, but does not specifically say that *only* AZ recipients can get a third dose.  It only says that if an mRNA vaccine is required for travel, it can be given.

6 minutes ago, K_e_short said:

The 42 day window is only for mixed doses of Pfizer and Moderna.

Also unclear, and dependent on which cruise line we're talking about.  On Royal Caribbean, several people have asked and gotten conflicting answers.  When it has been escalated to supervisors, most often people are being told that the 42 day interval applies to any mRNA series.

6 minutes ago, K_e_short said:

J and J is not approved in Canada and because we have so much supply of the other 3 types I'm not sure if it will be approved. The same risks that existed with AZ exist with J and J (blood clots, etc.).

This is just inaccurate, although the bottom line is the same.  J&J was approved for use in Canada months ago.  We had one small shipment delivered; it was found to be tainted during manufacturing and discarded.  No other deliveries have been received.  I suspect the procurement office deliberately put a stop on it, because of safety and efficacy concerns.