In March 27, a small plane took off runway 23 at Hermosillo International Airport in northwest Mexico en route to Tucson, Arizona. Onboard the Cessna 401 plane were seven Mexican nationals, including the state’s undersecretary of economic development. About four minutes after initiating the flight, the plane’s pilot asked air traffic control for an emergency permit to return. Permission was granted, but the plane never got back. It crashed about four miles west of the airport due to a mechanical failure. None of the passengers survived.

The reason for the passengers’ trip that morning? United States COVID-19 vaccines.

The plane had been used several times in the preceding days, flying people to and from Tucson International Airport, reportedly to get vaccinated as well. Two days prior to the accident, on March 25, the plane had a flight delayed due to an oil leak and took three test flights before finally departing. “It was the most turbulent flight of my life,” said M., a passenger that flew that day to receive the Pfizer-BioNTech vaccine in Arizona, who asked not to be further identified.

It was the exact same small plane used by Mexico’s President Andrés Manuel López Obrador on a visit to the state of Sonora during his successful 2016 presidential campaign.

The tragic flight reveals the current risks taken by middle and upper-class Mexican nationals to secure COVID-19 vaccines in a country struggling to roll out its mass vaccination campaign. For them, risking not only their US tourist visas but their lives are worth it when borders are closed, vaccines are not available, and distrust of the healthcare system persists.

“In my state of residence, Nuevo León, the distribution of vaccines is not going well. I was scared that [Mexican health officials] would give me a low-quality vaccine,” M. told PharmaBoardroom, adding that she chose Arizona because southern US states have fewer restrictions in terms of who qualifies for vaccinations.

E., another Mexican resident who took the Hermosillo-Tucson flight on the same Cessna plane around April 11, gave a similar reason for her decision to travel to the US. “I went to get vaccinated because, suffering from diabetes and hypertension, I am in the risk population. I was already hospitalized before due to the virus and was scared it would hit me again,” she told us, asking that her last name be omitted for fear of losing her US visa.

E. has already received two doses of Pfizer BioNTech’s vaccine in Chandler, Arizona. “I do not want to die of COVID. I was afraid that [Mexican health officials] would give me water instead of the vaccine. I do not trust the authorities,” she added.

For residents of Mexico’s northern states, access to the US vaccine stockpile comes at a relatively low price: a one-way ticket on the fallen plane was being charged at around USD 300. But with the Mexico-US border closed to all but “essential traffic,” and commercial airlines charging up to USD 600 for a regular ticket, a new industry was born; some with the required permits, others without. A pilot from the fallen Cessna 401 thought about the trips as a way of helping desperate citizens and charged just enough to cover the expenses of the trip, according to multiple sources.

If a person manages to present a tourism visa and a negative antigen test, the process of getting vaccinated with Arizona’s COVID-19 vaccine stockpile is seamless. After registering with the Arizona Department of Health Service’s website, vaccine seekers must check their eligibility and book an appointment. The system does not ask for nationality, place of residence or immigration status.

The Arizona Department of Health did not respond to a request for comment.

 

Two countries, two vaccine realities

The US-Mexico border separates more than two nations, it separates the country with the most vaccines given so far and one that has been outpaced by many countries within Latin America.

According to the Our World in Data project at the University of Oxford, roughly 15 million COVID-19 vaccine doses have been given in Mexico and only 3.6 percent of the population has been fully vaccinated. That puts the country on the lower part of the list among developed or emerging economies.

The country’s roll-out of its inoculation effort has been widely criticized considering that Mexico was the first Latin American country to receive a vaccine shipment. The messages coming from the administration did not aid that situation. President Lopez Obrador has notoriously refused to wear a mask, even after spending two weeks at home after getting infected. “Now, additionally, according to the doctors, I am not contagious,” he said after returning to work.

The President also refused to be vaccinated, first arguing that he would wait his turn and later pointing out the fact that he was already immune after being infected. But he finally backtracked and received the AstraZeneca shot last Tuesday with the hope giving confidence on the shot has been linked to serious side effect on some patients.

Lopez Obrador has been one of the most vocal leaders pressing the international community to improve poorer nations’ access to the vaccines. He has called the current distribution system “totally unfair.”

At the moment, Mexico has approved four vaccines: Pfizer-BioNTech, Oxford-AstraZeneca, Russia’s Sputnik V and China’s Sinovac.

On the other side of the border, the United States vaccination campaign has far outpaced everyone else. Over 215 million doses have been administered; almost half of the population has received at least one dose.

Even though Janssen’s vaccine use was halted after six women developed sever adverse reactions, the Biden administration said that there should be enough doses of vaccines from Pfizer and Moderna to vaccinate most U.S. adults by late May. This week, the US expanded the eligibility for vaccination to people 16 years and older and Biden celebrated that his administration achieved the goal of giving 200 million vaccines in his first 100 days in office.

Given the disparity between both countries, it is no wonder that Mexico’s residents, particularly in Northern states, would take the risk and fly to the US in their search for a shot.

 

Arriving with ease

Passengers taking the hour-long flight with the Cessna 401 on days prior to the crash first had to pay the USD 300 to the pilot and go to Hermosillo International Airport’s alternative private runway. Before boarding the plane, Mexican immigration officials checked their passports and their negative COVID test. The officials carried Secretariat of Foreign Affairs’ badges and charged the equivalent of USD 12.4 for administrative fees. No further questions were asked.

After one hour of flying, the plane arrived at Tucson International Airport’s private flight runway. The next step was one of the most feared by both M. and E.: passing immigration control operated by the Department of Homeland Security (DHS).

Even though the US-Mexico land border is closed to all but essential traffic, which evidently does not include vaccinations for Mexican nationals, it is open for people flying to US airports for all sort of reasons including tourism.

Accustomed to a harsh treatment by DHS’ officials at immigration checkpoints, the passengers feared being asked about their real motivation that day. But, to their surprise, private flight passengers receive a different treatment. “They were very kind people, very cordial,” said E. An opinion shared by M.: “I have never had a friendlier encounter with DHS.”

DHS officials did not ask for the motive of their travel that day; vaccines were not mentioned. In E’s case, not a single question was asked besides her passport and visa; no question about her final destination, COVID-19 test nor precedence.

The Department of Homeland Security did not respond to a request for comment regarding the system in place to prevent vaccine tourism at this stage of the country’s campaign.

After taking a picture and giving their fingerprints, with no further questions asked by DHS officers, the passengers exited the terminal and continued to Phoenix, where they would receive Pfizer’s vaccine days later.

 

Vaccinations Anonymous

The day of her appointment, E. drove to the volunteer-run vaccination site in Chandler, a city in the Phoenix metropolitan area. She hoped that it would be as efficient and easy as the arrival had been. And she was correct.

At the site, volunteers did not ask for identification, they asked her to show an automatic QR code given to her by the state’s health department website. The concern was not about the identity of the people but rather if they had allergies or any significant medical condition.

Since E. suffers from diabetes and hypertension, they instructed her to wait 30 minutes in a special area after the shot to see if she had an adverse reaction to the vaccine. “At that moment, they gave me a card with the vaccine information, the site and the appointment for the second shot,” she said.

 

Volunteering for vaccines

Meeting the state’s eligibility requirements for the vaccine is relatively easy today. Registration at Arizona’s state-operated COVID-19 vaccination sites in Maricopa and Pima counties (the two most populous counties in the state) is currently open to all Arizonans 16 and older. “We have been flexible and nimble throughout, while expanding the availability of state sites to vaccinate large numbers of people rapidly,” said Dr. Cara Christ, director of the Arizona Department of Health Services, when the measure was announced back in March.

But that was not always the case. The state implemented an initial strategy to inoculate its population in groups, starting with healthcare workers and the older population. Back then, one of the few ways to get around the restrictions was to volunteer at a vaccination site.

In late February, “A.”, a Mexican national living in Tucson who asked not to be fully identified, got a tip from a friend and registered with the Medical Reserve Corp to participate as a volunteer for about eight hours at the Abrazo Medical Center in Goodyear, a city in the Phoenix metro area. In exchange, he received Pfizer’s vaccine.

His task was being part of the screening phase, asking for birthdates, allergies and providing instructions about the process. According to him, there were around 70 volunteers running the site that day and they managed to inoculate between 500 and 600 people.

“The operation was very well organized. There was a very positive atmosphere since they were people doing it because they care,” A. explained.

While he is a legal Mexican resident of the state and the other two women in this story are not, A. is empathetic to his compatriots’ situation: “Somehow [Arizona] is allowing [vaccine tourism] by not screening passengers. Do you think they don’t know that people are coming to get vaccinated? I cannot comment because I am a guest in this country, but I understand. The need should be recognized and a system to bring more people should be put in place once the vaccination of residents is advanced. It might even help Arizona’s economy.”