As expected, Royal Caribbean has updated its policy to consider cruise ship passengers fully vaccinated if they have a mixed series of mRNA vaccines.

The Centers for Disease Control and Prevention (CDC) updated its guidance last week on mixed vaccines, which greatly affects residents of certain countries where the practice was encouraged, such as Canada or Germany.

As a result, Royal Caribbean has updated its rules for mixed vaccines from different manufacturers:

For sailings departing from the U.S., the CDC will now recognize a mixed series of mRNA vaccines (e.g., 1 shot of Pfizer with 1 shot of Moderna, in any order) as fully vaccinated. The doses must be administered a minimum of 28 days apart. The guest will be considered fully vaccinated 14 days after the final dose. 

Guests who received 1 shot of Johnson & Johnson, with any other vaccine, are considered fully vaccinated 14 days after the Johnson & Johnson shot.

Guests whose two-shot regimen consists of 1 mRNA dose (Pfizer or Moderna) with 1 AstraZeneca dose will not be considered vaccinated. We continue to encourage the CDC and other U.S. government officials to re-evaluate this policy.

The change in policy mirrors sister company Celebrity Cruises, which updated its policy a few days ago.

The full policy has been posted on Royal Caribbean's website.

Earlier this summer, Royal Caribbean and other cruise lines announced they would not consider someone with mixed vaccines fully vaccinated, following a CDC policy change.

Not allowing mixed vaccines has been a problem for Canadian cruisers because the practice is widespread in that country.

Certificate of Recovery from Covid-19

Royal Caribbean also added information for guests who have recovered from Covid-19, as well as digital certificates.

For U.S. departures, Royal Caribbean does not grant vaccine accommodation for reasons related to recent recovery from Covid-19.

However, Royal Caribbean will allow a certificate of recovery for departures outside the United States.

Guests will show the certificate at time of boarding that verifies that either the guest was diagnosed with Covid-19 within the 90 days prior to their sail date or that they are sailing before the end date noted on the Certificate of Recovery.

For sailings departing from Cyprus, the Certificate of Recovery must be issued 30 days after the day of the first positive Covid-19 test and is valid for either 90 days or until the expiry date displayed.

The Certificate of Recovery must include the following details: 

• Name of sailing guest
• Date of issuance of the Certificate of Recovery
• Medical services provider name

EU Digital COVID Certificate 

For sailings operating within the E.U only, guests may present an EU Digital COVID Certificate showing they have received a single dose of a 2-dose series of an approved COVID-19 vaccine after having previously been infected with COVID-19, where the Member State issuing the EU Digital COVID Certificate considers the vaccination course as completed. 

In this scenario the certificate must clearly show 1 of 1 vaccine completed.  The vaccine must have been administered at least 14 days before their sail date 

Celebrity Cruises has updated its policy to now allow some mixed vaccines and recognize those passengers as fully vaccinated.

In an updated policy posted to Celebrity's website, it says the the Centers for Disease Control and Prevention (CDC) has updated its guidelines regarding mixed vaccinations, which prompted Celebrity to change their policy.

Earlier this summer, many cruise lines were forced to not recognize any passenger who had a combination of vaccines from different manufacturers, including Royal Caribbean. The reason being the CDC did not recognize any mixed combination of Covid-19 vaccines as fully vaccinated.

According to Celebrity, the CDC has "clarified their position regarding mixed vaccinations."

Celebrity has seemingly followed that guidance from the CDC in their updated policy and will now recognize a mixed combination of mRNA Covid-19 vaccines (Pfizer/Moderna) as fully vaccinated.

• If a guest has already received two mRNA vaccines in mixed series at a minimum interval of 28 days, the CDC will consider that individual to be fully vaccinated against COVID-19.
• Guests who received the Janssen (aka Johnson & Johnson) vaccine before or after another COVID-19 vaccine should be considered to have received a valid, single-dose Janssen vaccination—not a mixed vaccination series—and are considered fully vaccinated against COVID-19.
• To be recognized as fully vaccinated, guests 12 years of age and older, must complete a vaccine series with the last dose administered at least 14 days prior to sailing.

"For sailings departing the United States, to be recognized as fully vaccinated, guests 12 years of age and older, must complete a vaccine series with the last dose administered at least 14 days prior to sailing. The CDC will also consider a guest fully vaccinated with proof of vaccination that can include mixed doses of the Pfizer and Moderna mRNA vaccines. Celebrity Cruise will not accept any form of Certificate of Recovery."

The issue of mixed vaccines affects residents of certain countries where the practice was encouraged by their governments, such as Canada.

A change to Royal Caribbean's policy has not yet been posted.

Celebrity also added a new option for passengers that lost their original vaccination card, but want to show an electronic copy instead.

Celebrity will now accept proof of vaccination from a passengers if that person can furnish proof from the government site or app.

Photos or photocopies of the original vaccination card are still not accepted.

The U.S. Centers for Disease Control and Prevention (CDC) posted a new update to its cruise ship operations manual asking cruise lines to take another look at some of the onboard rules related to mask use.

Currently, cruise lines like Royal Caribbean have certain areas of the ship where fully vaccinated guests can go and take off their masks while indoors. These areas are only open to fully vaccinated guests.

The CDC has issued an update recommending this practice stop because of the increased transmissibility of some Covid-19 variants, and published the new recommendation in its  Framework for Conditional Sailing Order (CSO).

On August 27, the CDC posted an update that it is recommending, but not requiring, cruise lines reconsider face mask rules such as these:

• Allowing fully vaccinated crew to remove masks indoors in areas inaccessible to passengers
• Designating areas as only accessible to fully vaccinated passengers and crew where masks and physical distancing are not required
• Advising passengers and crew on ships with 95% of crew and 95% of passengers who are fully vaccinated that they do not have to wear a mask or maintain physical distance in any areas. 

Royal Caribbean currently has certain areas of its cruise ships designated for only fully vaccinated passengers, where passengers there are allowed to take off their mask while in this area.

Admission to these vaccinated areas is enforced by crew members who check if a passenger is vaccinated or not.

The exact list of venues available only to fully vaccinated passengers depends on the ship, but here are some examples:

• The Chef’s Table
• Izumi Hibachi & Sushi
• Schooner Bar
• The Pub
• Viking Crown Lounge
• Solarium
• Casino Royale
• Vitality Spa

The CDC still allows cruise ships to offer select areas as only accessible to fully vaccinated passengers and crew where masks and physical distancing are not required, but this update is aimed at requesting the cruise lines to reconsider this policy.

The CDC also revised its testing requirements for fully vaccinated and unvaccinated cruise ship passengers for pre-embarkation, embarkation, and back-to-back sailing, for cruise ships operating under the CSO, including those choosing to follow CSO measures on a voluntary basis. 

The new recommendation matches what Royal Caribbean was already doing, which is require unvaccinated and fully vaccinated passengers bring a negative Covid test that was take no more than 3 days before boarding to the cruise terminal.

Royal Caribbean first added the requirement to get a negative Covid-19 test before cruises 5 nights or longer as of July 31, and then expanded that rule to include sailings of any length as of August 12.

Read more: When you should take a Covid test before your Royal Caribbean cruise?

According to the CDC, the change was made because of the CDC’s guidance for fully vaccinated people and the increased transmissibility of some Covid-19 variants of concern.

The U.S. Centers for Disease Control (CDC) issued a new warning on Friday to anyone who is at high risk of severe complications from Covid-19 not to go on a cruise, even if they are fully vaccinated.

According to the CDC's website, the warning applies to Older adults, people with weakened immune systems (including people who take medicines that suppress their immune systems) and people of any age with certain underlying medical conditions, because they are more likely to get severely ill if they get Covid-19.

"Severe illness means that a person with COVID-19 may need: hospitalization, intensive care, a ventilator to help them breathe or they may even die," according to the CDC's website

Why the change? The CDC says the new advice follows several coronavirus outbreaks that have been reported aboard cruise ships.

"The virus that causes Covid-19 spreads easily between people in close quarters aboard ships, and the chance of getting Covid-19 on cruise ships is high. Outbreaks of Covid-19 have been reported on cruise ships."

While there have been cases of Covid on cruise ships, protocols onboard have proven to contain the cases to just a few passengers. In many situations, cases were limited to families traveling together.

Royal Caribbean acts quickly with contact tracing and additional testing to quarantine and safely repatriate those passengers home, often via private jet transportation.

Royal Caribbean International President and CEO Michael Bayley said earlier this week there are typically one to two passengers that test positive for the illness on a typical sailing.

Mr. Bayley went on to say that due to the high levels of vaccinated passengers and frequent testing, a cruise ship, "is literally one of the safest places on the planet."

The new warning did not result in a change of the agency's Covid-19 levels, leaving cruise ships at level 3 or "high".

The CDC's 4-level system categorizes destinations, including international destinations and United States Territories, into the following four levels:

Level 4: Very high level of Covid-19
Level 3: High level of Covid-19
Level 2: Moderate level of Covid-19
Level 1: Low level of Covid-19

The new warning is in addition to the agency's previous guidance that unvaccinated passengers not go on cruise ships.

Due to Bahamian law, Royal Caribbean now requires anyone over the age of 12 to be fully vaccinated in order to go on a cruise. Children 11 and under do not have a vaccine option, and are allowed to sail albeit with additional requirements and protocols.

Update 8/20/21: Royal Caribbean confirms the Abbott BinaxNow COVID-19 Ag Card Test, which is taken at home and supervised by a telemedicine professional, is accepted. It must be taken under live video supervision.

Royal Caribbean recently added a new requirement for anyone going on a cruise from the U.S. will need to get a Covid-19 test taken before the sailing, and there is now a new option available to get that completed.

The cruise line has updated the test requirement policy on its website to say it would allow home/self-tests if there is documentation can be provided from a medical professional that they were supervised.

With this change, the at-home tests that are done in a video conference with a medical professional are acceptable. These tests can be completed in 15-minutes and do not require finding an appointment at a nearby testing center.

Over the last two weeks, Royal Caribbean has introduced a new requirement for passengers where they must provide a negative PCR or antigen test for Covid-19 during check-in.

This test must be taken no more than three days prior to sailing and must be arranged by each guest at their own expense with an accredited test provider.

Abbott BinaxNOW™ COVID-19 Ag Card Home Test is supervised and administered remotely via Zoom. Results are available within 15 minutes.

The test can be self-administered using a short nasal swab (not the deep and invasive nasopharyngeal swab) and check test results in 15 minutes.

The at-home tests by Abbott does require a prescription, which allows for someone to fill out a form to apply for an online prescription.

Results are available instantly email, as well as through the manufacturer's app. There is also a QR code provided to be shared via text, email and other methods.

The test can be used on children as young as two years old when samples are collected by an adult and for all people aged 15 years or older.

One issue with these at-home tests is there are reports of hours-long wait times due to an increase in demand for tests. Your experience may vary depending on when you opt to take the test.

Cruise ship passengers that test positive for Covid-19 are not just left behind at the nearest port. In fact, Royal Caribbean takes the health and safety of passengers, crew members, and the communities their ships visit seriously enough to hire private transportation home.

Unlike other industries that have had little to no government regulations regarding their Covid-19 response and protocols, the cruise industry has been held to a much higher standard with requirements and oversight.

Exemplifying the cruise industry's commitment to the welfare of its guests is the fact anyone that has tested positive for Covid during the course of a cruise has been flown home in a private jet.

Considering the expense and logistics involved in flying anyone home at the last minute on private transportation, the fact Royal Caribbean is using private jets and limousines for those afflicted with Covid is rather impressive.

Royal Caribbean says vaccinated guests and children not yet eligible to be vaccinated who book a cruise sailing on or before October 31, 2021 will have the following Covid-19 Assistance at no extra charge.

• 100% cruise fare refund for you, and your Travelling Party, if any of you tests positive for Covid-19 within 14 days prior to the cruise or at the boarding terminal.
• Pro-rated cruise fare refund if your cruise is cut short for reasons related to Covid-19.
• If you test positive for Covid-19 during the cruise, Royal Caribbean will cover the costs of Covid-19 related medical treatment onboard, any required land-based quarantine, and travel home for you and your Traveling Party.

Unvaccinated guests age 12 and older sailing from Florida homeports who booked prior to March 19, 2021 or after June 28, 2021 will not be subject to this Covid-19 Assistance, and must provide proof of travel insurance as outlined in prior to boarding.

Two RoyalCaribbeanBlog readers recently had the unfortunate opportunity to be flown home during their cruise due to Covid.  

Daniel was on Adventure of the Seas in June when towards the end of his cruise, he tested positive for Covid during a routine Covid test for all passengers. Everyone else in his traveling party tested negative.

Daniel was fully vaccinated and followed protocols, but unfortunately had to end his cruise early when he tested positive.

Daniel said a half hour or so after taking the test, crew members approached him on the pool deck and informed him he needed to quarantine in his room due to the positive test.

After the second test came back positive, he put on a hazmat suit and was brought to the ship's medical center to get bloodwork, urinalysis, and chest x-ray.

"The care was lovely and touching since I was scared, anxious, etc," he recalls.

After that he was quarantined in an oceanview stateroom and supplied with water, cleaning supplies, and unlimited room service.

He and his family were disembarked in Cozumel, where Royal Caribbean arranged for an ambulance to the airport, a private jet ambulance home and a limo van waiting for him in Tampa International Airport.

"Wonderful care and service from the flight crew," David said of getting home. "Royal Caribbean was amazing how they handled this nerve wracking experience."

Another RoyalCaribbeanBlog reader, smokeybandit, was on Adventure of the Seas more recently, and through contact tracing, his son was identified as a close contact of someone who tested positive on the ship.

He shared the experience on the RoyalCaribbeanBlog message boards.

"We never really asked for details on when or what they defined as a close contact since I figured we'd never get that detail as I'm sure they'd cite privacy.

Like Daniel, smokeybandit and his family were quarantined initially while another PCR test was administered. Just like Daniel, they were given complimentary room service, wifi, movies, etc.

Smokeybandit's family was taken off the ship in Nassau and boarded a limo van, where they were driven to the plane and flew directly home. 

His family boarded a 6 passenger Learjet that can convert to an air ambulance.  

Once they arrived home, a town car was waiting for his family to take them home.

Smokeybandit indicated that the transportation home was covered by Royal Caribbean, although he did have his own travel insurance.

The U.S. Centers for Disease Control and Prevention (CDC) has clarified their position regarding mixed vaccinations and provided updated guidance to Royal Caribbean.

The new guidance applies to sailings leaving the U.S. and primarily affects residents of countries where more than one type of vaccine was administered, such as Canada or Germany.

A Royal Caribbean spokesperson said currently, the CDC does not recognize any mixed combination of Covid-19 vaccines as fully vaccinated.

Royal Caribbean updated its policy posted online to say the CDC requires someone be fully vaccinated, if they complete a vaccine series with products from the same manufacturer with the last dose administered at least 14 days before their sail date.

The CDC has provided the following reference to support their decision:
https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html#Interchangeability

"COVID-19 vaccines are not interchangeable," CDC spokesperson Jasmine Reed told the CBC

"The safety and effectiveness of receiving two different COVID-19 vaccines has not been studied."

Royal Caribbean policy on August 2

Royal Caribbean continues to encourage the CDC and other U.S. government officials to re-evaluate this policy.

This is yet another change in the mixed vaccine policy, with the CDC issuing new guidance that requires cruise lines to adjust their policies.

Cruises departing ports outside of the U.S.

If your cruise sails from outside the United States, Royal Caribbean will allow guests who have received some mixed vaccine combinations.

For cruises departing from ports outside of the U.S., guests who are vaccinated with a mixed regimen consisting of two shots of the following manufacturer combinations: Pfizer and Moderna, or AstraZeneca with either Pfizer or Moderna, will be able to sail. Doses must be separated by at least 28 days and not more than 42 days for mixes of Pfizer and Moderna, and combinations of AstraZeneca with Pfizer or Moderna must be separated by at least 4 weeks and not more than 12 weeks.

Mixed vaccines may not be accepted at all ports of call. Guests who are vaccinated with a mixed series may not be allowed to go ashore at these ports or may need to undergo additional testing if they wish to go ashore.

Mixed vaccines in Canada

Canadian cruise fans have been the most vocal about the problem with the new policy preventing them from being able to sail.

Canada currently uses vaccines from Pfizer, Moderna, and AstraZeneca, as well as Johnson & Johnson, which uses a single shot.

The Canadian government says it's working with its international counterparts to resolve vaccine differences. 

"Over the next number of weeks and months, there may be revisions provided by health authorities around the world with respect to these vaccine regimes," Intergovernmental Affairs Minister Dominic LeBlanc said at a news conference last week. 

Regina-based infectious disease physician Dr. Alexander Wong believes the U.S. will soon bend its stance on mixing vaccines, "Looking at, for example, the U.S. and Canada, and how important that border is, I suspect it's going to get figured out sooner rather than later."

While cruise ships are sailing again, there is still confusion about Covid-19 vaccine requirements, and Royal Caribbean International's CEO tried to address the issue again this week.

Royal Caribbean International President and CEO Michael Bayley posted on social media an explanation of where things are right now with vaccine requirements.

Mr. Bayley has taken on a "hands on approach" to addressing customer concerns, especially on social media.

He started off by acknowledging the trouble some cruise fans have had with new protocols lately, "There is a lot of confusion and understandable concern over vaccine requirements."

He explained that depending on where a ship sails from, each country can have different regulations, "What guides our policy is primarily determined by which port and country the ship is home ported and sails from and returns to."

"For example If the ship sails from and returns to a USA port we are guided by CDC/FDA guidelines."

Mr. Bayley brought up the example of the United States, because he has heard from many Canadian guests and how they were guided by their government on when and how to get vaccinated against Covid-19 versus the U.S.

In recent weeks, cruise lines have added new protocols that prohibit some level of mixed vaccines, which depends on the mix of manufacturers and where you are sailing from.  

Royal Caribbean issued a mixed vaccine policy, but then revised their policy after getting a lot of questions from Canadian customers who would suddenly find themselves unable to sail.

The revised policy allows mixed vaccines in some situations, which is a step ahead of the U.S. Centers for Disease Control and Prevention (CDC) preference for vaccinations not be mixed.

According to Bayley, Royal Caribbean has brought up the issue of the differences in the Canadian government's approach with that of the CDC, "Please understand we are not in a position to disregard the relevant governing authority."

"I have received many emails on this issue and we raised this yesterday with the CDC and while obviously sympathetic they cannot change the current position. All cruise lines are in a similar position."

Celebrity vs Royal Caribbean's approach

Mr. Bayley also addressed the different paths Royal Caribbean International and Celebrity Cruises have taken in getting back to service.

In a comment to the same mixed vaccine post, Mr. Bayley responded to a question about, "Why Celebrity cruises, sailing out of Florida ports, are following the CDC guidelines, while Royal is bending to Governor De Santis’ orders?"

Mr. Bayley explained the different restart plans have to do with Royal Caribbean being a family cruise brand.

"In a normal year the majority of our guests are families. At any time throughout the year we carry approx 10 per cent plus of our guests who are kids 12 and under and they of course travel with their family."

"Because of the kids we have been sailing at around 90 percent vaccinated and so we would not be able to operate at the CDC 95 / 95 and so like Disney Cruises or MSC all family brands we chose this path. 

He said Florida's law, "presents challenges", but he said Royal Caribbean always complies with federal, state and local laws.

"Our wonderful sister brand Celebrity also welcomes kids and families and while they have a great time the number of kids and families is far less than Royal. Hope that clarifies."

"To be very clear both brands fully follow above and beyond the CDC guidelines."

Royal Caribbean has posted a new mixed vaccine policy to its website to address cruise ship passengers who have gotten more than one brand of Covid-19 vaccine.

The cruise line had posted a mixed vaccine policy last week that banned them, but quickly removed the policy completely in order to review the issue further following a lot of guest concern.

Royal Caribbean's new mixed vaccine policy, which depends on the mix of manufacturers and where you are sailing from.  

The policy begins with the ideal scenario for a fully vaccinated guest: Royal Caribbean accepts vaccines that are fully approved or authorized for emergency use by the U.S. FDA or the World Health Organization. All doses of your vaccine should be from the same manufacturer and of the same type (e.g. mRNA), in the required number of doses to be considered fully administered (e.g. 2 shots of Pfizer, Moderna, AstraZeneca, etc., or 1 shot of Johnson & Johnson). 

The mixed vaccine policy breaks down depending on where you are sailing from:

Cruises Departing from U.S. Ports 

Despite the U.S. Centers for Disease Control and Prevention (CDC) prefence for vaccinations not be mixed, Royal Caribbean will still allow mixed vaccines in some situations.

Royal Caribbean will accommodate guests who are vaccinated with mixed mRNA vaccines, such as 1 shot of Pfizer and 1 shot of Moderna. The doses must be separated by at least 28 days and not more than 42 days.

Royal Caribbean does not accept 1 shot of an mRNA vaccine (e.g., Pfizer or Moderna) mixed with 1 shot of a viral vector vaccine (e.g., AstraZeneca). 

Mixed vaccines may not be accepted at all ports of call. Guests who are vaccinated with a mixed series may need to undergo additional testing at embarkation if they wish to go ashore in these ports.

Cruises Departing from Ports Outside of the U.S.

For cruises departing from ports outside of the U.S., Royal Caribbean will accept guests who are vaccinated with a mixed regimen consisting of 2 shots of the following manufacturer combinations: Pfizer and Moderna, or AstraZeneca with either Pfizer or Moderna.

The doses must be separated by at least 28 days and not more than 42 days for mixes of Pfizer and Moderna, and separated by at least 4 weeks and not more than 12 weeks for combinations of AstraZeneca with Pfizer or Moderna.

Mixed vaccines may not be accepted at all ports of call. Guests who are vaccinated with a mixed series may not be allowed to go ashore at these ports, or may need to undergo additional testing if they wish to go ashore.

The full policy has been posted on Royal Caribbean's website.

The practice of mixing vaccines is common in countries like Canada or Germany, where those governments have been openly advocating this approach for months.

The updated policy would have resulted in many Canadian cruise fans potentially unable to sail.

It looks like Royal Caribbean has perhaps changed its mind about the mixed vaccine policy after all.

Over the weekend, Royal Caribbean had joined other cruise lines in adding language to its vaccination policy saying it would not accept mixed vaccines as being fully vaccinated.

As of this morning, that policy has been removed from its website, and there is no mention at all of mixed vaccines.

The rule change was originally about not considering someone who had taken doses of different brands of Covid-19 vaccines fully vaccinated. This would mean someone who took 1 dose Pfizer + 1 dose Moderna, or 1 dose AstraZeneca + 1 dose Pfizer, etc.

Royal Caribbean's revised policy on July 19

Royal Caribbean's policy on July 17

If a guest did have a mixed vaccine regiment, they would be considered instead unvaccinated.

The practice of mixing vaccines is prevalent in countries like Canada or Germany, where those governments have been openly advocating this approach for months.

The new policy would have resulted in many Canadian cruise fans potentially unable to sail.

Royal Caribbean has not commented publicly about the policy change, but it was not the only line to update its requirements.

Holland America Line, Norwegian Cruise Line and Princess Cruises all modified their Health and Safety protocols to exclude those who had received mixed COVID-19 vaccinations.  Royal Caribbean followed with their change a day later.

As of right now, Royal Caribbean's policy posted online makes no mention of mixed vaccines and it is not clear if public pressure or something else compelled them to reverse the change.