Prerequisites for mandatory COVID‐19 vaccination
Is the mandate legal?	There is precedent for requiring proof of vaccination (eg, yellow fever) for international travel to selected destinations under the International Health Regulations (https://www.who.int/ith/annex7‐ihr.pdf). Some countries have announced COVID‐19 vaccine mandates for domestic air travel (eg, Canada, Pakistan), and international travellers are increasingly required to show proof by airlines or countries (https://www.abc.net.au/news/2021‐10‐08/covid‐vaccine‐travel‐overseas‐from‐australia‐tga‐approved/100520008). There will be complexity depending on which COVID‐19 vaccines are accepted by different countries.
Is the burden of disease high enough?	The risk posed by international travel will vary across place and time, and responding to rapid change is not feasible. This means that a general mandate to protect Australian citizens and residents is more likely. Jurisdiction‐level mandates could be based on COVID‐19 burden in the state or territory of origin at different time points.
Is the vaccine safe?	As per Box 1: safety applies to any vaccine a traveller is required to have.
Do the vaccines reduce transmission?	As per Box 1.
Is vaccine supply sufficient and accessible?	The World Health Organization currently recommends against requirements for COVID‐19 vaccination for international travel as a condition of departure or entry (https://www.who.int/news‐room/articles‐detail/interim‐position‐paper‐considerations‐regarding‐proof‐of‐covid‐19‐vaccination‐for‐international‐travellers). This is partly on the basis of limited vaccine supply globally. For domestic travel within Australia, there may be populations where vaccine supply remains challenging. Thus other less restrictive measures should be considered, as below.
Have other less restrictive measures been tried first?	The impact on those who cannot, or will not, vaccinate would be significant if travel is indefinitely restricted for them, such as for those separated from family overseas. At the same time, it is desirable to limit transmission of SARS‐CoV‐2 resulting from travel. A step‐down requirement may be a reasonable compromise. For example, the European Union Digital COVID Certificate will provide proof that a person has been vaccinated against COVID‐19, received a negative test result, or recovered from COVID‐19. Medical exemptions must also be accessible and recognised. Type of quarantine should be adjusted according to individual and country risk level.
Procedural recommendations if a mandate is planned
Does the mandate penalise the poor unfairly?	Mandatory vaccination for global travellers will penalise those unable to access vaccination due to supply and slow country procurement. Many low and middle income countries that are dependent on vaccine supply through COVAX (https://www.who.int/initiatives/act‐accelerator/covax) need to be given consideration and their citizens not penalised unfairly, especially by countries that may have not contributed to COVAX supply. These ethical issues need to be considered and other means made available to travellers from these countries; ie, vaccination and quarantine on arrival.
Is there a plan to support those mandating vaccination?	A range of actors need to be involved with informing travellers about the mandates, including those working in the travel industry. There may be implications for those travelling away from Australia, as well as those wishing to travel into Australia for holidays, work or study. It is critical that easily navigable information is made available and translated so that there is sufficient time for travellers to understand the requirements. Communication about COVID‐19 vaccine requirements could also include recommendations for other relevant travel related vaccines.
Are affected populations considered in planning?	Restricting freedom of movement requires transparency and fairness, as well as raising operational considerations for incoming visitors. These include demonstration of proof of vaccination; how to regard receipt of vaccines that have not been approved under WHO Emergency Use Listing or licensed by the national regulator; and how to account for those who seek to travel from a country without adequate vaccine supply.
Conclusion	While mandatory vaccination is not justified for travel, evidence of vaccination, a negative test result or previous infection is reasonable to protect travellers and reduce transmission. The implementation of these requirements must consider inputs from all stakeholders, including those in the travel industry and travellers.