Mai Le in Boston does not know when her parents will be able to get vaccinated . The Vietnamese Americans went to Vietnam last January to visit family members and have been stuck there since. With Vietnam now struggling with a fourth wave of Covid-19 that has infected more than 1,400 people in the past three weeks – accounting about a quarter of the country’s total tally – she fears they are vulnerable. “I feel terrible. They should be vaccinated, not me. I’m younger, I’m healthier. They are in their seventies. They need it more than I do,” said Le, 42, an entrepreneur who has received both shots of the Pfizer vaccine. Adding to her worry is that her father has underlying health conditions that make him extremely vulnerable to lung infections. Le has contacted her congressman to suggest the United States vaccinate overseas Americans like her parents but has not received a response. She thinks the State Department has a duty to ensure citizens overseas receive appropriate medical assistance, but does not hold out much hope. “If my dad catches a cold, he can spend time in the intensive care unit for weeks. So imagine catching Covid, he’s a dead man. So yes, it is a priority, but that’s not how the US government thinks. They look at policies, pros and cons, costs and benefits,” she said. She is unsure whether it is better for her parents to stay in Vietnam and wait for its vaccination programme to gather speed – with about 1 per cent of the population having received at least one shot its roll-out is the slowest in Southeast Asia – or whether they should risk being exposed on the near 30-hour flight home. With some 9 million Americans living abroad, many face a similar predicament. While Asian economies like Vietnam, Thailand , Cambodia and Taiwan earned praise for their efforts early in the pandemic to stop the spread of the virus, some are now seeing a resurgence in cases. And while their overall infection levels remain far below many Western countries, their vaccination rates are also low compared to the West. In contrast the US, which has recorded more infections (around 33 million) and more deaths (around 586,000) than any other country, is making swift progress with its vaccine programme. As of May 16, more than 46 per cent of Americans and over a quarter of Europeans had received at least one dose of a Covid-19 vaccine . That compares to only 14.5 per cent of South Americans, 4.9 per cent of Asians and less than 1.3 per cent of Africans, according to Our World in Data. What’s more, the Washington-based Brookings Institution has estimated that the US might have a surplus of between 500 million and 1 billion Covid-19 doses, depending on its rollout strategy, enough to vaccinate the country’s entire population again. ‘AN ARSENAL OF VACCINES’ US President Joe Biden announced this week that he planned to distribute some 80 million Covid-19 vaccine doses worldwide as part of an effort to counter China and Russia , both of whom Washington believes are trying to use their vaccines to leverage diplomatic influence. Biden pledged to send 20 million doses of vaccines approved by the US Food and Drug Administration (FDA) – those made by Pfizer, Moderna and Johnson & Johnson – to countries in need, in addition to 60 million doses made by AstraZeneca slated to be shipped once that jab is approved by regulators. “We want to lead the world with our values. Just as in World War II, America was the arsenal of democracy, in the battle against the Covid-19 pandemic, our nation is going to be the arsenal of vaccines for the rest of the world,” he said. While Biden’s words may offer some hope to overseas Americans that their host countries may benefit from the donations, there has been no suggestion that the US will prioritise its citizens abroad with the jabs. Vaccination drives stutter as new Covid-19 waves hit Thailand, Vietnam Indeed, in a press briefing last week, the White House Press Secretary Jen Psaki said the US government had not “historically provided private health care for Americans living overseas, so that remains our policy”. A State Department spokesperson took a similar line: “The Department of State does not provide direct medical care to private US citizens abroad. We are committed to providing all possible consular assistance to US citizens in need overseas, including by providing information on local medical resources when appropriate.” That means overseas Americans like Le’s parents may simply have to wait. Last March, in the early days of the pandemic, the State Department advised American students, tourists and temporary overseas workers to return to the US. Many long-term expatriates, like American Gary Suwannarat in Thailand, chose to stay put. At the time, Thailand seemed like one of the safest places to be. Until the end of last year the country had recorded fewer than 7,000 infections, but that picture has changed significantly in recent weeks. Following a third wave of infections that began at a Bangkok nightclub in March, Thailand has now recorded more than 100,000 cases. Suwannarat, who lives in Chiang Mai and is the vice-chairwoman of Democrats Abroad Thailand, considered taking her husband and daughter, who lives in Bangkok, back to the US to get vaccinated. “But the danger of becoming infected during travel freaks me out,” said Suwannarat, 73. She said her daughter was concerned that flying back for vaccination ran counter to the principle of cutting down on travel to avoid spreading the disease. The health of Suwannarat’s husband is also a concern. He is in his late seventies and has chronic obstructive pulmonary disease and stroke-related conditions, which means he is not suited to air travel. “The implicit, if not explicit, message from some American officials in Thailand and in Washington is ‘You choose to live in Thailand. Take the vaccine available here when you can. Otherwise, fly back to the US’,” Suwannarat said. Hong Kong’s ‘wait and see’ vaccine sceptics should look at the struggles of Asia’s Covid-19 success stories She said that attitude left her “dumbstruck”, particularly as Biden had pledged in March that all US adults would be eligible for vaccination by May 1. Like Le, Bangkok-based members of Suwannarat’s organisation along with Republicans Overseas in Thailand and two other groups had raised the issue of vaccinating Americans overseas in a joint letter to US Secretary of State Antony Blinken earlier this month, but it has been unanswered. Marylouise Serrato, executive director of American Citizens Abroad, a Washington-based non-partisan non-profit group, said her group was working on a follow-up letter to the US authorities about vaccinating the Americans diaspora. “American Citizens Abroad will note in its upcoming communications to the US State Department and Congress that the Biden administration has announced the release of surplus vaccinations for distribution to foreign countries struggling with the Covid pandemic and that some of this surplus should be directed to overseas US taxpayers,” she said. VACCINE DIPLOMACY Biden’s pledge to send 80 million doses overseas comes amid concerns in the US that the West is falling behind China and Russia’s efforts at vaccine diplomacy. According to Beijing-based Bridge Consulting, as of May 10, China had sold 651 million vaccine doses – and donated 17.4 million – across the world, with Latin America and the Asia-Pacific being its biggest markets so far. Samantha Powers, Administrator of the United States Agency for International Development (USAID) and former US Ambassador to the United Nations , said in an article for Foreign Affairs magazine in November that vaccines should play central role to play in US foreign policy and that the country could reestablish its international reputation by taking a lead in global vaccine distribution. On the same day as Biden announced the vaccine donations, US-based academics at Duke University, the Center for Strategic and International Studies and others wrote an open letter to the president and Congress urging the government to address critical pandemic needs within the next six-to-nine months. Among their five recommended steps for action was to share all excess doses. “The US should allocate doses through Covax [the global collaboration to accelerate equitable access to Covid-19 vaccines ], regional bodies, and bilateral mechanisms, prioritising countries that are most vulnerable and/or those that have later delivery dates for their own vaccine orders,” the letter said. It said the government should immediately donate all available AstraZeneca vaccine doses following an urgent review by the FDA. It also called on the US to work with other G7 nations at the G7 Leaders’ Summit in Britain next month to share at least 1 billion doses with other countries by the end of this year. However, one of the signatories to the letter, Dr. Krishna Udayakumar, founding director of the Duke Global Health Innovation Center, told This Week in Asia he thought it was unlikely that the US government would provide access to vaccines for private citizens living abroad in the near future. “With vaccine doses from the US, I don’t think it would be feasible or advisable to specify that US private citizens get priority for access to donated doses from the US,” he said. “Allocation and distribution should follow each country’s policy and priorities.” At least for now, overseas Americans hoping for a jab will either have to head home or wait for the vaccination programmes in their host countries to gather steam. Tyler Kozole, a 28-year-old from Utah living in Cambodia, said he was not “overjoyed” that the only vaccines on offer in the country were made by China’s Sinopharm and Sinovac, as he had doubts over their efficacy. The NGO worker said he had read a New York Times article that said the Seychelles had suffered a big increase in infections despite high levels of the population having received the Sinopharm jab, which was this month approved by the World Health Organization for emergency use. Kozole said he would still take either option if offered and he expected to be given a shot within the next two months. By late February, Cambodia had recorded a total of around 500 cases since the beginning of the pandemic, but infection levels then shot up and it has now registered more than 22,000. However, while it is still logging hundreds of cases a day, the daily tally has been falling for the past two weeks. Kozole said either one of the Chinese vaccines would be “better than nothing”, but that even if he received a jab in Cambodia he was considering also getting the Pfizer vaccine when he returned to the US in September. Josh Kugler from Ohio said he was grateful that Taiwan had let him in to work as a junior high schoolteacher last August – a time when the US was inundated with Covid-19 cases. Like other Asian economies Taiwan has also seen a reversal of its Covid-19 fortunes. It had until recently kept new daily infections to the single digits, but its caseload has recently spiked and it recorded 335 new infections on May 17. “I don’t feel I deserve some special privilege because I’m American. When Taiwan secures vaccines for us, then I’ll take them,” said Kugler, 32. “Give them first to the most vulnerable, then when my age bracket or field of work is up for vaccination locally, charge me the same price as everyone else and I’ll get it. I’ll get in line with the Taiwanese while living here,” he said.

This data comes from MediaIntel.Asia's Media Intelligence and Media Monitoring Platform.