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How This Island Destination Became the Most Vaccinated Place in the U.S.

By Michelle Baran

Nov 10, 2021

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Beautiful beaches, check. High vaccination rate, check.

Photo by Maridav/Shutterstock

Beautiful beaches, check. High vaccination rate, check.

Puerto Rico has a higher vaccination rate than anywhere else in the country. How did the island territory get there?

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If you’re wondering which U.S. states have the highest COVID-19 vaccination rates, you’ll need to look no further than the Northeast. Vermont, with 72 percent of its population fully vaccinated, is in the top spot, followed by Connecticut and Maine, at 71 percent each (Massachusetts and New York are close behind at 70 and 67 percent, respectively). But none of these is the most vaccinated place in America. That title belongs to the U.S. island territory of Puerto Rico, which has fully vaccinated 74 percent of its 3 million people, according to the independent COVID tracking project Covid Act Now.

“The super star in America . . . it’s Puerto Rico,” Dr. Ashish Jha, dean of the Brown University School of Public Health, recently wrote in a Twitter thread highlighting Puerto Rico’s vaccination success story. 

So, how did they do it? “It’s not their immense wealth,” wrote Jha, noting that Puerto Rico is not a particularly rich destination when compared to much of the U.S. “They’ve done this largely [by] not tying vaccines to politics. . . . All their political parties actively support vaccinations.”

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Puerto Rico now ranks lowest in the country for new daily cases, and its COVID positive test rate (or the percentage of COVID test results that come back positive) is 2.4 percent, which is also among the lowest in the country. For comparison, states that are currently experiencing a surge in COVID cases have test positivity rates in the double digits, such as South Dakota, which had a test positivity rate of 18.5 percent at press time.

However, getting all of those jabs into the arms of millions of people in Puerto Rico was about more than just overcoming political disagreements or vaccine hesitancy. In a recent report about its COVID vaccine campaign in Puerto Rico, the U.S. Centers for Disease Control and Prevention (CDC) explained that there were other factors at play—namely a well-established healthcare system—that helped a team there mobilize quickly and effectively.

“Puerto Rico has a solid healthcare infrastructure with experienced vaccine providers,” Eunice Soto, an epidemiologist with CDC’s Puerto Rico team, said in a statement about the vaccine rollout there. “Hospitals, federally qualified health centers, and primary care centers were quickly brought up to speed to become the first line of vaccinators. Recruiting nontraditional vaccine providers in rural areas, where fewer vaccine providers were available, was essential to ensure availability across the island.”

Despite, or perhaps because of its high vaccination rate, the Caribbean island is open to travelers whether they are vaccinated or not. Prior to traveling to Puerto Rico, travelers need to fill out a Travel Declaration Form online, which produces a QR code that must be presented upon arrival. Those who are vaccinated with the Pfizer-BioNTech, Moderna, or Johnson & Johnson vaccine can upload their vaccination certificate to that online form, which allows them to bypass an otherwise mandatory pretravel COVID test.

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People who are not vaccinated are required to provide proof of a negative COVID-19 PCR or antigen test taken within 72 hours of arrival. Those who arrive without a test result will need to take a PCR or antigen test within 48 hours of arrival and quarantine until results are ready. Violators face a $300 fine.

>> Next: The AFAR Guide to Puerto Rico

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