(CNN) Florida issued new health guidelines Thursday in an attempt to cut down on "vaccine tourism," requiring that Covid-19 vaccines be given only to permanent and seasonal residents.
State Surgeon General Dr. Scott Rivkees signed a Public Health Advisory prioritizing Florida residents for the vaccines, days after Gov. Ron DeSantis said publicly that the shots should be reserved for part-time or full-time residents of the Sunshine State.
"We're only doing (shots) for Florida residents," DeSantis said Tuesday in Cape Coral. "You've got to live here either full-time or at least part-time."
At another news conference in Rockledge on Tuesday, DeSantis differentiated between "snowbirds," who live in Florida in winter months, and those just stopping in to try to get vaccinated.
"Now we do have part-time residents who are here all winter," he said. "They go to doctors here or whatever, that's fine. What we don't want is tourists, foreigners. We want to put seniors first, but we obviously want to put people that live here first in line."
The change came after news stories reported that some non-Floridians, including people with second homes in Florida and several wealthy Argentinians, had traveled to Florida to get vaccinated.
As of January 19, Florida has vaccinated more than 39,000 people who reside out-of-state, including over 1,000 who have received the recommended two doses, according to data from the Florida Department of Health. That's about 3.5% of the 1.12 million people who have been vaccinated in Florida. The state's data does not differentiate between tourists and part-time residents.
The revelations sparked frustration among Floridians unable to get vaccinated, forced to wait in hours-long lines or stymied by confusing or flailing websites.
But the issue is not specific to Florida. Vaccine tourism is the result of a few key factors: the shortage of vaccine compared to demand; the disorganized start to administering the shots; and the lack of consistent federal guidance, which has created different vaccine availability between states and even between counties.
Dr. Peter Hotez, a vaccine expert and the dean of the National School of Tropical Medicine at Baylor College of Medicine, said vaccine tourism highlighted the failures of the slow-moving federal vaccine rollout.
"If we're still in this situation a month from now, we're going to be in a lot of trouble," he said.
Florida had allowed anyone 65 and older to get vaccinated, regardless of where they live, making it one of the first states to open to that age group.
In contrast, many other US states have residency requirements and instruct people to bring ID, mail, or rent statements to prove it. A number of states have also hewed closer to the CDC vaccine committee's recommended Phase 1b guidelines that say vaccines should go to adults age 75 and up and frontline essential workers.
Naturally, people desperate for the vaccine, able to travel and lucky enough to get a vaccine appointment on finicky websites or hotlines, have gone far and wide to get them.
Mark and Connie Wallace, who live in Shelby County, Alabama, told CNN affiliate WBMA they drove almost two hours into Georgia to get vaccinated at a Publix pharmacy.
"They knew that we were coming from out of state and they said that that was fine," Connie Wallace said, "so we didn't feel like we were pushing anybody else out, which we didn't want to do."
Connie is 68 and has underlying health issues related to her heart, WBMA reported. The couple managed to get a vaccine appointment online and so ventured to Carrollton, Georgia, to get inoculated.
"I would have gone eight hours away if I had to," Mark Wallace told WBMA.
Similar interstate vaccinations have been seen at major metropolitan areas that cross borders.
New York City has vaccinated health care workers or other essential workers like teachers or firefighters who work in the city but live outside the five boroughs. According to NYC data, about 73% of those NYC has vaccinated live in the city, 15% live in another part of New York state, and the rest live in New Jersey, Connecticut, or another state or did not provide their residence.
Because the federal government allots vaccine based on population, this has created an uneven rollout.
Two weeks ago, Mayor Bill de Blasio sent a letter to then-Vice President Mike Pence asking him to allocate more doses to "New York City and other commuter jurisdictions who are vaccinating more than their residents."
Dr. William Schaffner, professor of infectious diseases at Vanderbilt University, said he recognized that a New Yorker might be frustrated to see a commuter from New Jersey crossing state lines to get vaccinated.
But as long as the vaccine is being used rather than sitting untouched, it's not a problem from a public health perspective.
"Rather than 'it's my vaccine, not yours,' (getting) vaccine in arms is what we want," he said. "I would hope we quickly have enough vaccine so we don't have to belabor these somewhat petty issues."
The end-goal is to vaccinate enough Americans to reach herd immunity, generally estimated to be around 70 to 80% of people. Schaffner indicated that the high demand for the coronavirus vaccine is essentially a good problem to have at this point.
"There are people who are eager to get the vaccine -- boy, that's a good thing," he said. "So let's not ding their resourcefulness and imagination."
Hotez said he didn't see vaccine tourism as a moral issue, but he emphasized that traveling during the pandemic has its own risks. And he noted that every state is similarly struggling to administer enough vaccines because of the federal problems.
"Vaccine tourists are most likely setting themselves up for disappointments," he said.