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Medical disclaimer: This guide shares my personal experience and general travel information. It is not medical advice and does not replace guidance from your own doctor or care team. Every health situation is different, so talk with your physician about the precautions and travel plans that are right for you before you book or travel.
Key takeaways:
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Airborne risk depends on the environment, so evaluate hotels and flights before you book, not just your mask.
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In hotels, shared hallways and common areas matter more than air vents, which are a very rare route when ventilation works.
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On flights, the biggest risks are airport crowds, boarding, sitting within two to three rows of an infected person, and long flights.
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Buy travel insurance with a pre-existing condition waiver within 14 to 21 days of your first trip deposit.
Who This Guide Is For
If you're immunocompromised, still masking, managing long COVID, or living with a condition that makes airborne illness a serious risk, and you've been quietly wondering whether travel is still possible for you, this guide is for you.
I'm Jennifer Farrar. I became disabled in 2022 from COVID-induced POTS and Gastroparesis. I wear an N95 every time I travel. I run a COVID Safe/Immunocompromised travel community on Facebook, and I built Accessible Escapes specifically because most travel agents have quietly pretended this conversation is over. For a lot of us, it isn't.
The travel industry has largely moved on from COVID precautions. You haven't, and you shouldn't have to apologize for that. There are still ways to travel safely, comfortably, and with real joy. The planning looks different, though, and it requires a level of specificity that most general travel advice completely misses.
Here is what I actually do when I plan my own trips and the trips I book for clients who are navigating immunosuppression, long COVID, and airborne illness risk.
How to Evaluate Destinations and Accommodations for Airborne Risk
Outdoor vs. Indoor Exposure
Destinations that offer primarily outdoor experiences tend to carry lower airborne transmission risk than dense, indoor-heavy itineraries. A national park trip, a road trip through rural areas, or a beach vacation will look different than a city-focused trip built around museums, restaurants, and public transit.
This doesn't mean indoor environments are off the table. It means being intentional about which indoor environments you choose and what you can control about them.
Hotels
COVID spreads in hotels mostly through shared spaces and contact points, not through air vents. I'm a travel agent, not an HVAC expert or virologist, so this is what I've found in the research and from expert opinion.
How does hotel ventilation work?
Hotels typically use one of three types of HVAC systems, including PTACs, the boxy units under many hotel windows. But ventilation can run separately from the unit, so the unit alone doesn't tell you how much fresh air a room gets. According to HVAC engineer Joey Fox, hotels use either hallway pressurization (air flows from the hallway under your door and out through the bathroom) or direct supply ventilation (air goes straight into the room through an airtight door, the current ASHRAE standard).
Can COVID travel through hotel air vents?
It's very rare. Joey Fox says, "If the ventilation is working properly, the risk of transmission from people in other dwellings or from people walking in the hallways is very low." A Taiwan quarantine hotel study found spread through structural defects like wall gaps and broken pipes, which a newer chain hotel is unlikely to have.
How does COVID most often spread in hotels?
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Lobbies and elevators
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Staff interactions, since the virus can linger in poorly ventilated rooms
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Opening your door onto a shared hallway
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Vents and drains (very rare)
What precautions should you take in a hotel?
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Choose a newer chain hotel or one where your door opens outside
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Look for a room with windows that open
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Place a HEPA purifier near the door if the hotel has indoor hallways
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Check your ventilation with Joey Fox's ventilation tips. A carbon dioxide reading of 1,500 ppm or higher in your room means ventilation is insufficient.
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Keep the room around 75 degrees Fahrenheit if your health allows
Before I book for a client, I confirm the windows open and ask whether the hotel has a HEPA air purifier they can put in the room. You don't need permission to bring your own, but some hotels stock them.
My full research is in this post: COVID and Other Airborne Germ Risks in Hotels: Myths, Realities, and Research.
Flights
Cabin air on modern planes is well filtered. Most COVID risk on a flight comes from the airport, boarding, and who sits near you. Aircraft exchange air 20 to 30 times an hour and filter recirculated air through hospital-grade HEPA filters, so risk rises when the air isn't moving. Here is a summary of the studies I found.
Where are the biggest COVID risks when flying?
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Airport lines, security and food courts. Crowds are packed in, and you often have to lower your mask for ID checks or to eat.
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Boarding and deplaning. The air circulation is off while the plane is parked, and passengers walk right past you.
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Within two to three rows of an infected person. One study found a 4.41-fold higher attack rate within two rows, though particles can travel farther.
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Longer flights. One study estimated a mean risk of about 1 in 1,800 on a 0.9-hour flight and about 1 in 120 on an 8.7-hour flight, and you're more likely to take your mask off on a long one.
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Seats near the bathroom. Lines form there, and you end up sitting among the crowd.
What helps most on a flight?
A fit-tested N95 worn the whole way, a window seat toward the middle of the plane, and your air vent pointed at you.
You can find the studies and my full list of recommendations here: Getting Sick on Planes: Research and Mitigation Strategies for Those Who Still Take COVID Precautions.
What to Pack for Immunocompromised and COVID-Cautious Travel
This is what I carry every time I travel, and what I recommend to clients who are managing immunosuppression or significant airborne illness risk.
Some of the links below are Amazon affiliate links. I may earn a small commission on your purchase at no extra cost to you.
A fit-tested N95.
This is the N95 I use. It fits both my husband's face and mine. Fit-test your mask before you go, and bring more masks than you think you'll need.
A sip valve for your mask.
This sip valve lets you drink without breaking your mask's seal. Pair it with a smoothie or milkshake from the airport so you can stay full without taking your mask off to eat.
A portable HEPA air purifier.
I use the Smart Air Qt3 because it's cheap and effective. As soon as I reach a hotel room, I turn it on and let it run for a few minutes before I take off my mask.
A personal laminar air purifier.
The Airfanta Wear is a laminar air purifier. Unlike other air purifiers, which are meant to clean a whole room, it cleans the air directly in front of your face. Some travelers use one while their mask is off to eat. It's too risky for me on a plane, where you're packed in close to other passengers, and some flight attendants won't let you run one in the air. I'd use it only in a place like a quiet restaurant, and only if it fits your comfort level.
HOCL spray.
HOCL spray kills norovirus, which hand sanitizer doesn't. I use it to wipe down seats and surfaces on planes, trains and in my room.
CPC mouthwash and a nasal rinse.
After every high-risk encounter, I use CPC mouthwash and a nasal rinse.
COVID tests.
I carry Metrix tests plus a few rapid tests.
Extra medication. Bring extra of your regular medication, and ask your doctor whether you should carry antivirals in case you get COVID.
Travel insurance that covers your condition.
Travel Insurance for Immunocompromised Travelers
Travel insurance is not optional for immunocompromised travelers. It is the piece of trip planning most likely to determine whether a medical event during a trip becomes manageable or financially catastrophic.
The Pre-Existing Condition Waiver
This is the most critical element to understand. Most travel insurance policies exclude pre-existing conditions unless you purchase a policy that includes a pre-existing condition waiver. Most waivers also require that you purchase the policy within a specified window after your initial trip deposit, typically 14 to 21 days.
If you wait until you've finalized all your travel plans to buy insurance, you may have missed the waiver window. I recommend purchasing your policy within two weeks of putting down your first deposit, every time.
Medical Evacuation Coverage
Verify that your policy includes emergency medical evacuation coverage, and verify the coverage limit. Medical evacuations from international destinations can cost tens of thousands of dollars, which is why the best plans offer up to $1 million per person for evacuation. A low limit may not be sufficient for a remote destination.
Cancel for Any Reason (CFAR)
For immunocompromised travelers whose health can change rapidly, Cancel for Any Reason coverage provides a level of flexibility that standard cancellation coverage doesn't. This policy add-on allows cancellation up to a specified time before departure for any reason, with partial reimbursement, typically 50 to 75% of non-refundable trip costs. For a traveler who may need to make a last-minute decision based on their health, that flexibility can be worth the added premium.
I hold an Allianz General Certificate and work with Allianz as a preferred insurance supplier. I also work with Travel Guard and Chubb. I'm happy to walk through policy options with any client during a consultation. The details matter most here, and a generalist booking site will not give you this kind of guidance.
My Own Protocols as a COVID-Cautious Traveler
I wear an N95 on every flight, from the moment I board until I exit the airport. I wear a well-fitted N95 in any crowded enclosed indoor space, including terminals, busy dining rooms, and crowded entertainment venues. I eat outdoors whenever possible. I run my portable HEPA filter in my hotel room for the duration of every trip. I test before I travel and when I have any symptoms.
I do not expect the world to accommodate these precautions, and I don't ask other travelers to change their behavior. I make my own exposure decisions deliberately, based on the specific environment I'm in.
I also acknowledge the emotional weight of all this. Planning a trip around health risk takes more energy than planning one that doesn't. There is grief in the gap between what travel used to feel like and what it feels like now. I know that directly. My goal is to help you find the version of travel that is genuinely worth the energy you're spending on it, not to sell you an overly optimistic picture of what risk-free travel looks like.
I run a COVID Safe/Immunocompromised Facebook Group for travelers who are navigating exactly this. If you want community alongside practical guidance, you're welcome there: join the COVID Safe/Immunocompromised Facebook group.
Plan Your Trip With an Immunocompromised Travel Specialist
Travel planning for immunocompromised travelers requires a different level of attention than a standard booking. It involves asking the right questions about hotel ventilation, knowing how airborne illness spreads on flights, understanding which travel insurance provisions actually cover your condition, and managing the details that make the difference between a trip that works and one that doesn't.
That's exactly what a free consultation is for. We'll talk through your health needs, your travel goals, what I've seen work and not work for travelers in similar situations, and which options I'd recommend for you.
No commitment. No pressure. Just a real conversation with someone who understands this from the inside.
Jennifer Farrar is a CLIA Accessible Cruise Certificate holder, Special Needs at Sea Certified Accessible Travel Advocate, and founder of Accessible Escapes, a travel agency. She became disabled in 2022 from COVID-induced POTS and Gastroparesis and built her agency to serve the travelers the mainstream travel industry has left behind. She runs a COVID Safe/Immunocompromised Facebook community and writes about accessible, immunocompromised, and chronic illness travel.
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