U.S. Army veteran Leighton Slattery, 83, who lives with his daughter outside of Jakarta, Indonesia, says the two have spent much of the year housebound as they implored officials to share coronavirus vaccines donated by the U.S. government.

In Bangalore, India, Asray Gopa, 17, still waits to get vaccinated because - unlike his friends in the United States - he is not old enough to obtain the shots under that country's rules.

And in Bangkok, businessman Charlie Blocker, 59, spent weeks scouring that city for a vaccine as the coronavirus exploded. But he got nowhere even as the U.S. government shipped doses to its embassy. He and he and his family would later be hospitalized with covid-19.

Slattery, Gopa and Blocker are all U.S. citizens, attempting to navigate the pandemic without easy access to the high-quality vaccines that are the linchpin of the U.S. strategy. They are among 14 Americans abroad who spoke with The Washington Post about their struggles to get the shots, saying they received little guidance from the Biden administration and watched enviously as hundreds of thousands of doses in the United States expired this summer and fall without any takers.

The disparity has grown as millions of people in the United States are receiving their third dose of high-quality vaccines, while some citizens abroad have yet to get their first. And months of pleading from the expats and their advocates, who represent as many as 9 million Americans overseas, has produced no change in policy.

"You have Americans who are filing and paying taxes, and a promise by the administration that all Americans will get vaccinated, and yet that whole community has been left out of the equation," said Marylouise Serrato, executive director of American Citizens Abroad, which advocates for expatriates.

The White House has insisted that it has no special responsibility to vaccinate Americans abroad, citing precedent that the U.S. government doesn't provide private health care to citizens living overseas. State Department officials also don't want to spark international disputes over vaccine priorities, particularly with many countries struggling to secure enough doses to immunize their own citizens.

"It's a thorny issue," said Jennifer Kates, director of global health at the Kaiser Family Foundation. "We're in a pandemic, so maybe there should be some bending of the normal way of doing things ... but on the other hand, what does it look like if the U.S. government is all of a sudden swooping in and providing preferential treatment in a country where no one else is getting vaccinated?"

The U.S. government has urged expatriates to return home for vaccinations, saying it's for their safety and citing the ample supply of shots in this country. But Americans abroad said it's not that simple, citing pandemic travel restrictions, often considerable costs and health risks.

"Where I live ... covid-19 is rampant," said Gopa, who originally grew up outside of Chicago, before his family moved to India to help his ailing grandparents. "You don't want me to travel home and bring a dangerous covid-19 variant."

Americans overseas say they had reason to expect easy access to high-quality vaccines, like the three shots authorized by the Food and Drug Administration, citing the vows by the administration that it would provide shots to all U.S. citizens while becoming an "arsenal of vaccines" for the world.

"Every American 12 and older, no matter where they live, has vaccines readily available to them," White House coronavirus coordinator Jeffrey Zients said at a July briefing, a clip that a coalition of international Americans cut into a video they circulated last month, criticizing the administration.

White House officials say that Zients was referring to Americans who live in the United States. Asked about the continued struggles of Americans to secure shots overseas, a spokesperson touted a three-pronged approach that many expats criticize as insufficient.

"Where countries have a robust vaccination program, the Administration will pursue diplomatic options to ensure American citizens can receive vaccines in their country of residence," White House spokesperson Kevin Munoz wrote in a statement.

He added that the administration "will ensure that U.S. citizens overseas who travel back to the U.S. to get vaccinated can be vaccinated easily and effectively" and "will provide clear information to U.S. citizens overseas regarding their eligibility to receive a vaccination in the country in which they reside."

Officials at the State Department, which is helping oversee the U.S. global vaccination rollout, also predicted that shortages abroad would be alleviated over time but offered no specific timetables. The administration this week touted that it had delivered 200 million doses of vaccines to more than 100 countries.

"We expect increasing availability of vaccines for U.S. citizens overseas as the United States' efforts to increase global access to vaccines continue," a State Department spokesperson wrote in an email. "We encourage all countries to ensure all persons within their borders, regardless of status and including U.S. citizens, can receive vaccines through national vaccination programs."

President Joe Biden vowed this summer that U.S. vaccine donations abroad would be "no strings attached," empowering countries that receive them to use the doses as they saw fit. The move was seen as a diplomatic rebuke of rivals like China and Russia, which have attached preconditions to their vaccine donations. But it left the White House with little influence over who receives the doses it gives away.

Some Americans abroad have argued that the administration should attach strings, at least to ensure that U.S. citizens don't get left at the back of the line. For instance, Indonesia has received donated doses of Pfizer-BioNTech vaccines from the United States but generally excluded foreign residents from getting those shots, said Slattery and his 19-year-old daughter, Megan.

"We're on the daily lookout for vaccination sites," said Megan Slattery, who last week received her first shot after finding a hospital willing to administer Moderna vaccines to any unvaccinated person, regardless of citizenship. Meanwhile, her father settled for a Chinese-made vaccine, Sinovac, which has been found to have limited effectiveness, and said he remains eager to get an FDA-authorized vaccine. Both of them say they are immunocompromised because of health problems.

Other U.S. citizens said that encouraging Americans to travel home isn't practical during a pandemic, and noted that peer nations like France have taken steps to inoculate their citizens abroad.

"People ask me why I don't just fly back to the U.S. to get my shots, but I simply cannot afford it," said Kim Walsh, 31, who grew up in California and worked as an accountant there but now lives in Bali, Indonesia with her partner. The two work for a small health supplement company and live "paycheck to paycheck," Walsh said, struggling to navigate the pandemic even as the island's tourism-based economy all but shut down last year.

Walsh faulted the U.S. Embassy in Indonesia for its aloof response to Americans' requests for help. She finally secured a Moderna shot this month after spending much of the year searching for an FDA-authorized vaccine. "I feel like I shouldn't have had to go through so much stress and anxiety to get a vaccine that is widely available in the U.S.," Walsh said.

Blocker, a Kentucky-born businessman who lives in Bangkok with his family, describes another harrowing struggle to obtain a vaccine. As infections surged by more than 4,000 percent across Thailand in April, he said he desperately hunted for an effective vaccine for himself and his family. "Did we search? Yes. But it was all in vain," Blocker said.

Thailand's vaccine supply at the time was limited to a small pool of Chinese-made vaccines, and an even smaller cache of AstraZeneca doses and shots available on the black market. The United States did ship FDA-authorized vaccines to Thailand as part of a plan to immunize U.S. government workers, including staff at a local Centers for Disease Control and Prevention hub. But Americans in private business like Blocker, who works in the hospitality industry, got no access.

On May 29, Blocker was admitted to Bangkok's Bumrungrad International Hospital with coronavirus-associated pneumonia, where he stayed for nearly two weeks, reliant on oxygen. His wife and teenage son soon joined him, battling their own infections. Despite their continued efforts, the family would not be fully vaccinated until August, after they traveled back to the United States to get the two-dose Pfizer-BioNTech regimen, a trip that kept Blocker away from his office for more than a month.

Blocker estimates that he spent about $30,000 to cover his family's travel, medical and associated costs that could have been avoided had he and his wife been vaccinated last spring, at the same time as their peers in Kentucky and U.S. government workers in Bangkok.

Now he's weighing the need for a booster dose, having read reports about waning immunity and is worried about the prospect of another international trip. "The question on everyone's mind: Are we going through this all over again?" said Blocker.

The issue has caught the attention of members of Congress, with Democrats like Sen. Chris Murphy, D-Conn., and House Oversight Committee Chairwoman Carolyn Maloney, D-N.Y., pressing the administration to take action.

Murphy has suggested sending additional vaccine doses to embassies overseas that would be targeted to American expats and advanced legislation that would mandate the U.S. government to craft a strategy to help citizens abroad. Other lawmakers have pushed plans to empower the Defense Department, which has immunized tens of thousands of service members overseas, to play a larger role in delivering shots to citizens abroad.

But Democrats say they've heard little from the White House, and they're growing frustrated by the inaction. "This is a pretty extraordinary moment, and that creates a higher level obligation for the U.S. government," said a senior Democratic congressional aide, who spoke on the condition of anonymity to detail conversations with the White House. "I don't think, for a lot of people, it will resolve itself ... it will be a hanging issue in a lot of countries."

Gopa, the teenage expat in India, says he's braced for continued uncertainty. That country's vaccine rollout for children has stalled, which means that only those 18 and over can get shots, and his 17th birthday was just last month. Unless something changes, "it'd take 11 more months to get one vaccine," he said./agencies