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Frequently Asked Questions: Guidance for Travelers to Enter the U.S.

Updated Date: April 21, 2022

Since January 22, 2022, DHS has required non-U.S. individuals seeking to enter the United States via land ports of entry and ferry terminals at the U.S.-Mexico and U.S.-Canada borders to be fully vaccinated for COVID-19 and provide proof of vaccination upon request.  On April 21, 2022, DHS announced that it would extend these requirements. In determining whether and when to rescind this order, DHS anticipates that it will take account of whether the vaccination requirement for non-U.S. air travelers remains in place.

These requirements apply to non-U.S. individuals who are traveling for essential or non-essential reasons. They do not apply to U.S. citizens, Lawful Permanent Residents, or U.S. nationals.

Effective November 8, 2021, new air travel requirements applied to many noncitizens who are visiting the United States temporarily. These travelers are also required to show proof of COVID-19 vaccination. All air travelers, including U.S. persons, must test negative for COVID-19 prior to departure. Limited exceptions apply. See  CDC guidance  for more details regarding air travel requirements.

Below is more information about what to know before you go, and answers to Frequently Asked Questions about cross-border travel.

Entering the U.S. Through a Land Port of Entry or Ferry Terminal

Q. what are the requirements for travelers entering the united states through land poes.

A:  Before embarking on a trip to the United States, non-U.S. travelers should be prepared for the following:

• Possess proof of an approved COVID-19 vaccination as outlined on the  CDC  website.
• During border inspection, verbally attest to their COVID-19 vaccination status. 
• Bring a  Western Hemisphere Travel Initiative  compliant border crossing document, such as a valid passport (and visa if required), Trusted Traveler Program card, a Department of State-issued Border Crossing Card, Enhanced Driver’s License or Enhanced Tribal Card when entering the country. Travelers (including U.S. citizens) should be prepared to present the WHTI-compliant document and any other documents requested by the CBP officer.

 Q. What are the requirements to enter the United States for children under the age of 18 who can't be vaccinated?

A:  Children under 18 years of age are excepted from the vaccination requirement at land and ferry POEs.

Q: Which vaccines/combination of vaccines will be accepted?

A:  Per CDC guidelines, all Food and Drug Administration (FDA) approved and authorized vaccines, as well as all vaccines that have an Emergency Use Listing (EUL) from the World Health Organization (WHO), will be accepted.

Accepted Vaccines:

• More details are available in CDC guidance  here .
• 2 weeks (14 days) after your dose of an accepted single-dose COVID-19 vaccine;
• 2 weeks (14 days) after your second dose of an accepted 2-dose series;
• 2 weeks (14 days) after you received the full series of an accepted COVID-19 vaccine (not placebo) in a clinical trial;
• 2 weeks (14 days) after you received 2 doses of any “mix-and-match” combination of accepted COVID-19 vaccines administered at least 17 days apart.

Q. Is the United States requiring travelers to have a booster dose to be considered fully vaccinated for border entry purposes?

A:  No. The CDC guidance for “full vaccination” can be found here.

Q: Do U.S. citizens or lawful permanent residents need proof of vaccination to return to the United States via land POEs and ferry terminals?

A:  No. Vaccination requirements do not apply to U.S. citizens, U.S. nationals, or Lawful Permanent Residents (LPRs). Travelers that exhibit signs or symptoms of illness will be referred to CDC for additional medical evaluation.

Q: Is pre- or at-arrival COVID testing required to enter the United States via land POEs or ferry terminals?

A: No, there is no COVID testing requirement to enter the United States via land POE or ferry terminals. In this respect, the requirement for entering by a land POE or ferry terminal differs from arrival via air, where there is a requirement to have a negative test result before departure.

Processing Changes Announced on January 22, 2022 

Q: new changes were recently announced. what changed on january 22.

A:  Since January 22, 2022, non-citizens who are not U.S. nationals or Lawful Permanent Residents have been required to be vaccinated against COVID-19 to enter the United States at land ports of entry and ferry terminals, whether for essential or nonessential purposes. Previously, DHS required that non-U.S. persons be vaccinated against COVID-19 to enter the United States for nonessential purposes.  Effective January 22, all non-U.S. individuals, to include essential travelers, must be prepared to attest to vaccination status and present proof of vaccination to a CBP officer upon request. DHS announced an extension of this policy on April 21, 2022.

Q: Who is affected by the changes announced on January 22?

A: This requirement does not apply to U.S. citizens, U.S. nationals, or U.S. Lawful Permanent Residents. It applies to other noncitizens, such as a citizen of Mexico, Canada, or any other country seeking to enter the United States through a land port of entry or ferry terminal.

Q: Do U.S. citizens need proof of vaccination to return to the United States via land port of entry or ferry terminals?

A: Vaccination requirements do not apply to U.S. Citizens, U.S. nationals or U.S. Lawful Permanent Residents. Travelers that exhibit signs or symptoms of illness will be referred to CDC for additional medical evaluation. 

Q: What is essential travel?

A:  Under the prior policy, there was an exception from temporary travel restrictions for “essential travel.” Essential travel included travel to attend educational institutions, travel to work in the United States, travel for emergency response and public health purposes, and travel for lawful cross-border trade (e.g., commercial truckers). Under current policy, there is no exception for essential travel.

Q: Will there be any exemptions? 

A: While most non-U.S. individuals seeking to enter the United States will need to be vaccinated, there is a narrow list of exemptions consistent with the Centers for Disease Control and Prevention (CDC) Order in the air travel context.

• Certain categories of individuals on diplomatic or official foreign government travel as specified in the CDC Order
• Children under 18 years of age;
• Certain participants in certain COVID-19 vaccine trials as specified in the CDC Order;   
• Individuals with medical contraindications to receiving a COVID-19 vaccine as specified in the CDC Order;
• Individuals issued a humanitarian or emergency exception by the Secretary of Homeland Security;
• Individuals with valid nonimmigrant visas (excluding B-1 [business] or B-2 [tourism] visas) who are citizens of a country with limited COVID-19 vaccine availability, as specified in the CDC Order
• Members of the U.S. Armed Forces or their spouses or children (under 18 years of age) as specified in the CDC Order; and
• Individuals whose entry would be in the U.S. national interest, as determined by the Secretary of Homeland Security.

Q: What documentation will be required to show vaccination status?

A:  Non-U.S. individuals are required to be prepared to attest to vaccination status and present proof of vaccination to a CBP officer upon request regardless of the purpose of travel.

The current documentation requirement remains the same and is available on the CDC website . Documentation requirements for entry at land ports of entry and ferry terminals mirror those for entry by air.

Q: What happens if someone doesn’t have proof of vaccine status?

A: If non-U.S. individuals cannot present proof of vaccination upon request, they will not be admitted into the United States and will either be subject to removal or be allowed to withdraw their application for entry.

Q: Will incoming travelers be required to present COVID-19 test results?

A: There is no COVID-19 testing requirement for travelers at land border ports of entry, including ferry terminals.

Q: What does this mean for those who can't be vaccinated, either due to age or other health considerations? 

A: See CDC guidance for additional information on this topic. Note that the vaccine requirement does not apply to children under 18 years of age.

Q: Does this requirement apply to amateur and professional athletes?

A: Yes, unless they qualify for one of the narrow CDC exemptions.

Q: Are commercial truckers required to be vaccinated?

A: Yes, unless they qualify for one of the narrow CDC exemptions. These requirements also apply to bus drivers as well as rail and ferry operators.

Q. Do you expect border wait times to increase?

A:  As travelers navigate these new travel requirements, wait times may increase. Travelers should account for the possibility of longer than normal wait times and lines at U.S. land border crossings when planning their trip and are kindly encouraged to exercise patience.

To help reduce wait times and long lines, travelers can take advantage of innovative technology, such as facial biometrics and the CBP OneTM mobile application, which serves as a single portal for individuals to access CBP mobile applications and services.

Q: How is Customs and Border Protection staffing the ports of entry? 

A: CBP’s current staffing levels at ports of entry throughout the United States are commensurate with pre-pandemic levels. CBP has continued to hire and train new employees throughout the pandemic. CBP expects some travelers to be non-compliant with the proof of vaccination requirements, which may at times lead to an increase in border wait times. Although trade and travel facilitation remain a priority, we cannot compromise national security, which is our primary mission. CBP Office of Field Operations will continue to dedicate its finite resources to the processing of arriving traffic with emphasis on trade facilitation to ensure economic recovery.

Q: What happens if a vaccinated individual is traveling with an unvaccinated individual?  

A:  The unvaccinated individual (if 18 or over) would not be eligible for admission.

Q: If I am traveling for an essential reason but am not vaccinated can I still enter?

A:  No, if you are a non-U.S. individual. The policy announced on January 22, 2022 applies to both essential and non-essential travel by non-U.S. individual travelers. Since January 22, DHS has required that all inbound non-U.S. individuals crossing U.S. land or ferry POEs – whether for essential or non-essential reasons – be fully vaccinated for COVID-19 and provide related proof of vaccination upon request.

Q: Are sea crew members on vessels required to have a COVID vaccine to disembark?

A:  Sea crew members traveling pursuant to a C-1 or D nonimmigrant visa are not excepted from COVID-19 vaccine requirements at the land border. This is a difference from the international air transportation context.

Entering the U.S. via Air Travel

Q: what are the covid vaccination requirements for air passengers to the united states  .

A:  According to CDC requirements [www.cdc.gov/coronavirus/2019-ncov/travelers/noncitizens-US-air-travel.html | Link no longer valid], most noncitizens who are visiting the United States temporarily must be fully vaccinated prior to boarding a flight to the United States. These travelers are required to show proof of vaccination. A list of covered individuals is available on the CDC website.  

Q: What are the COVID testing requirements for air passengers to the United States?  

A:  Effective Sunday, June 12 at 12:01 a.m. ET, CDC will no longer require pre-departure COVID-19 testing for U.S.-bound air travelers.

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Plan your Travel

⚠   The COVID-19 Public Health Emergency expired as of May 11, 2023. This site will no longer be updated and will remain online for historical purposes only.

For current COVID-19 guidance, please visit the Centers for Disease Control and Prevention (CDC) .

• Before booking your trip, check for international travel advisories  and destination-specific COVID-19 risk . Refer to individual state, territorial, tribal, and local government websites for domestic travel advisories and information about quarantine or other restrictions.   
• The UNWTO-IATA Destination Tracker is a free online tool for travelers to get information on COVID-19 requirements for international travel and the measures in place at the destination.  
• Review CDC’s considerations for Travel During COVID-19 before you go to determine your personal risk.  
• Pack Smart! Pack Safe! Know what is in your carry-on and checked bags and make sure there are no prohibited items inside before arriving at the checkpoint. As a temporary exemption from the 3-1-1 rule, TSA is allowing one oversized liquid hand sanitizer container, up to 12 ounces per passenger, in carry-on bags. These will need to be placed in a bin during the screening process. Passengers may also bring hand wipes through checkpoints.  
• Unused COVID-19 test kits do not contain dangerous goods and are typically allowed in both carry-on and checked baggage.  
• COVID-19 test kits containing diagnostic samples (e.g., nasal swabs and vials of sputum) are not allowed in carry-on baggage. These samples must be properly packaged, handled, and identified as a UN3373 Category B Infectious Substance (PDF) during transportation. Passengers should check with their carrier before packing COVID-19 test kits containing diagnostic samples in checked baggage or shipping as cargo. Individual carriers and international requirements may be more restrictive than domestic regulations. Visit FAA’s Pack Safe site for more information.  
• CDC recommends wearing a mask throughout your travel experience.   
• Consider joining TSA PreCheck ™. Members continue to be eligible for expedited screening procedures and have the shortest wait times. TSA PreCheck provides the most convenience and least amount of physical contact at the TSA checkpoint. Visit TSA PreCheck to enroll today.   
• Have a travel plan that does not rely on the U.S. government for assistance. Visit travel.state.gov for more information.   
• Make two copies of all your travel documents in case of emergency, and leave one with a trusted friend or relative.  
• Remember, if you are sick, stay home and do not travel! Contact your airline regarding their  re-booking and cancellation policies . 

*All information developed in accordance with CDC guidelines. 

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Meningococcal Disease in Saudi Arabia - Vaccine Requirements for Travel During the Hajj and Umrah Pilgrimages

• The Hajj , or pilgrimage to Mecca, Saudi Arabia, is one of the world’s largest mass gatherings . In 2024, Hajj will take place during June 14–19th. In addition, Umrah pilgrimage to Mecca can occur throughout the year.
• Mass gatherings, such as Hajj or Umrah, can increase the risk for infections such as meningococcal disease .
• In 2024, there have been reports of meningococcal disease in travelers who had been in Saudi Arabia for Umrah. 
• Before traveling to Saudi Arabia, you should be up to date on all routine vaccines and travel related vaccines , including meningococcal vaccine .
• Saudi Arabia requires that all travelers aged one year and older arriving for Hajj or Umrah pilgrimage show proof they have received a quadrivalent (ACWY) meningococcal vaccine in the last 3–5 years ( depending on vaccine type ) and at least 10 days prior to the planned travel. This vaccine is recommended for protection against meningococcal disease caused by serogroups A, C, W, and Y.
• Visit a travel medicine specialist or healthcare professional 4–6 weeks before travel for specific advice related to your destination and this event. 
• You should seek medical care immediately if you develop fever, headache, stiff neck, nausea, or vomiting during or after travel.
• Monitor travel warnings and alerts from the U.S. Department of State and consider signing up for the Smart Traveler Enrollment Program .

Meningococcal disease refers to illness caused by bacteria called Neisseria meningitidis . These illnesses are often severe, can be deadly , and include infections of the lining of the brain and spinal cord (meningitis) and bloodstream. Keeping up to date with recommended vaccines is the best protection against meningococcal disease.

People spread meningococcal bacteria to other people by sharing respiratory and throat secretions (saliva or spit). Generally, it takes close contact (for example, coughing or kissing) or lengthy contact (for example, sharing a room) to spread these bacteria. Crowding and mass gatherings have been associated with meningococcal disease outbreaks in the past.

Traveler Information

• Consular & Travel Services – Hajj and Umrah Visa (Embassy of the Kingdom of Saudi Arabia)
• Health Requirements and Recommendations for Travelers to Saudi Arabia for Hajj  (Saudi Ministry of Health) (PDF)
• Health Information for Travelers to Saudi Arabia
• Meningococcal Disease

Clinician Information

• Saudi Arabia: Hajj/Umrah Pilgrimage in the CDC Yellow Book: Health Information for International Travel
• Travel to Mass Gatherings in the CDC Yellow Book: Health Information for International Travel
• Meningococcal Disease in the CDC Yellow Book: Health Information for International Travel
• Meningococcal Disease for Clinicians
• International Certificate of Vaccination or Prophylaxis (ICVP)
• Meningococcal Disease Cases Linked to Travel to the Kingdom of Saudi Arabia (KSA): Ensure Pilgrims Aged One Year and Older Traveling to KSA Are Current on Meningococcal Vaccination

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Coronavirus Updates

Cdc says travel is safe for fully vaccinated people, but opposes nonessential trips.

Rachel Treisman

The Centers for Disease Control and Prevention updated its domestic travel guidance for fully vaccinated people on Friday, lifting certain requirements while continuing to advise mitigation measures like mask-wearing and hand-washing. Angus Mordant/Bloomberg via Getty Images hide caption

The Centers for Disease Control and Prevention updated its domestic travel guidance for fully vaccinated people on Friday, lifting certain requirements while continuing to advise mitigation measures like mask-wearing and hand-washing.

The Centers for Disease Control and Prevention has updated its domestic travel guidance for fully vaccinated people, lifting certain testing and self-quarantine requirements and recommending precautions like wearing a mask and avoiding crowds. But health officials continue to discourage nonessential travel, citing a sustained rise in cases and hospitalizations.

The CDC updated its website on Friday to reflect the latest scientific evidence, writing that "people who are fully vaccinated with an FDA-authorized vaccine can travel safely within the United States."

The announcement comes less than a month after the CDC first released updated guidance about gatherings for fully vaccinated people, which it described as a "first step" toward returning to everyday activities.

Air Travel Is Opening Up Again, But That Doesn't Mean The Pandemic Is Over

The CDC considers someone fully vaccinated two weeks after they receive the last dose of vaccine. Those individuals will no longer need to get tested before or after travel unless their destination requires it, and do not need to self-quarantine upon return.

The new guidance means, for example, that fully vaccinated grandparents can fly to visit their healthy grandkids without getting a COVID-19 test or self-quarantining as long as they follow other recommended measures while traveling, according to CDC Director Rochelle Walensky.

Those measures include wearing a mask over their nose and mouth, staying 6 feet from others and washing their hands frequently. Masks are required on all planes traveling into, within or out of the U.S., under an executive order issued by President Biden.

But Walensky, speaking at a White House COVID-19 Response Team briefing on Friday, nonetheless discouraged all nonessential travel, citing a continued increase in the seven-day average of cases and hospitalizations.

"While we believe that fully vaccinated people can travel at low risk to themselves, CDC is not recommending travel at this time due to the rising number of cases," Walensky said.

CDC Director Fears 'Impending Doom' If U.S. Opens Too Quickly

She said that while vaccinated people can do more things safely, most Americans are not yet fully vaccinated. Those who are not must have a negative test 1-3 days before they travel under CDC guidance. They must either get tested 3-5 days after they return and self-quarantine for 7 days, or self-quarantine for 10 days with no test.

Walensky said on Monday that there is more travel occurring now than throughout the pandemic, including the winter holidays. She acknowledged that people have been looking to get away over spring break or take advantage of what they perceive as a "relative paucity in cases," and she said the country was seeing an uptick in cases as a result.

"The thing that's different this time is that we actually have it in our power to be done with the scale of the vaccination," she said. "And that will be so much slower if we have another surge to deal with as well."

The U.S. is already seeing an uptick in domestic travel, and many Americans are looking to book trips in the coming months in what experts described to NPR as a sign of "clear pent up demand for travel."

As the country's supply of COVID-19 doses has grown, so has Biden's goal for the number of shots in arms during his first 100 days, doubling the target to 200 million by the end of this month. Many states have already expanded eligibility to all adults or are set to do so in the coming weeks, well ahead of the president's May 1 deadline.

According to NPR's vaccine tracker , 16.9% of the U.S. population is fully vaccinated, and 30% has had at least one dose. Researchers estimate that 70% to 85% of the country would need to have immunity for COVID-19 to stop spreading through communities.

International travel restrictions remain

The CDC is not lifting travel restrictions barring the entry of most non-U.S. citizens from places including China, Brazil, South Africa and parts of Europe. It will continue to require airline passengers entering the U.S. to get a test within three days of their departure and show proof of a negative result before boarding.

The travel industry has been pushing for some of these restrictions to end. A group of 26 organizations sent a letter to White House COVID-19 czar Jeffrey Zients urging the federal government "to partner with us to develop, by May 1, 2021, a risk-based, data-driven roadmap to rescind inbound international travel restrictions."

While Some Spring Breakers Swarm Beaches, Many Stay Home, Dreaming Of Summer Travel

"To be clear, at this time, we do not support removal or easing of core public health protections, such as the universal mask mandate, inbound international testing requirement, physical distancing or other measures that have made travel safer and reduced transmission of the virus," they wrote. "However, the data and science demonstrate that the right public health measures are now in place to effectively mitigate risk and allow for the safe removal of entry restrictions."

Travel and tourism have taken a considerable hit because of the pandemic with industry groups noting that overseas travel to the U.S. declined by 81% in 2020, causing billions of dollars in losses. Without lifting international travel bans, the U.S. Travel Association estimates that some 1.1 million American jobs will not be restored and billions in spending will be lost by the end of the year.

"Fortunately, enough progress has been made on the health front that a rebound for domestic leisure travel looks possible this year, but that alone won't get the job done," Roger Dow, the association's president and CEO, said in a statement . "A full travel recovery will depend on reopening international markets, and we must also contend with the challenge of reviving business travel."

Fauci Expects Surge In Vaccinations To Keep A 4th Coronavirus Wave At Bay

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What’s Going on With the Testing Requirement for Travel?

The requirement to test for Covid before flying to the United States is hated by many travelers and the U.S. travel industry. But the government shows no sign of getting rid of it.

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By Heather Murphy

• Published May 19, 2022 Updated June 10, 2022

[Update: The United States will lift the virus testing mandate for international air travelers on June 12. Read more here .]

As countries, including Canada and Britain , have lifted their Covid testing requirements for vaccinated visitors in recent months, some Americans are irate that they still have to show a negative test to board a flight back to the United States.

Jason Miller, a 37-year-old software engineer who lives in Texas, is so frustrated with the rule that he recently sent letters to the White House and several lawmakers and began encouraging others to do the same. “I support the C.D.C., still wear a N95 mask when in crowds and when I travel,” he said. But, he no longer feels that the rule provides value, in large part because “the testing has not stopped variants from entering the country.”

Other travelers have posted similar comments on social media, and a good portion of the travel industry in the United States has made clear it feels the same way.

But they have gotten little satisfaction from the Biden administration and public health officials.

On May 6, Jen Psaki, then the White House press secretary, said she was “not aware of a timeline” for ending the testing requirement and that the administration would base its decision on a Centers for Disease Control and Prevention recommendation. As to what, specifically, the C.D.C. is using to determine whether testing is still necessary, an agency spokeswoman offered the vague explanation that it “is looking at different indicators” and “evaluating all guidance and orders based on the latest science and state of the pandemic.”

The obligatory test has not just created logistical hassles, it has fundamentally shifted the experience of traveling internationally, travelers say.

“It was always in the forefront of my mind,” said Danielle Bradbury, 42, who recently spent 12 days in Israel for her job developing medical devices while her husband cared for their two children back in Boston. “Every time I left the hotel, I asked myself, how much risk of not being able to get home am I putting myself in?”

Why was testing started in the first place?

In January 2021 , when the C.D.C. first instituted the rule that all U.S.-bound travelers 2 years and older had to show a negative test or proof of recovery before boarding a flight, the United States joined a sea of countries experimenting with different ways to slow the virus’s spread across borders. A statement from the State Department announcing the requirement played up the difficulty in getting a test abroad, suggesting that the rule also aimed to discourage Americans from traveling internationally. At that point fewer than 10 percent of Americans were vaccinated and case counts were rising, hitting a record of more than 300,000 new cases on Jan. 8.

Testing was not the first travel limitation the United States had deployed. In the winter of 2020, President Trump banned visitors from China, much of Europe , Brazil and Iran. When President Biden took office he layered the testing requirement on top of the travel bans. (He also expanded the ban to India .)

In late 2021, the United States pivoted away from country-specific bans and doubled down on testing, shortening the window from within three days of travel to one day, even for vaccinated Americans. By then it had become clear that vaccinated people could also spread the coronavirus . (Most unvaccinated visitors from abroad were prohibited from entering the country, even with testing.)

How effective has the policy been?

It depends how you define success, said Jeremy Goldhaber-Fiebert, a professor of health policy at Stanford University. If success was reducing the number of infected people who flew to the United States, he said, the testing requirement achieved that.

“It certainly prevented people who tested positive from getting on planes and it almost certainly prevented some amount of transmission on aircraft and in airports,” he said.

The exact number of infected people who were prevented from boarding planes is unknown, however, because no one tracks whether a passenger cancels a flight because of Covid. Most of the evidence is anecdotal; lots of people have stories about testing positive before flying home.

If success means keeping new variants out of the country, then it failed, said Dr. William Morice , the chair of lab medicine and pathology at the Mayo Clinic.

“The reality is that none of these measures have prevented the rapid global spread of any variant of concern,” he said.

But if success was not preventing the arrival of new variants, but instead delaying their arrival so that hospitals and authorities could be more prepared, then it may have worked. Mark Jit , a professor of vaccine epidemiology at the London School of Hygiene and Tropical Medicine, who has studied the effectiveness of travel requirements, said that this is what testing does well.

“Testing can prevent the peak from being reached so quickly,” he said.

Still, once a variant is already widespread in a country, he found, a travel test has little effect.

Why are many countries getting rid of testing requirements now?

Explanations from authorities include readiness to enter a new phase of the pandemic, high vaccination rates and a determination that new variants are manageable.

“The current variant is making people less ill and the number of people being admitted to intensive care is limited,” the Netherlands government said in a typical statement in March, as it ended travel testing, among other Covid-related recommendations.

What’s the argument for getting rid of the U.S. requirement?

The primary argument is that it’s not doing enough good to rationalize the hassle.

Dr. Tom Frieden, who was the C.D.C. director during the Ebola outbreak of 2014, was among those who made this point. “Between super-effective vaccinations that we have and Paxlovid, which is a super-effective treatment, Omicron is less deadly than flu most years and we don’t require people to test for flu before they get on a plane,” he said. “If a more dangerous variant emerges,” he noted, “that’s a very different situation.”

Others argue that it doesn’t make sense to inconvenience so many people for a system that’s full of holes. Antigen tests — one option for travelers to the United States — are notoriously unreliable in the early stage of infection, said Anne Wyllie, a microbiologist at the Yale School of Public Health. For this reason she called the requirement “hygiene theater.”

The testing requirement is not just annoying for travelers, it’s economically damaging, according to the U.S. Travel Association, a trade group. In a recent letter to Dr. Ashish K. Jha, the White House Covid coordinator, signed by more than 260 businesses, including airlines, cruise operators, casinos, tourism boards, Disney Parks and a zoo, the group said “the economic costs associated with maintaining the measure are significant.”

“Given the slow economic recovery of the business and international travel sectors, and in light of medical advancements and the improved public health metrics in the U.S., we encourage you to immediately remove the inbound testing requirement for vaccinated air travelers,” the group wrote.

A survey commissioned by the group found that 46 percent of international travelers would be more likely to visit the United States without the requirement. A similar survey by the Points Guy, a site that specializes in traveling with credit card points and miles, found that more than half of its participating readers would be more likely to travel abroad without the requirement.

What’s the argument for keeping the policy?

Meegan Zickus, who runs a Facebook group for people with weakened immune systems, said that testing has become more important since the mask requirement went away. Without a testing requirement, most travelers are not going to bother to test or stay home, even if they suspect that they are infected, she said.

“Judging by the past two years, the only way to protect others is some type of enforced testing,” she said, because “the moral compass points directly to self.”

Dr. Seema Yasmin , a public health doctor and the director of the Stanford Health Communication Initiative, echoed this point. “I would say that it can give a high level of reassurance when 75 percent of people are not wearing a mask and might even be coughing and sneezing loudly,” Dr. Yasmin said.

(Though airplane ventilation systems appear to significantly mitigate spread of the coronavirus, research suggests that people sitting within a few rows still pose a risk to one another.)

“Some testing is better than none,” said Nathaniel Hafer , a molecular biologist at the UMass Chan Medical School.

Many countries also use testing to incentivize vaccination by waiving the requirement for vaccinated people, said Meghan Benton , a research director at the Migration Policy Institute, which tracks travel requirements. The United States encourages vaccination in its own way by prohibiting most unvaccinated visitors from abroad from entering.

Could a lawsuit end testing the way it did the mask mandate?

Given that there are currently at least four pending lawsuits that challenge the international testing requirement, some wonder whether it might be struck down by a judge’s decision, as the requirement to wear a mask on airplanes and other forms of transport was in April.

Lawrence O. Gostin, a professor of global health law at Georgetown Law, does not think so. The C.D.C. can require testing from visitors entering the country from abroad because of the Public Health Service Act, which was explicitly created to prevent the introduction of dangerous infectious diseases in the United States, he said.

The rule, he said, “would be exceedingly difficult to successfully challenge in the courts, even for the most conservative judges.”

52 Places for a Changed World

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• Symptoms and Complications
• People at Increased Risk and Childhood Lead Poisoning
• Communication Resources and Tools
• News and Features
• State and Local Programs
• Blood Lead Level Guidance
• Laboratory Considerations
• Policy Resources
• Scientific Publications
• Lead Advisory Committees

Guidelines and Recommendations

At a glance.

Resources and guidance documents to support effective childhood lead poisoning prevention programs.

Some of the documents below refer to a blood lead level of 5 micrograms per deciliter (μg/dL) as the CDC's blood lead reference value. CDC uses a blood lead reference value of 3.5 micrograms per deciliter (µg/dL) to identify children with blood lead levels that are higher than most children's levels. This level is based on the 97.5th percentile of the blood lead values among U.S. children ages 1-5 years from the 2015-2016 and 2017-2018 National Health and Nutrition Examination Survey (NHANES) cycles. Children with blood lead levels at or above the BLRV represent the top 2.5% with the highest blood lead levels.

Some of the documents on this page are presented for historical purposes and are not being maintained or updated.

** These documents are being kept on this website for historical purposes and are no longer in print.

Healthcare systems/insurance guidelines

• A Purchaser's Guide to Clinical Preventive Services: Moving Science into Coverage (2006) – This is an important resource on preventive services, including elevated blood lead level screening. The guide translates clinical guidelines and medical evidence, providing large employers with the information they need to select, define, and implement preventive medical benefits. The section on elevated blood lead level screening starts on page 164 of the guide, under the Evidence Statement for Child Health Promotion. The guide was developed by CDC, the Agency for Healthcare Research and Quality, and the National Business Group on Health.
• Overcoming Barriers to Data-Sharing Related to the HIPAA Privacy Rule: A Guide for State and Local Childhood Lead Poisoning Prevention Programs – This guide reviews HIPAA requirements and exceptions, focusing on those for public health agencies, and describes permissible uses of lead-related data under the HIPAA Privacy Rule.
• HIPAA Privacy Rule and Public Health: Guidance from CDC and the U.S. Department of Health and Human Services

Primary prevention guidelines

• Recommendations of the Advisory Committee for Childhood Lead Poisoning Prevention (ACCLPP) "Low Level Lead Exposure Harms Children: A Renewed Call of Primary Prevention"
• CDC Response to Advisory Committee on Childhood Lead Poisoning Prevention (ACCLPP) Recommendations in "Low Level Lead Exposure Harms Children: A Renewed Call of Primary Prevention
• Building Blocks for Primary Prevention: Protecting Children from Lead-Based Paint Hazards (2005) – This publication offers a comprehensive collection of 70 "building blocks," which are primary prevention strategies to reduce exposure to hazards in housing. More information about the publication. Source: Alliance for Healthy Homes
• Preventing Lead Exposure in Young Children: A Housing-Based Approach to Primary Prevention of Lead Poisoning (2004) – This document presents recommendations from the Centers for Disease Control and Prevention's Advisory Committee on Childhood Lead Poisoning Prevention for a housing-based approach to primary prevention of childhood lead poisoning to accelerate progress towards the elimination of elevated blood lead levels in children.

Screening and case management guidelines

• Mission Unleaded: How to test children for lead with maximum accuracy – reducing the risk of contamination during blood collection for lead testing.
• Educational Services for Children Affected by Lead Expert Panel. Educational interventions for children affected by lead . (2015)

Note: CDC uses a blood lead reference value of 3.5 micrograms per deciliter (µg/dL) to identify children with blood lead levels that are higher than most children's levels. This level is based on the on the 97.5th percentile of the blood lead values among U.S. of children ages 1-5 years from the 2015-2016 and 2017-2018 National Health and Nutrition Examination Survey (NHANES) cycles. Children with blood lead levels at or above the BLRV represent those at the top 2.5% with the highest blood lead levels.

The documents below refer to a blood-lead level of 10 micrograms per deciliter (μg/dL) as the CDC level of concern for adverse health outcomes in children. This terminology is outdated, and readers are referred to the ACCLPP recommendations of 2012 .

• CDC. Guidelines for the Identification and Management of Lead Exposure in Pregnant and Lactating Women (2010) – These guidelines are based on scientific data and practical considerations regarding preventing lead exposure during pregnancy, assessment and blood lead testing during pregnancy, medical and environmental management to reduce fetal exposure, breastfeeding, and follow up of infants and children exposed to lead in utero .
• CDC. Recommendations for Blood Lead Screening of Medicaid-Eligible Children Aged 1–5 Years: an Updated Approach to Targeting a Group at High Risk . MMWR . August 7, 2009; 58(RR09);1-11.
• CDC. Interpreting and Managing Blood Lead Levels <10 µg/dL in Children and Reducing Childhood Exposures to Lead: Recommendations of CDC's Advisory Committee on Childhood Lead Poisoning Prevention . MMWR . November 2, 2007; 56(RR08):1-14;16.Erratum: Vol. 56, No. RR-8 MMWR . November 30, 2007; 56(47):1241-1242.
• Recommendations for Preventing Lead Poisoning among the Internally Displaced Roma Population in Kosovo from the Centers for Disease Control and Prevention (2007) – Lead exposure is a continuing urgent health problem for Roma in Kosovo. The Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and the United Nations International Children's' Emergency Fund (UNICEF) have collaborated in blood lead surveillance of the Roma children living in refugee camps in Kosovo. This document includes recommendations.
• Managing Elevated Blood Lead Levels Among Young Children: Recommendations from the Advisory Committee on Childhood Lead Poisoning Prevention (2002) – This report from the Advisory Committee on Childhood Lead Poisoning Prevention is intended to facilitate the management of children with elevated blood lead levels by providing case managers with information and guidance.
• CDC. Recommendations for Blood Lead Screening of Young Children Enrolled in Medicaid: Targeting a Group at High Risk—United States . MMWR . December 8, 2000; 49(RR-14):1-13.
• Screening Young Children for Lead Poisoning: Guidance for State and Local Public Health Officials, Centers for Disease Control and Prevention (1997) – The policy outlined in the document has two main purposes: to increase screening and follow-up care of children who most need these services, and to help communities pursue the most appropriate approach to the prevention of childhood lead poisoning.

Surveillance guidelines

• Conducting Blood Lead Prevalence Studies Training Module
• Conducting Environmental Sampling Training Module
• Using GIS to Assess and Direct Childhood Lead Poisoning Prevention: Guidance for State and Local Childhood Lead Poisoning Prevention Programs (2004) – These guidelines were prepared to help new lead epidemiologists quickly learn how to use geographic information systems (GIS) mapping technology to assess and direct childhood lead poisoning elimination efforts.

Lead toxicology reports

• Interaction Profile for Lead, Manganese, Zinc, and Copper – The ATSDR Interaction Profile succinctly characterizes the toxicologic and adverse health effects information for mixtures of hazardous substances. (May, 2004).
• ToxFAQs™ for Lead – This fact sheet answers the most frequently asked health questions about lead.
• Toxicological Profile for Lead – This ATSDR toxicological profile succinctly characterizes the toxicologic and adverse health effects information for lead.

Childhood Lead Poisoning Prevention

CDC’s Childhood Lead Poisoning Prevention Program (CLPPP) is dedicated to reducing childhood lead poisoning as a public health problem.

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The Administration will end the COVID-19 vaccine requirements for international air travelers at the end of the day on May 11, the same day that the COVID-19 public health emergency ends. This means starting May 12, noncitizen nonimmigrant air passengers will no longer need to show proof of being fully vaccinated with an accepted COVID-19 vaccine to board a flight to the United States. CDC’s Amended Order Implementing Presidential Proclamation on Safe Resumption of Global Travel During the COVID-19 Pandemic will no longer be in effect when the Presidential Proclamation Advancing the Safe Resumption of Global Travel During the COVID-19 Pandemic is revoked .

Please see: https://www.whitehouse.gov/briefing-room/statements-releases/2023/05/01/the-biden-administration-will-end-covid-19-vaccination-requirements-for-federal-employees-contractors-international-travelers-head-start-educators-and-cms-certified-facilities/

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Executive Order on Promoting COVID- ⁠ 19 Safety in Domestic and International   Travel

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows: 

Section 1.  Policy.  Science-based public health measures are critical to preventing the spread of coronavirus disease 2019 (COVID-19) by travelers within the United States and those who enter the country from abroad.  The Centers for Disease Control and Prevention (CDC), the Surgeon General, and the National Institutes of Health have concluded that mask-wearing, physical distancing, appropriate ventilation, and timely testing can mitigate the risk of travelers spreading COVID-19.  Accordingly, to save lives and allow all Americans, including the millions of people employed in the transportation industry, to travel and work safely, it is the policy of my Administration to implement these public health measures consistent with CDC guidelines on public modes of transportation and at ports of entry to the United States.   

Sec. 2.  Immediate Action to Require Mask-Wearing on Certain Domestic Modes of Transportation.

(a)  Mask Requirement.   The Secretary of Labor, the Secretary of Health and Human Services (HHS), the Secretary of Transportation (including through the Administrator of the Federal Aviation Administration (FAA)), the Secretary of Homeland Security (including through the Administrator of the Transportation Security Administration (TSA) and the Commandant of the United States Coast Guard), and the heads of any other executive departments and agencies (agencies) that have relevant regulatory authority (heads of agencies) shall immediately take action, to the extent appropriate and consistent with applicable law, to require masks to be worn in compliance with CDC guidelines in or on: 

(i)    airports; 

(ii)   commercial aircraft; 

(iii)  trains; 

(iv)   public maritime vessels, including ferries; 

(v)    intercity bus services; and

(vi)   all forms of public transportation as defined in section 5302 of title 49, United States Code.

(b)  Consultation.   In implementing this section, the heads of agencies shall consult, as appropriate, with interested parties, including State, local, Tribal, and territorial officials; industry and union representatives from the transportation sector; and consumer representatives.

(c)  Exceptions.   The heads of agencies may make categorical or case-by-case exceptions to policies developed under this section, consistent with applicable law, to the extent that doing so is necessary or required by law.  If the heads of agencies do make exceptions, they shall require alternative and appropriate safeguards, and shall document all exceptions in writing.

(d)  Preemption.  To the extent permitted by applicable law, the heads of agencies shall ensure that any action taken to implement this section does not preempt State, local, Tribal, and territorial laws or rules imposing public health measures that are more protective of public health than those required by the heads of agencies. 

(e)  Coordination.  The Coordinator of the COVID-19 Response and Counselor to the President (COVID-19 Response Coordinator) shall coordinate the implementation of this section.  The heads of agencies shall update the COVID-19 Response Coordinator on their progress in implementing this section, including any categorical exceptions established under subsection (c) of this section, within 7 days of the date of this order and regularly thereafter.  The heads of agencies are encouraged to bring to the attention of the COVID-19 Response Coordinator any questions regarding the scope or implementation of this section.

Sec. 3.  Action to Implement Additional Public Health Measures for Domestic Travel. 

(a)  Recommendations.   The Secretary of Transportation (including through the Administrator of the FAA) and the Secretary of Homeland Security (including through the Administrator of the TSA and the Commandant of the Coast Guard), in consultation with the Director of CDC, shall promptly provide to the COVID-19 Response Coordinator recommendations concerning how their respective agencies may impose additional public health measures for domestic travel.

(b)  Consultation.   In implementing this section, the Secretary of Transportation and the Secretary of Homeland Security shall engage with interested parties, including State, local, Tribal, and territorial officials; industry and union representatives from the transportation sector; and consumer representatives.  

Sec. 4.  Support for State, Local, Tribal, and Territorial Authorities.  The COVID-19 Response Coordinator, in coordination with the Secretary of Transportation and the heads of any other relevant agencies, shall promptly identify and inform agencies of options to incentivize, support, and encourage widespread mask-wearing and physical distancing on public modes of transportation, consistent with CDC guidelines and applicable law.

Sec. 5.  International Travel. 

(a)  Policy.   It is the policy of my Administration that, to the extent feasible, travelers seeking to enter the United States from a foreign country shall be: 

(i)   required to produce proof of a recent negative COVID-19 test prior to entry; and 

(ii)  required to comply with other applicable CDC guidelines concerning international travel, including recommended periods of self-quarantine or self-isolation after entry into the United States.

(b)  Air Travel.  

(i)    The Secretary of HHS, including through the Director of CDC, and in coordination with the Secretary of Transportation (including through the Administrator of the FAA) and the Secretary of Homeland Security (including through the Administrator of the TSA), shall, within 14 days of the date of this order, assess the CDC order of January 12, 2021, regarding the requirement of a negative COVID-19 test result for airline passengers traveling into the United States, in light of subsection (a) of this section.  Based on such assessment, the Secretary of HHS and the Secretary of Homeland Security shall take any further appropriate regulatory action, to the extent feasible and consistent with CDC guidelines and applicable law.  Such assessment and regulatory action shall include consideration of: 

(A)  the timing and types of COVID-19 tests that should satisfy the negative test requirement, including consideration of additional testing immediately prior to departure; (B)  the proof of test results that travelers should be required to provide; (C)  the feasibility of implementing alternative and sufficiently protective public health measures, such as testing, self-quarantine, and self-isolation on arrival, for travelers entering the United States from countries where COVID-19 tests are inaccessible, particularly where such inaccessibility of tests would affect the ability of United States citizens and lawful permanent residents to return to the United States; and (D)  measures to prevent fraud.

(ii)   The Secretary of HHS, in coordination with the Secretary of Transportation (including through the Administrator of the FAA) and the Secretary of Homeland Security (including through the Administrator of the TSA), shall promptly provide to the President, through the COVID-19 Response Coordinator, a plan for how the Secretary and other Federal Government actors could implement the policy stated in subsection (a) of this section with respect to CDC-recommended periods of self-quarantine or self-isolation after a flight to the United States from a foreign country, as he deems appropriate and consistent with applicable law.  The plan shall identify agencies’ tools and mechanisms to assist travelers in complying with such policy.

(iii)  The Secretary of State, in consultation with the Secretary of HHS (including through the Director of CDC), the Secretary of Transportation (including through the Administrator of the FAA), and the Secretary of Homeland Security, shall seek to consult with foreign governments, the World Health Organization, the International Civil Aviation Organization, the International Air Transport Association, and any other relevant stakeholders to establish guidelines for public health measures associated with safe international travel, including on aircraft and at ports of entry.  Any such guidelines should address quarantine, testing, COVID-19 vaccination, follow-up testing and symptom-monitoring, air filtration requirements, environmental decontamination standards, and contact tracing.  

(c)  Land Travel.  The Secretary of State, in consultation with the Secretary of HHS, the Secretary of Transportation, the Secretary of Homeland Security, and the Director of CDC, shall immediately commence diplomatic outreach to the governments of Canada and Mexico regarding public health protocols for land ports of entry.  Based on this diplomatic engagement, within 14 days of the date of this order, the Secretary of HHS (including through the Director of CDC), the Secretary of Transportation, and the Secretary of Homeland Security shall submit to the President a plan to implement appropriate public health measures at land ports of entry.  The plan should implement CDC guidelines, consistent with applicable law, and take into account the operational considerations relevant to the different populations who enter the United States by land.

(d)  Sea Travel.  The Secretary of Homeland Security, through the Commandant of the Coast Guard and in consultation with the Secretary of HHS and the Director of CDC, shall, within 14 days of the date of this order, submit to the President a plan to implement appropriate public health measures at sea ports.  The plan should implement CDC guidelines, consistent with applicable law, and take into account operational considerations.  

(e)  International Certificates of Vaccination or Prophylaxis.  Consistent with applicable law, the Secretary of State, the Secretary of HHS, and the Secretary of Homeland Security (including through the Administrator of the TSA), in coordination with any relevant international organizations, shall assess the feasibility of linking COVID-19 vaccination to International Certificates of Vaccination or Prophylaxis (ICVP) and producing electronic versions of ICVPs.  

(f)  Coordination.  The COVID-19 Response Coordinator, in consultation with the Assistant to the President for National Security Affairs and the Assistant to the President for Domestic Policy, shall coordinate the implementation of this section.  The Secretary of State, the Secretary of HHS, the Secretary of Transportation, and the Secretary of Homeland Security shall update the COVID-19 Response Coordinator on their progress in implementing this section within 7 days of the date of this order and regularly thereafter.  The heads of all agencies are encouraged to bring to the attention of the COVID-19 Response Coordinator any questions regarding the scope or implementation of this section.

Sec. 6.  General Provisions.   (a)  Nothing in this order shall be construed to impair or otherwise affect:

(i)   the authority granted by law to an executive department or agency, or the head thereof; or

(ii)  the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

(b)  This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

(c)  This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

JOSEPH R. BIDEN JR.

THE WHITE HOUSE, January 21, 2021.

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