[Federal Register Volume 87, Number 67 (Thursday, April 7, 2022)]
[Notices]
[Pages 20405-20416]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-07450]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention


Amended Order Implementing Presidential Proclamation on Advancing 
the Safe Resumption of Global Travel During the COVID-19 Pandemic

AGENCY: Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Notice of Agency Amended Order.

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SUMMARY: The Centers for Disease Control and Prevention (CDC), located 
within the Department of Health and Human Services (HHS), has amended 
its Order issued October 20, 2021, to align with revised CDC guidance 
published on January 4, 2022, related to isolation and quarantine after 
travel.

DATES: This Amended Order will be implemented at 12:01 a.m. EDT on 
April 14, 2022.

FOR FURTHER INFORMATION CONTACT: Candice Swartwood, Division of Global 
Migration and Quarantine, Centers for Disease Control and Prevention, 
1600 Clifton Road NE, MS H24-8, Atlanta, GA 30329; Telephone: 404-498-
1600; Email: [email protected].

SUPPLEMENTARY INFORMATION: On October 25, 2021, the President issued a 
Proclamation pursuant to Sections 1182(f) and 1185(a)(1) of Title 8, 
and Section 301 of Title 3, United States Code (the Proclamation) 
titled, ``Advancing the Safe Resumption of Global Travel During the 
COVID-19 Pandemic.'' Pursuant to this Proclamation, the President has

[[Page 20406]]

implemented a global suspension and limitation on entry for noncitizens 
who are nonimmigrants seeking to enter the United States by air travel 
and who are not fully vaccinated against COVID-19. The Proclamation 
directs the Secretary of HHS, through the CDC Director, to implement 
the Proclamation as it applies to public health in accordance with 
appropriate public health protocols and consistent with CDC's 
independent public health judgment. The Proclamation does not apply to 
crew members of airlines or other aircraft operators if they follow 
industry standard protocols for the prevention of COVID-19.
    In this notice, CDC announces an Amended Order that revises some of 
the post-arrival requirements for certain people eligible for an 
exception to the vaccination requirement to travel to the United 
States. The Amended Order reduces the number of days for such persons 
to self-quarantine after international travel from seven days to five 
days. The number of days for isolation for those who are diagnosed with 
COVID-19 or have COVID-19 symptoms is also reduced from 10 days to five 
days. This Amended Order additionally clarifies language already on the 
Attestation Form that children under two years of age do not need to 
complete (or have a parent or guardian complete on their behalf) the 
attestation.
    A copy of the Amended Order and Attestation Form is below. A copy 
of these documents can be found at: https://www.cdc.gov/quarantine/order-safe-travel.html.

Centers for Disease Control and Prevention (CDC)

Department of Health and Human Services (HHS)

Amended Order Implementing Presidential Proclamation on Advancing the 
Safe Resumption of Global Travel During the COVID-19 Pandemic

Summary

    On October 25, 2021, the President issued a Proclamation pursuant 
to Sections 1182(f) and 1185(a)(1) of Title 8, and Section 301 of Title 
3, United States Code, (the Proclamation), titled, ``Advancing the Safe 
Resumption of Global Travel During the COVID-19 Pandemic.'' Pursuant to 
this Proclamation, the President has implemented a global suspension 
and limitation on entry for noncitizens who are nonimmigrants seeking 
to enter the United States by air travel and who are not fully 
vaccinated against COVID-19. The Proclamation directs the Secretary of 
Health and Human Services (HHS), through the Director of the Centers 
for Disease Control and Prevention (CDC), to implement the Proclamation 
as it applies to public health in accordance with appropriate public 
health protocols and consistent with CDC's independent public health 
judgment.
    The Proclamation does not alter the obligation of persons, 
including persons whose entry is not covered by the Proclamation, to 
comply with the requirements of state, local, territorial, or Tribal 
authorities, or the applicable requirements of CDC Orders, including:
     Requirement for Negative Pre-Departure COVID-19 Test 
Result or Documentation of Recovery from COVID-19 for All Airline or 
Other Aircraft Passengers Arriving in the United States from any 
Foreign Country (published at 86 FR 7387, January 28, 2021; amended and 
republished at 86 FR 69256, December 7, 2021) (as may be further 
amended);
     Requirement for Persons to Wear Masks While on Conveyances 
and at Transportation Hubs (published at 86 FR 8025, February 3, 2021) 
(as may be further amended); and
     Other CDC Orders that may be published relating to 
preventing the introduction, transmission, and spread of COVID-19 into 
and throughout the United States.
    This Amended Order further amends the previous Order signed by the 
CDC Director on October 30, 2021, to align with revised CDC guidance 
related to isolation and quarantine after travel that was published on 
January 4, 2022. The new guidance reduces the number of days 
recommended for a person to self-quarantine after travel from 7 days to 
5 days. The new guidance also reduces the number of days recommended 
for isolation for people who are diagnosed with COVID-19 or have COVID-
19 symptoms from 10 days to 5 days. This Amended Order also clarifies 
language already on the attestation form that children under 2 years of 
age do not need to complete (or have a parent or guardian complete on 
their behalf) the attestation. The Amended Order also revises what is 
required for some people eligible for an exception to the vaccination 
requirement and what public health actions, such as self-quarantine or 
testing, may be required for such eligible people after arriving in the 
United States. This Amended Order shall enter into effect at 12:01 a.m. 
EDT on April 14, 2022.

Definitions

    For purposes of this Amended Order, the following definitions 
apply:
    Accepted COVID-19 Vaccine means:
     A vaccine authorized for emergency use or approved by the 
U.S. Food and Drug Administration (FDA); \1\ or
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    \1\ For a list of vaccines approved or authorized in the United 
States to prevent COVID-19, see https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html.
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     A vaccine listed for emergency use (EUL) by the World 
Health Organization (WHO); \2\ or
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    \2\ For more information about WHO-listed COVID-19 vaccines, see 
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-(covid-19)-
vaccines.
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     A vaccine or combination of vaccines listed by CDC in the 
Technical Instructions.
    Covered Individual means any passenger covered by the Proclamation 
and this Amended Order: A noncitizen \3\ who is a nonimmigrant seeking 
to enter the United States by air travel. This term does not apply to 
crewmembers of airlines or other aircraft operators if such crewmembers 
and operators adhere to all industry standard protocols for the 
prevention of COVID-19, as set forth in relevant guidance for 
crewmember health issued by the CDC or by the Federal Aviation 
Administration in coordination with the CDC.
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    \3\ For purposes of this Amended Order, U.S. lawful permanent 
residents and U.S. nationals will be treated in the same manner as 
U.S. citizens. For more details regarding who is not a Covered 
Individual under the Order, see: https://www.cdc.gov/coronavirus/2019-ncov/travelers/proof-of-vaccination.html#immigrants.
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    Covered Individual Attestation means the attestation in Attachment 
A,\4\ in written or electronic form, that must be completed by each 
Covered Individual as a condition of their being able to enter the 
United States under the Proclamation and this Amended Order.
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    \4\ CDC encourages airlines and aircraft operators to 
incorporate the attestation into paperless check-in processes. An 
airline or aircraft operator may use a third party (including a 
third-party application) to collect attestations, including to 
provide translations. However, an airline or aircraft operator will 
have sole legal responsibility to provide and collect attestations, 
to ensure the accuracy of any translation, and to comply with all 
other obligations under agency directives implementing the 
Proclamation. An airline or aircraft operator is responsible for any 
failure of a third party to comply with such directives. An airline 
or aircraft operator may not shift any legal responsibility to a 
third party.
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    Excepted Covered Individual means a Covered Individual who is not 
fully vaccinated against COVID-19 and meets the criteria for an 
exception under the Proclamation and this Amended Order.
    Foreign country means anywhere that is not a state, territory, or 
possession of the United States.
    Foreign Country with Limited COVID-19 Vaccine Availability means a 
foreign country where less than 10 percent of

[[Page 20407]]

the country's total population has been fully vaccinated with any 
available COVID-19 vaccine. These countries are listed by CDC in 
Technical Instructions.
    Fully Vaccinated Against COVID-19 \5\ means it has been:
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    \5\ While not a requirement of this Amended Order, CDC 
recommends that all travelers get a booster dose when eligible to 
stay up to date with their COVID-19 vaccines. See https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html.
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     2 weeks (14 days) or more since a person received one dose 
of an accepted single-dose-series COVID-19 vaccine; OR
     2 weeks (14 days) or more since a person received a second 
dose in a 2-dose series of an accepted COVID-19 vaccine; OR
     2 weeks (14 days) since a person received the full series 
of an accepted COVID-19 vaccine (not placebo) in a clinical trial; OR
     2 weeks (14 days) since the person received 2 doses of any 
``mix-and-match'' combination of accepted COVID-19 vaccines 
administered at least 17 days apart; \6\ OR
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    \6\ The recommended interval between the first and second doses 
of FDA-approved/authorized and WHO-EUL listed vaccines varies by 
vaccine type. However, for purposes of interpretation of vaccine 
records, the second dose in a two dose heterologous series must have 
been received no earlier than 17 days (21 days with a 4-day grace 
period) after the first dose.
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     2 weeks (14 days) or more since the person received a 
complete series of a vaccine or combination of vaccines listed by CDC 
in Technical Instructions.
    Not Fully Vaccinated Against COVID-19 means a person does not meet 
the definition of Fully Vaccinated Against COVID-19.
    Post-Arrival Viral Test means a viral test taken by an Excepted 
Covered Individual, obtained 3-5 days after arriving in the United 
States or other period as specified in the most current CDC guidance in 
effect at the time the Excepted Covered Individual completes the 
Covered Individual Attestation.\7\
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    \7\ Requirement for Proof of COVID-19 Vaccination for Air 
Passengers, available at https://www.cdc.gov/coronavirus/2019-ncov/travelers/proof-of-vaccination.html.
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    Post-Arrival Vaccination means completion of the primary series of 
an Accepted COVID-19 Vaccine by an Excepted Covered Individual followed 
by a two-week period in order to become Fully Vaccinated Against COVID-
19 within 60 days of arriving in the United States, or as soon 
thereafter as is medically appropriate, if the Excepted Covered 
Individual plans to be in the United States for longer than 60 days.
    Proof of Being Fully Vaccinated Against COVID-19 means a paper or 
digital format of a vaccination record or a verifiable vaccination 
record, as listed by CDC in Technical Instructions, confirming that the 
person is Fully Vaccinated Against COVID-19.
    Self-isolation/Self-isolate means actions taken by an Excepted 
Covered Individual who tests positive on a viral test for COVID-19 
administered on a specimen collected 3-5 days (or other period as 
specified in the most current CDC guidance in effect at the time the 
Excepted Covered Individual completes the Covered Individual 
Attestation) after arriving in the United States or develops COVID-19 
symptoms.8 9 These actions include separating from other 
individuals and staying in a home or other residence for at least 5 
calendar days (or other period as specified in the most current CDC 
guidance in effect at the time the Excepted Covered Individual 
completes the Covered Individual Attestation) after symptom onset or 
the date of first positive test if asymptomatic.\10\ The actions also 
include observing other public health precautions as set forth in the 
most current CDC guidance in effect at the time the Excepted Covered 
Individual completes the Covered Individual Attestation, such as 
properly wearing a well-fitting mask any time the Excepted Covered 
Individual must be around other people during the isolation period and 
for an additional 5 days after ending isolation.11 12
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    \8\ Ibid.
    \9\ Symptoms of COVID-19, available at https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html.
    \10\ Requirement for Proof of COVID-19 Vaccination for Air 
Passengers, available at https://www.cdc.gov/coronavirus/2019-ncov/travelers/proof-of-vaccination.html.
    \11\ Ibid.
    \12\ Quarantine and Isolation, available at https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html.
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    Self-quarantine means actions taken by an Excepted Covered 
Individual to separate from other individuals after arriving in the 
United States, including staying in a home or other residence for a 
full 5 days, or other period as specified in the most current CDC 
guidance in effect at the time the Excepted Covered Individual 
completes the Covered Individual Attestation, and observing public 
health precautions as set forth in the most current CDC guidance in 
effect at the time the Excepted Covered Individual completes the 
Covered Individual Attestation.13 14
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    \13\ Requirement for Proof of COVID-19 Vaccination for Air 
Passengers, available at https://www.cdc.gov/coronavirus/2019-ncov/travelers/proof-of-vaccination.html.
    \14\ Travel Guidance for Non-U.S. Citizens, Non-U.S. Immigrants, 
available at https://www.cdc.gov/coronavirus/2019-ncov/travelers/noncitizens-US-air-travel.html.
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    Viral test means a viral detection test for current infection 
(i.e., a nucleic acid amplification test [NAAT] or a viral antigen 
test) approved, cleared, or authorized by the FDA for the detection of 
SARS-CoV-2.
    United States or U.S. has the same definition as ``United States'' 
in 42 CFR 71.1(b), meaning ``the 50 States, District of Columbia, and 
the territories (also known as possessions) of the United States, 
including American Samoa, Guam, the Northern Mariana Islands, the 
Commonwealth of Puerto Rico, and the U.S. Virgin Islands.''

Background

    Since January 2020, the respiratory disease known as ``COVID-19,'' 
caused by a novel coronavirus (SARS-CoV-2), has spread globally, 
including cases reported in all 50 states within the United States, 
plus the District of Columbia and all U.S. territories. As of March 29, 
2022, there have been almost 481,756,700 million cases of COVID-19 
globally, resulting in almost 6,128,000 deaths.\15\ More than 
79,827,900 cases have been identified in the United States, with new 
cases reported daily, and over 975,500 deaths attributed to the 
disease.\16\ Additionally, throughout the duration of this pandemic, 
cases have tended to surge in waves, especially after high-volume 
travel periods or when new variants have emerged.\17\
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    \15\ https://covid19.who.int/.
    \16\ https://covid.cdc.gov/covid-data-tracker/#datatracker-home.
    \17\ Ibid.
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    On November 24, 2021, the Republic of South Africa informed the 
World Health Organization (WHO) of a new variant of SARS-CoV-2, the 
virus that causes COVID-19, that was detected in that country. On 
November 26, 2021, WHO designated the variant B.1.1.529 as a variant of 
concern and named it Omicron.\18\ This decision was based on the 
evidence presented to the Technical Advisory Group on SARS-CoV-2 Virus 
Evolution (TAG-VE) which is a group of independent experts charged with 
assessing the evolution of SARS-CoV-2 and examining if specific 
mutations and combinations of mutations may alter how the virus spreads 
and whether it may cause more severe illness. The evidence presented to 
the TAG-VE noted that Omicron has several mutations that may have an 
impact on

[[Page 20408]]

how easily it spreads or the severity of illness it causes.\19\
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    \18\ https://www.who.int/news/item/26-11-2021-classification-of-omicron-(b.1.1.529)-sars-cov-2-variant-of-concern.
    \19\ https://www.who.int/news/item/28-11-2021-update-on-omicron.
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    Even as COVID-19 rates fall in most of the United States, Omicron 
and sub-variants are still highly prevalent in other parts of the 
world. WHO and CDC continue to collaborate with researchers around the 
world to better understand Omicron and track potential future variants 
of SARS-CoV-2. Studies include assessments of transmissibility, 
severity of infection (including symptoms), and how well people who are 
fully vaccinated and boosted are protected against infection, 
hospitalization, and death. While data indicate that current vaccines 
are less effective at preventing infection from Omicron as compared to 
other variants, data also suggest that hospitalization and death rates 
are lower for individuals infected with Omicron who are vaccinated 
compared with other variants.20 21 With an estimated 100 
percent increase in transmission for Omicron when compared to the 
original virus, vaccinations continue to play an important role in 
protecting the public from severe illness.\22\ A booster dose of 
vaccine mitigates the reduction in vaccine effectiveness, and CDC has 
provided guidance advising that people stay up to date with their 
COVID-19 vaccines, including getting a booster dose if 
eligible.23 24
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    \20\ Johnson AG, Amin AB, Ali AR, et al. COVID-19 Incidence and 
Death Rates Among Unvaccinated and Fully Vaccinated Adults with and 
Without Booster Doses During Periods of Delta and Omicron Variant 
Emergence--25 U.S. Jurisdictions, April 4-December 25, 2021. MMWR 
Morb Mortal Wkly Rep. ePub: 21 January 2022. DOI: http://dx.doi.org/10.15585/mmwr.mm7104e2.
    \21\ Thompson MG, Natarajan K, Irving SA, et al. Effectiveness 
of a Third Dose of mRNA Vaccines Against COVID-19-Associated 
Emergency Department and Urgent Care Encounters and Hospitalizations 
Among Adults During Periods of Delta and Omicron Variant 
Predominance--VISION Network, 10 States, August 2021-January 2022. 
MMWR Morb Mortal Wkly Rep. ePub: 21 January 2022. DOI: http://dx.doi.org/10.15585/mmwr.mm7104e3.
    \22\ Ibid.
    \23\ Accorsi EK, Britton A, Fleming-Dutra KE, Smith ZR, Shang N, 
Derado G, et al. Association Between 3 Doses of mRNA COVID-19 
Vaccine and Symptomatic Infection Caused by the SARS-CoV-2 Omicron 
and Delta Variants. JAMA 2022. https://jamanetwork.com/journals/jama/fullarticle/2788485.
    \24\ https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html.
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    The United States is taking a multi-layered approach to combatting 
COVID-19 by taking concurrent efforts to prevent and slow the continued 
introduction of cases and further spread of the virus within U.S. 
communities. Vaccines remain the best public health measure to protect 
people from severe illness or death from COVID-19, slow transmission, 
and reduce the likelihood of new variants emerging.
    On October 25, 2021, the President issued a Proclamation under 3 
U.S.C. 301 and 8 U.S.C. 1182(f), 1185(a)(1), titled, ``Advancing the 
Safe Resumption of Global Travel During the COVID-19 Pandemic.'' The 
Proclamation revoked prior, country-specific presidential proclamations 
issued under these authorities in response to the outbreak of COVID-19. 
In their place, the President implemented a global suspension and 
restriction on entry for noncitizens who are nonimmigrants seeking to 
enter the United States by air travel and who are not fully vaccinated 
against COVID-19, with only limited exceptions. This Amended Order and 
associated Technical Instructions continue to implement the 
Proclamation. As further explained in this Amended Order, CDC continues 
to implement the Proclamation and require that Covered Individuals who 
are fully vaccinated show Proof of Being Fully Vaccinated Against 
COVID-19 and complete a Covered Individual Attestation attesting that 
they are fully vaccinated. Excepted Covered Individuals who are unable 
to present Proof of Being Fully Vaccinated Against COVID-19 must 
present a Covered Individual Attestation to the airline or aircraft 
operator prior to boarding the aircraft and attest that they have 
arranged to take specified public health actions after arrival in the 
United States.

Persons Whose Entry Is Not Covered by the Proclamation or Who Are 
Excepted Covered Individuals

    The Proclamation applies only to non-U.S. citizens seeking entry as 
nonimmigrants. Individuals seeking admission to the United States as 
immigrants are subject to the medical examination and vaccination 
requirements of 8 U.S.C. 1182(a)(1)(A) and 42 CFR part 34. These 
requirements are further described in CDC's COVID-19 Technical 
Instructions for Panel Physicians.\25\
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    \25\ https://www.cdc.gov/immigrantrefugeehealth/panel-physicians/covid-19-technical-instructions.html.
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    The Proclamation does not apply to crewmembers of airlines or other 
aircraft operators if they follow industry standard protocols for the 
prevention of COVID-19.26 27 Accordingly, per the terms of 
the Proclamation, these individuals are not Covered Individuals and are 
not required to present Proof of Being Fully Vaccinated nor required to 
present a completed Covered Individual Attestation to the airline or 
aircraft operator before boarding an aircraft destined to the United 
States.
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    \26\ Crewmembers on official duty assigned by the airline or 
operator that involves operation of aircraft, or the positioning of 
crew not operating the aircraft (i.e., on ``deadhead'' status), are 
exempt from the requirements of this Amended Order provided their 
assignment is under an air carrier's or operator's occupational 
health and safety program that follows applicable industry standard 
protocols for the prevention of COVID-19 as set forth in the most 
current relevant guidance issued by the CDC or the Federal Aviation 
Administration in coordination with the CDC (e.g., SAFO 20009, 
COVID-19: Updated Interim Occupational Health and Safety Guidance 
for Air Carriers and Crews, available at https://www.faa.gov/other_visit/aviation_industry/airline_operators/airline_safety/safo/all_safos/media/2020/SAFO20009.pdf.).
    \27\ CDC Technical Instructions: https://www.cdc.gov/quarantine/order-safe-travel/technical-instructions.html.
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    The Proclamation permits Excepted Covered Individuals to enter the 
United States by air if they meet certain criteria as determined by the 
CDC. Except for children under the age of 2 years, Excepted Covered 
Individuals are required to present a Covered Individual Attestation to 
the airline or aircraft operator before boarding an aircraft destined 
to the United States attesting that they meet criteria outlined in the 
Technical Instructions for certain categories of exceptions.\28\
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    \28\ Ibid.
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    In the Covered Individual Attestation, Excepted Covered Individuals 
must also attest to arranging to take specified post-arrival public 
health actions that, depending on the exception, could include a Post-
arrival Viral Test, Self-quarantine, or Self-isolation if they test 
positive; and a Post-arrival Vaccination if their exception requires it 
and they are staying in the country for more than 60 days. Information 
about the requirements for these actions is detailed in the definitions 
of this Amended Order, Technical Instructions, and in CDC guidance.\29\ 
The exception categories include:
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    \29\ Requirement for Proof of COVID-19 Vaccination for Air 
Passengers, available at https://www.cdc.gov/coronavirus/2019-ncov/travelers/proof-of-vaccination.html.
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    Diplomatic and Official Foreign Government Travel. The Proclamation 
excepts any noncitizen seeking entry into or transiting the United 
States for certain diplomatic or official foreign government 
activities. This includes:
     Noncitizens traveling pursuant to one of the following 
nonimmigrant visa classifications: A-1, A-2, C-2, C-3 (as a foreign 
government official or immediate family member of an official), E-1 (as 
an employee of TECRO or TECO or the employee's immediate family 
members), G-1, G-2, G-3, G-4, NATO-1 through NATO-4, or NATO-6 (or 
seeking to enter as a nonimmigrant in one of those NATO 
classifications); or

[[Page 20409]]

     Any noncitizen whose travel falls within the scope of 
section 11 of the United Nations Headquarters Agreement or other travel 
pursuant to a United States legal obligation (as evidenced by a letter 
of invitation from the United Nations or other documentation showing 
the purpose of such travel).
    These persons must provide proof of their visa classification or an 
official letter, such as a letter from the U.S. government or foreign 
government. If they have been invited by the United Nations, they will 
need to present a letter of invitation from the United Nations or other 
documentation showing the purpose of such travel. They will also be 
required to provide the Covered Individual Attestation to the airline 
or aircraft operator before boarding an aircraft destined to the United 
States. In the attestation, they must attest to having arranged to 
receive a Post-arrival Viral Test after arriving in the United States; 
to Self-quarantine, except during periods when their attendance is 
required to carry out the purposes of the diplomatic or official 
foreign government travel (e.g., to attend official meetings or 
events); and Self-isolate if the result of the post-arrival viral test 
is positive or if they develop COVID-19 symptoms. Individuals who meet 
the Diplomatic and Official Foreign Government Travel exception will 
not be required to attest to arranging for a Post-arrival 
Vaccination.\30\
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    \30\ As noted in Frequently Asked Questions on CDC's website 
(see https://www.cdc.gov/coronavirus/2019-ncov/travelers/proof-of-vaccination.html), this policy has been in place since December 2021 
and was subsequently included in the Covered Individual Attestation. 
It is incorporated into the substance of this Amended Order, 
consistent with the need to expedite diplomatic and official foreign 
government travel and comity regarding how U.S. diplomats are 
treated abroad.
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    Children. The Proclamation excepts noncitizens who are 
nonimmigrants for whom, given their age, requiring vaccination would be 
inappropriate as determined by the CDC, taking into account global 
vaccine availability for individuals in that age group. In the United 
States, COVID-19 vaccinations are widely available for children and 
adolescents, with a vaccine approved or authorized for those 5 years 
and older.\31\ However, the same availability does not exist 
globally.\32\ Accordingly, considering the difficulty potentially posed 
to families traveling together when some members of the family can be 
vaccinated and others cannot, persons under the age of 18 years meet 
the age-based exception in the Proclamation.
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    \31\ https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/children-teens.html.
    \32\ https://www.who.int/news/item/24-11-2021-interim-statement-on-covid-19-vaccination-for-children-and-adolescents.
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    Noncitizens who are nonimmigrants and who are children ages 2 
through 17 and unable to present Proof of Being Fully Vaccinated 
Against COVID-19 must present a completed Covered Individual 
Attestation to the airline or aircraft operator prior to embarking an 
aircraft destined to the United States. CDC has determined that 
children under 2 years of age do not need to have an attestation 
completed because many are infants in arms, who are not required to 
have an airline ticket and for whom an attestation presents significant 
logistical burdens. Children ages 2 through 17 will be required to 
attest (or have a parent or guardian attest on their behalf) to 
arranging to get a Post-arrival Viral Test and Self-isolate if the test 
result is positive or if the child develops COVID-19 symptoms. However, 
children ages 2 through 17 will not be required to attest (or have a 
parent or guardian attest on their behalf) to having arranged to Self-
quarantine in the United States after arrival. Based on the potential 
difficulty that self-quarantine may pose to children ages 2 through 17, 
especially when accompanied by a vaccinated parent or guardian who is 
not required to self-quarantine, CDC has determined that self-
quarantine should not be required. As previously stated, children under 
2 years of age are not required to attest (or have a parent or guardian 
attest on their behalf) to arranging to complete any post-arrival 
public health requirements. CDC believes that this approach fairly 
balances the interests of families traveling to the United States with 
protecting the public's health. CDC guidance strongly recommends 
vaccination for all adolescents and eligible children. However, given 
the still evolving circumstances of vaccination for children, 
attestation regarding post-arrival vaccination will not be required for 
children ages 2 through 17 at this time. This determination will be 
periodically reevaluated.
    Clinical Trials. The Proclamation excepts noncitizens who are 
nonimmigrants and who have participated or are participating in certain 
clinical trials for COVID-19 vaccination, as determined by the CDC. 
Qualifying vaccine candidates that meet CDC criteria for the exception 
are specified in the Technical Instructions.\33\ Because these clinical 
trial participants may have received a COVID-19 vaccine or series of 
COVID-19 vaccines that do not meet the definition of an Accepted COVID-
19 Vaccine, these participants may not be able to present Proof of 
Being Fully Vaccinated Against COVID-19. Accordingly, noncitizens who 
are nonimmigrants and who have participated or are participating in 
certain COVID-19 vaccine trials and unable to present Proof of Being 
Fully Vaccinated Against COVID-19 must present a completed Covered 
Individual Attestation to the airline or aircraft operator prior to 
embarking an aircraft destined to the United States.
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    \33\ https://www.cdc.gov/quarantine/order-safe-travel/technical-instructions.html (Table 3).
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    To meet the clinical trial exception, Covered Individuals must 
provide official documentation of clinical trial participation outlined 
further in the Technical Instructions. Those who meet the clinical 
trial exception must attest (or have a parent or guardian attest on 
their behalf) to having arranged to receive a Post-arrival Viral Test, 
and Self-isolate if the test result is positive or if they develop 
COVID-19 symptoms. However, CDC has determined that these individuals 
should not be required to attest to arranging to self-quarantine or to 
be vaccinated after arriving in the United States. Requiring self-
quarantine after arrival could potentially discourage clinical trial 
participation which would not serve the interests of public health and 
requiring vaccination could potentially invalidate the clinical trial 
study.
    Medical Contraindications. The Proclamation excepts noncitizens who 
are nonimmigrants for whom receiving an accepted COVID-19 vaccine is 
medically contraindicated as determined by CDC.\34\ Accordingly, CDC 
has determined that for an individual to meet this exception, a 
licensed physician must have determined that the individual has a 
medical contraindication to an accepted COVID-19 vaccine (e.g., a 
demonstrated anaphylactic reaction to a prior dose of a COVID-19 
vaccine or vaccine component). As further described in the Technical 
Instructions, such individuals are not required to present Proof of 
Being Fully Vaccinated Against COVID-19. COVID-19 vaccinations have 
been overwhelmingly proven to be safe and effective at preventing 
severe illness, hospitalizations, and deaths from COVID-19. However, as 
is the case with any vaccine, certain medical complications can occur, 
such as a severe allergic reaction. CDC intends for this exception to 
be applied in strict

[[Page 20410]]

accordance with scientific evidence and has provided additional details 
concerning exceptions for medical contraindications in the Technical 
Instructions. Persons who believe they meet the criteria for this 
exception must present a signed letter from a licensed physician 
documenting a medical contraindication to receiving a COVID-19 vaccine. 
In the Covered Individual Attestation, they must attest that they meet 
the exception, and must attest to having arranged to obtain a Post-
arrival Viral Test, Self-quarantine, and Self-isolate if they test 
positive or if they develop COVID-19 symptoms.
---------------------------------------------------------------------------

    \34\ Objections to vaccination based on religious or moral 
convictions do not qualify under this or any other exception listed 
in the Proclamation or this Amended Order.
---------------------------------------------------------------------------

    Humanitarian and Emergency Exceptions. The Proclamation excepts any 
noncitizen nonimmigrant who has been granted an exception by the CDC 
for humanitarian or emergency reasons, as determined by the CDC. CDC 
applies this exception extremely narrowly, such as when an individual 
must travel to the United States to preserve health and safety (e.g., 
emergency medical evacuations) and is unable to complete the 
vaccination requirement before travel. Individuals and organizations 
sponsoring individuals who meet the exception criteria should contact 
the U.S. embassy or consulate in or nearest the country from which they 
are departing for the United States. The embassy will then transmit 
this information to CDC for consideration. Any noncitizen who is a 
nonimmigrant granted an exception for humanitarian or emergency reasons 
must present an official U.S. government letter and a completed Covered 
Individual Attestation to the airline or aircraft operator prior to 
embarking an aircraft destined to the United States. Such individual 
must attest to having arranged to obtain a Post-arrival Viral Test, 
Self-quarantine, and Self-isolate if they test positive or develop 
COVID-19 symptoms. They also must attest to having arranged to receive 
a Post-arrival Vaccination within 60 days of arriving in the United 
States, or as soon thereafter as is medically appropriate as determined 
by CDC, if they intend to stay in the United States for more than 60 
days.
    Limited Vaccine Availability. The Proclamation excepts any 
noncitizen who is a nonimmigrant with a nonimmigrant visa (excluding a 
B-1 or B-2 visa) and who is a citizen of a Foreign Country with Limited 
COVID-19 Vaccine Availability, which is defined pursuant to the 
Proclamation and this Amended Order as a foreign country where less 
than 10 percent of the country's total population has been fully 
vaccinated with any available COVID-19 vaccine or is otherwise 
determined by the Director of the CDC to qualify as a country where the 
availability of COVID-19 vaccination is limited.\35\ The list of 
countries falling below the 10 percent threshold is maintained by CDC 
in the Technical Instructions and reviewed on a regular basis. In 
developing and maintaining this list, CDC relies on official source 
data as reported by foreign ministries of health but may also rely on 
other sources such as additional information provided by U.S. embassies 
and consulates.
---------------------------------------------------------------------------

    \35\ https://covid.cdc.gov/covid-data-tracker/#datatracker-home.
---------------------------------------------------------------------------

    Individuals entering the United States under this exception must 
show proof that they meet the exception through a passport issued by a 
foreign country with limited COVID-19 vaccine availability and a non-B-
1 or B-2 nonimmigrant visa as well as a completed Covered Individual 
Attestation to the airline or aircraft operator prior to embarking an 
aircraft destined to the United States. Additionally, these individuals 
must attest to having arranged to obtain a Post-arrival Viral Test, 
Self-quarantine, and Self-isolate if they test positive or develop 
COVID-19 symptoms. They also must attest to having arranged to receive 
a Post-arrival Vaccination within 60 days of arriving in the United 
States, or as soon thereafter as is medically appropriate as determined 
by CDC, if they intend to stay in the United States for more than 60 
days.
    Members of the U.S. Armed Forces. The Proclamation and this Amended 
Order except noncitizens who are members of the U.S. Armed Forces and 
the spouses and children under 18 years of age of members of the U.S. 
Armed Forces. CDC applies this exception in a similar manner as in the 
CDC Order, Requirement for Proof of Negative COVID-19 Test or Recovery 
from COVID-19 for All Air Passengers Arriving in the United States. 
Members of the U.S. Armed Forces and their family members observe U.S. 
Department of Defense (DoD) guidance to prevent the transmission of 
COVID-19 as set forth in Force Protection Guidance (Supplement 20) 
Revision 1--Department of Defense Guidance for Personnel Traveling 
During the Coronavirus Disease 2019 Pandemic \36\ (January 10, 2022) or 
subsequent updated DoD guidance. Accordingly, members of the U.S. Armed 
Forces and their family members, if traveling with a U.S. military 
identification document or other proof of status as a member of the 
U.S. Armed Forces or as a spouse, or child ages 2 through 17 of a 
member of the U.S. Armed Forces, must attest (or have a parent or 
guardian attest on their behalf if a child ages 2 through 17) to their 
status on the Covered Individual Attestation, but are not required to 
attest to having arranged to complete any post-arrival public health 
requirements. As previously stated, children under 2 years of age are 
not required to attest or have a parent or guardian attest on their 
behalf, to having arranged to complete any post-arrival public health 
requirements.
---------------------------------------------------------------------------

    \36\ https://media.defense.gov/2022/Jan/11/2002920095/-1/-1/1/FORCE-HEALTH-PROTECTION-GUIDANCE-SUPPLEMENT-20-REVISION-1-DEPARTMENT-OF-DEFENSE-GUIDANCE-FOR-PERSONNEL-TRAVELING-DURING-THE-CORONAVIRUS-DISEASE-2019-PANDEMIC.PDF.
---------------------------------------------------------------------------

    Sea Crew Members. The Proclamation excepts any noncitizen seeking 
entry to or transiting through the United States as a sea crew member 
traveling pursuant to a C-1 and D nonimmigrant visa if such sea crew 
member adheres to all industry standard protocols for the prevention of 
COVID-19, as set forth in relevant guidance for sea crew member health 
by the CDC.\37\ Any passenger granted an exception as a sea crew member 
must present documentation to the airline from their employer 
indicating that their entry to or transit through the United States is 
required for the purpose of operating a vessel or return travel after 
disembarking the vessel. Sea crew members entering the United States 
under this exception must present a completed Covered Individual 
Attestation to the airline or aircraft operator prior to embarking an 
aircraft destined to the United States. Sea crew members traveling on 
this exception also must attest to having arranged to obtain a Post-
arrival Viral Test, Self-quarantine, and Self-isolate if they test 
positive or develop COVID-19 symptoms. They also must attest to a Post-
arrival Vaccination within 60 days of arriving in the United States, or 
as soon thereafter as is medically appropriate as determined by CDC if 
they intend to stay in the United States for more than 60 days. Given 
that sea crew members may need to board a ship soon after arrival in 
the United States, CDC has provided additional information about how 
Excepted Covered Individuals who are sea crew

[[Page 20411]]

members can meet the requirements of the Amended Order and post-arrival 
requirements on CDC's website.\38\
---------------------------------------------------------------------------

    \37\ See CDC's guidance: https://www.cdc.gov/coronavirus/2019-ncov/travelers/proof-of-vaccination.html for additional information 
regarding post-arrival public health management of sea crew. 
Relevant CDC guidance pertaining to sea crew members serving on 
board cruise ships has been issued separately (available at https://www.cdc.gov/quarantine/cruise/index.html). Additional guidance 
applicable to crew serving onboard all vessels is available at 
https://www.cdc.gov/quarantine/maritime/recommendations-for-ships.html.
    \38\ https://www.cdc.gov/coronavirus/2019-ncov/travelers/proof-of-vaccination.html#faq-exceptions.
---------------------------------------------------------------------------

    National Interest Exception. The Proclamation excepts any 
noncitizen or group of noncitizens whose entry would be in the U.S. 
national interest, as determined by the Secretary of State, the 
Secretary of Transportation, or the Secretary of Homeland Security or 
their designees. Any Excepted Covered Individual granted an exception 
in the national interest must present an official U.S. government 
letter and a completed Covered Individual Attestation to the airline or 
aircraft operator prior to embarking an aircraft destined to the United 
States. Such an individual must also attest to having arranged to: 
Obtain a Post-arrival Viral Test; Self-quarantine, except during 
periods when attendance is required to carry out the purposes of the 
travel for the U.S. national interest (e.g., to attend official 
meetings or events); and Self-isolate if they test positive or develop 
COVID-19 symptoms. They also must attest to having arranged to receive 
a Post-arrival Vaccination within 60 days of arriving in the United 
States, or as soon thereafter as is medically appropriate, if they 
intend to stay in the United States for more than 60 days.

Requirement To Provide a Covered Individual Attestation

    The Proclamation directs the HHS Secretary, acting through the CDC 
Director, to implement the Proclamation as it applies to public health 
through such procedures as may be established, and consistent with 
CDC's independent public health judgment. In accordance with the 
President's direction, this Amended Order requires that Covered 
Individuals seeking to enter the United States by air travel who are 
fully vaccinated may embark an aircraft destined for the United States 
only if they show Proof of Being Fully Vaccinated Against COVID-19 and 
complete a Covered Individual Attestation attesting that they are fully 
vaccinated.
    Additionally, Covered Individuals seeking to enter the United 
States by air travel and who are not Fully Vaccinated Against COVID-19 
may embark an aircraft destined for the United States only if they 
qualify as Excepted Covered Individuals pursuant to the Proclamation. 
Under the Proclamation and this Amended Order, such individuals must 
agree, depending on their category of exception, that they will comply 
with applicable public health precautions established by CDC to protect 
against the public health risk posed by these travelers entering into 
the United States. These include:
     Providing proof in the form of an attestation of pre-
departure testing for COVID-19 or documentation of recovery from COVID-
19, as determined by the CDC;
     taking precautions during air travel to protect against 
the further introduction, transmission, and spread of COVID-19, 
including by complying with the requirement to wear a face mask, as 
determined by the CDC;
     providing proof in the form of an attestation of having 
arranged for post-arrival testing for COVID-19, as determined by the 
CDC; and
     providing proof in the form of an attestation of having 
arranged to self-quarantine or self-isolate after arriving in the 
United States, as determined by the CDC.
    Some categories of Excepted Covered Individuals (subject to certain 
exceptions) must also attest to having arranged to become fully 
vaccinated against COVID-19 within 60 days \39\ of arriving in the 
United States if the individual intends to stay in the United States 
for more than 60 days, or as soon thereafter as is medically 
appropriate as determined by the CDC, and must provide proof in the 
form of an attestation of having arranged to become fully vaccinated 
against COVID-19 after arriving in the United States.
---------------------------------------------------------------------------

    \39\ CDC considers 60 days an appropriate time frame for 
requiring that persons arriving in the United States be fully 
vaccinated against COVID-19. The mRNA COVID-19 vaccines (Pfizer-
BioNTech and Moderna) available in the United States are 
administered 3-4 weeks apart (see https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html). It takes 14 days after 
the second dose to be considered fully vaccinated. Therefore, it is 
reasonable to conclude that individuals should be able to complete 
the vaccination series and the 14-day period within 60 days of 
arriving in the United States.
---------------------------------------------------------------------------

    The Covered Individual Attestation must be completed, in written or 
electronic form, by the Covered Individual and is subject to 18 U.S.C. 
1001. As further explained in the attached Attestation form (Attachment 
A), persons who knowingly submit false information may be subject to 
fines, imprisonment, and other penalties. Airlines or other aircraft 
operators, as directed by the Transportation Security Administration 
(TSA), including through the Security Directive issued, and consistent 
with this Amended Order, are required to retain a copy of the Covered 
Individual Attestation for 2 years; however, individuals are not 
required to retain a copy of the attestation in their possession upon 
arriving in the United States.
    Future CDC Orders implementing the Proclamation may require other 
public health measures consistent with the Proclamation to protect 
against the further introduction, transmission, and spread of COVID-19 
into the United States by Covered Individuals.

Statement of Good Cause Under the Administrative Procedure Act

    This Amended Order is not a legislative rule within the meaning of 
the Administrative Procedure Act (APA), but rather an Order 
implementing the Proclamation, which itself is not subject to the APA. 
Because this Amended Order qualifies as a legislative rule under the 
APA, notice and comment and a delay in the effective date are not 
required because there is good cause to dispense with prior public 
notice and comment and for a delay in the effective date. See 5 U.S.C. 
553(b)(B), (d)(3). Considering the rapid and unpredictable developments 
in the public health emergency caused by COVID-19, it would be 
impracticable and contrary to the public's health, and by extension the 
public's interest, to delay the issuance and effective date of this 
Amended Order implementing the Proclamation. In light of the rapid 
spread of Omicron and its impact on travel, any delay in issuing these 
amendments would adversely affect travelers and the air travel industry 
by depriving these persons and entities of the ability to rely on the 
most up-to-date findings and scientific determinations relating to the 
ongoing COVID-19 pandemic. In addition, the APA does not require a 
delay in the effective date because this Amended Order relieves certain 
restrictions. See 5 U.S.C. 553(d)(1).
    This Amended Order is being issued to align with revised CDC 
guidance related to isolation and quarantine after travel that was 
published on January 4, 2022 and make other changes based on CDC's 
public health expertise. Revised CDC guidance reduces the number of 
days recommended for a person to self-quarantine after travel from 7 to 
5 days.40 41 Additionally, the new guidance reduces the 
number of days recommended for isolation for people who are diagnosed 
with COVID-19 or have COVID-19 symptoms from 10 days to 5 days. Further 
delay to these updates

[[Page 20412]]

may result in travelers quarantining or isolating longer than needed 
after travel. This Amended Order also allows for these time periods to 
be adjusted if further updates are made to CDC's guidance. Updates will 
be reflected in the attestation and on CDC's website.\42\
---------------------------------------------------------------------------

    \40\ Quarantine and Isolation, available at https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html.
    \41\ Travel Guidance for Non-U.S. Citizens, Non-U.S. Immigrants, 
available at https://www.cdc.gov/coronavirus/2019-ncov/travelers/noncitizens-US-air-travel.html.
    \42\ Requirement for Proof of COVID-19 Vaccination for Air 
Passengers, available at https://www.cdc.gov/coronavirus/2019-ncov/travelers/proof-of-vaccination.html.
---------------------------------------------------------------------------

    This Amended Order also provides that children under 2 years of age 
do not need to complete (or have a parent or guardian complete on their 
behalf) an attestation, revises what is required for Excepted Covered 
Individuals to meet the criteria for an exception, and provides more 
clarity on what public health actions (e.g., Self-quarantine, Post-
arrival Viral Test) may be required after arriving in the United 
States. It is imperative that these amendments be issued without 
further delay so that affected individuals have the necessary clarity 
when arranging their travel and post-travel plans in accordance with 
the requirements of this Amended Order. Overall, these updates reduce 
the burden to the air passenger, such as by reducing the time period 
they would be required to attest to arranging after arrival in the 
United States and being more explicit about which activities are not 
required for certain exceptions.
    This Amended Order is an economically significant regulatory action 
under Executive Order 12866 and has therefore been reviewed by the 
Office of Information and Regulatory Affairs of the Office of 
Management and Budget. Similarly, the Office of Information and 
Regulatory Affairs has determined that if this Amended Order were a 
rule, it would be a major rule under Subtitle E of the Small Business 
Regulatory Enforcement Fairness Act of 1996 (the Congressional Review 
Act), 5 U.S.C. 804(2), but there would not be a delay in its effective 
date as the agency has determined that there would be good cause to 
make the requirements herein effective immediately under the APA, 5 
U.S.C. 808(2).
    If any provision of this Amended Order continuing to implement the 
Proclamation, or the application of any provision to any carriers, 
persons, or circumstances, shall be held invalid, the remainder of the 
provisions, or the application of such provisions to any carriers, 
persons, or circumstances other than those to which it is held invalid, 
shall remain valid and in effect.
    Pursuant to 5 U.S.C. 553(b)(B), and for the reasons stated above, I 
hereby conclude that notice-and-comment rulemaking would defeat the 
purpose of this Amended Order implementing the Proclamation and 
endanger the public health, and is, therefore, impracticable and 
contrary to the public interest. For the same reasons, I have 
determined, consistent with 5 U.S.C. 553(d)(3), that there is good 
cause to make this Amended Order implementing the Proclamation 
effective without a 30-day delay in effective date. In addition, 
consistent with 5 U.S.C. 553(d)(1), this Amended Order implementing the 
Proclamation does not require a 30-day delay in effective date because 
it relieves certain restrictions.

Action

    Accordingly, for the reasons set forth in the Proclamation and in 
this Amended Order:

1. Directions to Airlines and Other Aircraft Operators

    As directed by TSA, including through its Security Directive or 
Emergency Amendment issued after consultation with CDC, and consistent 
with this Amended Order, any airline or other aircraft operator 
transporting by air into the United States individuals who are Covered 
Individuals from any foreign country, as determined and confirmed by 
the airline or other aircraft operator, is required to:
    A. Confirm that every Covered Individual, unless excepted, prior to 
boarding the aircraft, has presented paper or digital documentation of 
Proof of Being Fully Vaccinated Against COVID-19 that includes personal 
identifiers (e.g., name and date of birth) that match the personal 
identifiers on the passenger's passport or other travel documents, and 
provides a Covered Individual Attestation.
    B. Confirm that every Covered Individual who has not presented 
Proof of Being Fully Vaccinated Against COVID-19 prior to boarding the 
aircraft has presented documentation proving that they are an Excepted 
Covered Individual under the Proclamation and this Amended Order as 
further explained by CDC in the Technical Instructions.
    C. Confirm that every Excepted Covered Individual \43\ who has not 
presented Proof of Being Fully Vaccinated Against COVID-19 prior to 
boarding the aircraft provides a Covered Individual Attestation, and as 
further explained in the Technical Instructions, attests to the 
following (as applicable):
---------------------------------------------------------------------------

    \43\ Parents or guardians of children under 2 years of age do 
not need to attest on behalf of these children, but they must 
present proof of the child's age to the airline or aircraft operator 
before boarding.
---------------------------------------------------------------------------

    a. Being excepted from the requirement to present Proof of Being 
Fully Vaccinated Against COVID-19 for one of the reasons set forth in 
the Proclamation and this Amended Order;
    b. having arranged to be tested with a COVID-19 viral test 3-5 days 
after arriving in the United States, or other period as specified in 
the most current CDC guidance in effect at the time the Excepted 
Covered Individual completes the Covered Individual Attestation, unless 
the Excepted Covered Individual has documentation of having recovered 
from COVID-19 in the past 90 days, or other period as specified in the 
most current CDC guidance in effect at the time the Excepted Covered 
Individual completes the Covered Individual Attestation;
    c. having arranged to self-quarantine, even if the test result to 
the post-arrival viral test is negative, unless the Excepted Covered 
Individual has documentation of having recovered from COVID-19 in the 
past 90 days or other period as specified in the most current CDC 
guidance in effect at the time the Excepted Covered Individual 
completes the Covered Individual Attestation; and
    d. having arranged to self-isolate if the result of the post-
arrival viral test is positive or if they develop COVID-19 symptoms.
    D. Confirm that every Excepted Covered Individual who does not 
present Proof of Being Fully Vaccinated Against COVID-19, provides a 
Covered Individual Attestation, as applicable and as further explained 
in the Technical Instructions, attesting to the following:
    a. Having arranged to become fully vaccinated against COVID-19 
within 60 days after arriving in the United States, or as soon 
thereafter as is medically appropriate as determined by CDC, if such 
person intends to stay in the United States for more than 60 days, 
unless the individual is excepted from this requirement.
    E. Not board any Covered Individual without confirming the 
applicable documentation as set forth in A, B, C, or D of this section.
    The attestation is attached to this Amended Order as Attachment 
A.\44\
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    \44\ CDC has provided a combined passenger disclosure and 
attestation that fulfills the requirements of CDC Orders: 
Requirement for Proof of Negative COVID-19 Test Result or Recovery 
from COVID-19 for All Airline Passengers Arriving into the United 
States and Order Implementing Presidential Proclamation on Advancing 
the Safe Resumption of Global Travel During the COVID-19 Pandemic.

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[[Page 20413]]

2. Requirements for Aircraft Passengers

    In addition, I order that any aircraft passenger \45\ who is a 
Covered Individual under the Proclamation, prior to boarding an 
aircraft traveling from a foreign country to the United States, shall:
---------------------------------------------------------------------------

    \45\ A parent or other authorized individual may present the 
required documentation on behalf of a passenger ages 2 through 17. 
An authorized individual may act on behalf of any passenger who is 
unable to act on their own behalf (e.g., by reason of age, or 
physical or mental impairment). There are no documentation 
requirements for passengers under the age of 2 years of age.
---------------------------------------------------------------------------

    A. Present to the airline or other aircraft operator paper or 
digital documentation reflecting Proof of Being Fully Vaccinated 
Against COVID-19 and provide a Covered Individual Attestation;
    OR
    B. If not presenting Proof of Being Fully Vaccinated Against COVID-
19, present to the airline or aircraft operator documentation 
confirming that they are an Excepted Covered Individual under the 
Proclamation and this Amended Order, as applicable and as further 
explained by CDC in the Technical Instructions.
    C. If an Excepted Covered Individual,\46\ accurately complete and 
provide the airline or aircraft operator with a Covered Individual 
Attestation, as further explained by CDC in the Technical Instructions, 
attesting that the Excepted Covered Individual (as applicable):
---------------------------------------------------------------------------

    \46\ Parents or guardians of children under 2 years of age do 
not need to attest on behalf of these children, but they must 
present proof of the child's age to the airline or aircraft operator 
before boarding.
---------------------------------------------------------------------------

    a. Is excepted from the requirement to present Proof of Being Fully 
Vaccinated Against COVID-19 for one of the reasons set forth in the 
Proclamation and this Amended Order;
    b. has arranged to be tested with a COVID-19 viral test 3-5 days 
after arriving in the United States, or other period as specified in 
the most current CDC guidance in effect at the time the Excepted 
Covered Individual completes the Covered Individual Attestation, unless 
the Excepted Covered Individual has documentation of having recovered 
from COVID-19 in the past 90 days, or other period as specified in the 
most current CDC guidance in effect at the time the Excepted Covered 
Individual completes the Covered Individual Attestation;
    c. has arranged to self-quarantine, even if the test result to the 
post-arrival viral test is negative, unless the Excepted Covered 
Individual has documentation of having recovered from COVID-19 in the 
past 90 days, or other period as specified in the most current CDC 
guidance in effect at the time the Excepted Covered Individual 
completes the Covered Individual Attestation; and
    d. has arranged to self-isolate if the result of the post-arrival 
viral test is positive or if they develop COVID-19 symptoms.
    D. If an Excepted Covered Individual, provide the airline or 
aircraft operator with a Covered Individual Attestation, as applicable 
and as further explained by CDC in the Technical Instructions, 
additionally attesting that the Excepted Covered Individual:
    (1) has arranged to become fully vaccinated against COVID-19 within 
60 days after arriving in the United States, or as soon thereafter as 
is medically appropriate as determined by CDC, if intending to stay in 
the United States for more than 60 days, unless the individual is 
excepted from this requirement.
    E. Retain a copy of the applicable documentation listed in parts A, 
B, C, and D of this section and produce such documentation upon 
request, or as required by, any U.S. government official or a 
cooperating state, local, territorial, or Tribal public health 
authority after arrival in the United States.
    Willfully giving false or misleading information to the government 
may result in criminal penalties under, inter alia, 18 U.S.C. 1001.
    This Amended Order shall be enforced through the relevant 
provisions of law, in coordination with other federal departments and 
agencies, including the U.S. Department of Justice, U.S. Department of 
Homeland Security, U.S. Department of State, and U.S. Department of 
Transportation.

Effective Date

    This Amended Order shall enter into effect at 12:01 a.m. EDT on 
April 14, 2022.

ATTACHMENT A: COMBINED PASSENGER DISCLOSURE AND ATTESTATION TO THE 
UNITED STATES OF AMERICA

    This combined passenger disclosure and attestation fulfills the 
requirements of U.S. Centers for Disease Control and Prevention (CDC) 
Amended Orders: Requirements for Negative Pre-Departure COVID-19 Test 
Result or Documentation of Recovery from COVID-19 for All Airline or 
Other Aircraft Passengers Arriving into the United States from Any 
Foreign Country and Implementing Presidential Proclamation on Advancing 
the Safe Resumption of Global Travel During the COVID-19 Pandemic.\47\ 
As directed by the CDC and the Transportation Security Administration 
(TSA), through Security Directive 1544-21-03 and Emergency Amendment 
1546-21-02, and consistent with CDC's Order implementing the 
Proclamation, all airline or other aircraft operators must provide the 
following disclosures to all passengers prior to their boarding a 
flight from a foreign country to the United States.
---------------------------------------------------------------------------

    \47\ These requirements (e.g., proof of negative COVID-19 test 
result or recovery and proof of being fully vaccinated against 
COVID-19) do not apply to crewmembers of airlines or other aircraft 
operators if they are traveling for the purpose of operating the 
aircraft or repositioning (i.e., on ``deadhead'' status), provided 
their assignment is under an air carrier's or operator's 
occupational health and safety program that follows applicable 
industry standard protocols for the prevention of COVID-19 as set 
forth in relevant Safety Alerts for Operators (SAFOs) issued by the 
Federal Aviation Administration (FAA).
---------------------------------------------------------------------------

Airline and Aircraft Operator Disclosure Requirements

    As required by United States federal law, all airlines or other 
aircraft operators must collect the passenger attestation on behalf of 
the U.S. Government.\48\
---------------------------------------------------------------------------

    \48\ Section 1 and Section 2 of this attestation do not need to 
be completed by or on behalf of children under 2 years of age. The 
airline or other aircraft operator may permit them to board an 
aircraft without an attestation.
---------------------------------------------------------------------------

Required Proof of Negative COVID-19 Test Result or Recovery From COVID-
19

    All airlines and other aircraft operators must additionally confirm 
one of the following for each passenger ages 2 years or older prior to 
their boarding a flight to the United States from a foreign country:
    1. A negative result for a Qualifying Test; or
    2. Documentation of Recovery from COVID-19 in the form of a 
positive COVID-19 viral test on a sample taken no more than 90 days 
prior to departure and a letter from a licensed healthcare provider or 
public health official stating that the passenger has been cleared for 
travel.

Required Proof of COVID-19 Vaccination for Non-U.S. Citizen, 
Nonimmigrant Air Passengers

    As directed by the TSA, including through a security directive or 
emergency amendment, all airlines and other aircraft operators must 
additionally confirm one of the following for each noncitizen who is a 
nonimmigrant passenger prior to their boarding a flight to the United 
States from a foreign country:

[[Page 20414]]

    1. Proof of being Fully Vaccinated Against COVID-19; or
    2. Proof of being excepted from the requirement to be Fully 
Vaccinated Against COVID-19.
OMB Control No.: 0920-1318
Expiration Date: 05/31/2022

PASSENGER DISCLOSURE AND ATTESTATION TO THE UNITED STATES OF AMERICA

    The information provided below must be accurate and complete to the 
best of the individual's knowledge. Under United States federal law, 
the applicable portion of the attestation must be completed for each 
passenger ages 2 years or older and the attestation must be provided to 
the airline or aircraft operator prior to boarding a flight to the 
United States from a foreign country. Failure to complete and present 
the applicable portion of the attestation, or submitting false or 
misleading information, could result in delay of travel, denial of 
boarding, or denial of boarding on future travel, or put the passenger 
or other individuals at risk of harm, including serious bodily injury 
or death. Any passenger who fails to comply with these requirements may 
be subject to criminal penalties. Willfully providing false or 
misleading information may lead to criminal fines and imprisonment 
under, among other provisions, 18 U.S.C. 1001. Providing this 
information can help protect you, your friends and family, your 
communities, and the United States. CDC appreciates your cooperation.
    One attestation form must be filled out for each passenger ages 2 
years or older. The attestation may be filled out by the air passenger 
or on behalf of the air passenger by a legal representative, such as a 
parent or guardian.

--Section 1: All air passengers ages 2 years or older flying to the 
United States must complete Section 1.
--Section 2: Any passenger age 2 years or older who is not a U.S. 
citizen, U.S. national, lawful permanent resident, or an immigrant 
(``Covered Individual'') who is seeking to enter the United States by 
air travel must also complete Section 2 of this attestation and comply 
with applicable after travel requirements in Section 2.\49\
---------------------------------------------------------------------------

    \49\ Any passenger who is not a U.S. citizen, U.S. national, 
lawful permanent resident, or an immigrant is referred to as a 
Covered Individual because they are covered by the Presidential 
Proclamation and CDC's Amended Order: Implementing Presidential 
Proclamation on Advancing the Safe Resumption of Global Travel 
During the COVID-19 Pandemic. This term does not apply to 
crewmembers of airlines or other aircraft operators if such 
crewmembers and operators adhere to all industry standard protocols 
for the prevention of COVID-19, as set forth in relevant guidance 
for crewmember health issued by the CDC or by the FAA in 
coordination with the CDC.
    Public reporting burden of this collection of information is 
estimated to average 2 hours per response, including the time for 
reviewing instructions, searching existing data sources, gathering 
and maintaining the data needed, and completing and reviewing the 
collection of information. An agency may not conduct or sponsor, and 
a person is not required to respond to, a collection of information 
unless it displays a currently valid OMB Control Number. Comments 
regarding this burden estimate or any other aspect of this 
collection of information, including suggestions for reducing this 
burden, may be submitted to CDC/ATSDR Reports Clearance Officer, 
1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA 
0920-1318.

    I, __________am attesting on (Select one):
PRINT FIRST AND LAST NAME
[ballot] My own behalf [ballot] Behalf of:

-----------------------------------------------------------------------
PRINT FIRST AND LAST NAME

SECTION 1: Requirement for Proof of Negative COVID-19 Test Result or 
Recovery From COVID-19 (check one box)

A. NEGATIVE PRE-DEPARTURE TEST RESULT

[ballot] I attest that I have (or the person I am attesting on behalf 
of has) received a negative pre-departure test result for COVID-19. The 
test was a viral test that was conducted on a specimen collected no 
more than 1 calendar day before the flight's departure.

B. DOCUMENTATION OF RECOVERY FROM COVID-19

[ballot] I attest that I have (or the person I am attesting on behalf 
of has) tested positive for COVID-19 and been cleared for travel by a 
licensed healthcare provider or public health official. The test was a 
viral test that was conducted on a specimen collected no more than 90 
days before the flight's departure.

C. HUMANITARIAN EXEMPTION

[ballot] I attest that I have (or the person I am attesting on behalf 
of has) received a humanitarian exemption to the testing requirement, 
as determined by CDC and documented by an official U.S. Government 
letter.

SECTION 2: Requirement for Proof of COVID-19 Vaccination for Covered 
Individuals (Not a U.S. Citizen, U.S. National, Lawful Permanent 
Resident, or an Immigrant)

A. FULLY VACCINATED (If you check box A, skip to signature page and 
sign the form to complete Attestation.)

[ballot] I attest that I am (or the person I am attesting on behalf of 
is) fully vaccinated against COVID-19.

B. NOT FULLY VACCINATED

[ballot] I am not fully vaccinated and attest that I am (or the person 
I am attesting on behalf of is) excepted from the requirement to 
present Proof of Being Fully Vaccinated Against COVID-19 based on one 
of the following (check only one box, as applicable):
    [ballot] Diplomatic and Official Foreign Government Travel 
(complete C only, then sign the form to complete Attestation).
    [ballot] Child ages 2 through 17 years (complete D only, then sign 
the form to complete Attestation).
    [ballot] Participant in certain COVID-19 vaccine trials, as 
determined by CDC (complete D only, then sign the form to complete 
Attestation).
    [ballot] Medical contraindication to an accepted COVID-19 vaccine, 
as determined by CDC (complete E only, then sign the form to complete 
Attestation).
    [ballot] Humanitarian or emergency exception, as determined by CDC 
and documented by an official U.S. Government letter (complete F only, 
then sign the form to complete Attestation).
    [ballot] Valid nonimmigrant visa holder (excluding B-1 or B-2 
visas) and citizen of a Foreign Country with Limited COVID-19 Vaccine 
Availability, as determined by CDC (complete F only, then sign the form 
to complete Attestation).
    [ballot] Member of the U.S. Armed Forces or spouse or child (ages 2 
through 17 years) of a member of the U.S. Armed Forces (proceed to 
signature line only, then sign the form to complete Attestation).
    [ballot] Sea crewmember traveling pursuant to a C-1 and D 
nonimmigrant visa (complete F only, then sign the form to complete 
Attestation).
    [ballot] Person whose entry is in the U.S. national interest as 
determined by the Secretary of State, the Secretary of Transportation, 
the Secretary of Homeland Security, or their designees (complete G 
only, then sign the form to complete

[[Page 20415]]

Attestation).

C. EXCEPTION: Diplomat and Official Foreign Government Travel

[ballot] I attest that I am (or the person I am attesting on behalf of 
is) excepted from the requirement to present Proof of Being Fully 
Vaccinated Against COVID-19 and made the following arrangements (must 
check all boxes in C and then sign Attestation).
    [ballot] To be tested with a COVID-19 viral test 3-5 days after 
arriving in the United States, unless I have (or this person has) 
documentation of having recovered from COVID-19 in the past 90 days;
    [ballot] To self-quarantine for a full 5 calendar days following 
arrival, even if the result of my (or this person's) post-arrival viral 
test is negative, except during periods when my (or this person's) 
attendance is required to carry out the purposes of the diplomatic or 
official foreign government travel (e.g., to attend official meetings 
or events), unless I have (or this person has) documentation of having 
recovered from COVID-19 in the past 90 days; and
    [ballot] To self-isolate for a full 5 calendar days and properly 
wear a well-fitting mask any time I am (or this person is) around 
others during my (or this person's) isolation period and for an 
additional 5 days after ending isolation,
     if the result of the post-arrival viral test is positive; 
or
     if I develop (or this person develops) COVID-19 symptoms.

D. EXCEPTIONS

 Child ages 2 through 17 years
 Participant in certain COVID-19 vaccine trials as determined 
by CDC
[ballot] I attest that I am (or the person I am attesting on behalf of 
is) excepted from the requirement to present Proof of Being Fully 
Vaccinated Against COVID-19 and made the following arrangements (must 
check all boxes in D and then sign Attestation).
    [ballot] To be tested with a COVID-19 viral test 3-5 days after 
arriving in the United States, unless I have (or the person has) 
documentation of having recovered from COVID-19 in the past 90 days;
    [ballot] To self-isolate for a full 5 calendar days and properly 
wear a well-fitting mask any time I am (or this person is) around 
others during my (or this person's) isolation period and for an 
additional 5 days after ending isolation,
     if the result of the post-arrival viral test is positive, 
or
     if I develop (or this person develops) COVID-19 symptoms.

E. EXCEPTION: Medical Contraindication to an Accepted COVID-19 Vaccine 
as Determined by CDC

[ballot] I attest that I am (or the person I am attesting on behalf of 
is) excepted from the requirement to present Proof of Being Fully 
Vaccinated Against COVID-19 and made the following arrangements (must 
check all boxes in E and then sign Attestation).
    [ballot] To be tested with a COVID-19 viral test 3-5 days after 
arriving in the United States, unless I have (or this person has) 
documentation of having recovered from COVID-19 in the past 90 days;
    [ballot] To self-quarantine for a full 5 calendar days, even if the 
result of my (or this person's) post-arrival viral test is negative, 
unless I have (or this person has) documentation of having recovered 
from COVID-19 in the past 90 days; and
    [ballot] To self-isolate for a full 5 calendar days and properly 
wear a well-fitting mask any time I am (or this person is) around 
others during my (or this person's) isolation period and for an 
additional 5 days after ending isolation,
     if the result of the post-arrival viral test is positive, 
or
     if I develop (or this person develops) COVID-19 symptoms.

F. EXCEPTIONS

     Humanitarian or emergency exception as determined by CDC;
     Valid nonimmigrant visa holder (excluding B-1 or B-2 
visas) and citizen of a Foreign Country with Limited COVID-19 Vaccine 
Availability as determined by CDC; or
     Sea crewmember traveling pursuant to a C-1 and D 
nonimmigrant visa
[ballot] I attest that I am (or the person I am attesting on behalf of 
is) excepted from the requirement to present Proof of Being Fully 
Vaccinated Against COVID-19 and made the following arrangements (must 
check all boxes in F and then sign Attestation).
    [ballot] To be tested with a COVID-19 viral test 3-5 days after 
arriving in the United States, unless I have (or this person has) 
documentation of having recovered from COVID-19 in the past 90 days;
    [ballot] To self-quarantine for a full 5 calendar days, even if the 
result of my (or this person's) post-arrival viral test is negative, 
unless I have (or this person has) documentation of having recovered 
from COVID-19 in the past 90 days;
    [ballot] To self-isolate for a full 5 calendar days and properly 
wear a well-fitting mask any time I am (or this person is) around 
others during my (or this person's) isolation period and for an 
additional 5 days after ending isolation,
     if the result of the post-arrival viral test is positive; 
or
     if I develop (or this person develops) COVID-19 symptoms; 
and
    [ballot] To become fully vaccinated against COVID-19 within 60 days 
of arriving in the United States, or as soon thereafter as is medically 
appropriate, if intending to stay in the United States for more than 60 
days.

G. EXCEPTION: Person Whose Entry Is in the U.S. National Interest

[ballot] I am (or the person I am attesting on behalf of is) excepted 
from the requirement to present Proof of Being Fully Vaccinated Against 
COVID-19 and made the following arrangements (must check all boxes in G 
and then proceed to sign Attestation).
    [ballot] To be tested with a COVID-19 viral test 3-5 days after 
arriving in the United States, unless I have (or this person has) 
documentation of having recovered from COVID-19 in the past 90 days;
    [ballot] To self-quarantine for a full 5 calendar days, even if the 
result of my (or this person's) post-arrival viral test is negative, 
except during periods when my (or this person's) attendance is required 
to carry out the purposes of the travel for the U.S. national interest 
(e.g., to attend official meetings or events), unless I have (or this 
person has) documentation of having recovered from COVID-19 in the past 
90 days.
    [ballot] To self-isolate for a full 5 calendar days and properly 
wear a well-fitting mask any time I am (or this person is) around 
others during my (or this person's) isolation period and for an 
additional 5 days after ending isolation
     if the result of the post-arrival viral test is positive, 
or
     if I develop (or this person develops) COVID-19 symptoms; 
and
    [ballot] To become fully vaccinated against COVID-19 within 60 days 
of arriving in the United States, or as soon thereafter as is medically 
appropriate, if intending to stay in

[[Page 20416]]

the United States for more than 60 days.

____________Print Name
____________Signature
_______Date

Privacy Act Statement for Travelers Relating to the Requirement To 
Provide Proof of a Negative COVID-19 Test Result

    The U.S. Centers for Disease Control and Prevention (CDC) requires 
airlines and other aircraft operators to collect this information 
pursuant to 42 CFR 71.20 and 71.31(b), as authorized by 42 U.S.C. 264. 
Providing this information is mandatory for all passengers arriving by 
aircraft into the United States. Failure to provide this information 
may prevent you from boarding the plane. Additionally, passengers will 
be required to attest to providing complete and accurate information, 
and failure to do so may lead to other consequences, including criminal 
penalties. CDC will use this information to help prevent the 
introduction, transmission, and spread of communicable diseases by 
performing contact tracing investigations and notifying exposed 
individuals and public health authorities; and for health education, 
treatment, prophylaxis, or other appropriate public health 
interventions, including the implementation of travel restrictions.
    The Privacy Act of 1974, 5 U.S.C. 552a, governs the collection and 
use of this information. The information maintained by CDC will be 
covered by CDC's System of Records No. 09-20-0171, Quarantine- and 
Traveler-Related Activities, Including Records for Contact Tracing 
Investigation and Notification under 42 CFR parts 70 and 71. See 72 FR 
70867 (Dec. 13, 2007), as amended by 76 FR 4485 (Jan. 25, 2011) and 83 
FR 6591 (Feb. 14, 2018). CDC will only disclose information from the 
system outside the CDC and the U.S. Department of Health and Human 
Services as the Privacy Act permits, including in accordance with the 
routine uses published for this system in the Federal Register, and as 
authorized by law. Such lawful purposes may include, but are not 
limited to, sharing identifiable information with state and local 
public health departments, and other cooperating authorities. CDC and 
cooperating authorities will retain, use, delete, or otherwise destroy 
the designated information in accordance with federal law and the 
System of Records Notice (SORN) set forth above. You may contact the 
system manager at [email protected] or by mailing Policy Office, 
Division of Global Migration and Quarantine, Centers for Disease 
Control and Prevention, 1600 Clifton Road NE, MS H16-4, Atlanta, GA 
30329, if you have questions about CDC's use of your data.

Authority

    The authority for the Presidential Proclamation is Sections 1182(f) 
and 1185(a)(1) of Title 8, and Section 301 of Title 3, United States 
Code. CDC's Order is issued pursuant to the Presidential Proclamation.

Sherri Berger,
Chief of Staff, Centers for Disease Control and Prevention.
[FR Doc. 2022-07450 Filed 4-4-22; 4:15 pm]
BILLING CODE 4163-18-P