[Federal Register Volume 87, Number 105 (Wednesday, June 1, 2022)]
[Notices]
[Pages 33158-33173]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-11752]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention


Notice of Extension and Modification of Temporary Suspension of 
Dogs Entering the United States From High-Risk Rabies Countries

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

ACTION: Notice.

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SUMMARY: The Centers for Disease Control and Prevention (CDC), within 
the Department of Health and Human Services (HHS), announces an 
extension and modification of the current temporary suspension of the 
importation into the United States of dogs from high-risk rabies-
enzootic countries (high-risk countries). This suspension includes dogs 
that have been in any high-risk countries during the previous six 
months.

DATES: The extension and modification of the temporary suspension of 
the importation of dogs into the United States from high-risk rabies 
countries will be implemented on June 10, 2022 and will remain in 
effect through January 31, 2023.

FOR FURTHER INFORMATION CONTACT: Ashley C. Altenburger, J.D., Division 
of Global Migration and Quarantine, Centers for Disease Control and 
Prevention, 1600 Clifton Road NE, MS H16-4, Atlanta, GA 30329. 
Telephone: 1-800-232-4636. For information regarding CDC regulations 
for the importation of dogs: Dr. Emily Pieracci, D.V.M., Division of 
Global Migration and Quarantine, Centers for Disease Control and 
Prevention, 1600 Clifton Road NE, MS V-18-2, Atlanta, GA 30329. 
Telephone: 1-800-232-4636.

SUPPLEMENTARY INFORMATION: While CDC is modifying the terms of the 
suspension to allow more dog importations, a suspension remains 
necessary to protect the public's health against the reintroduction of 
the canine rabies virus variant (CRVV) into the United States. This 
extension and modification is based on various factors, including: The 
threat that unvaccinated or inadequately vaccinated dogs from high-risk 
countries continue to pose; insufficient veterinary controls in place 
in high-risk countries to prevent the export of inadequately vaccinated 
dogs; and ongoing limited availability of public health resources at 
the Federal, State, and local levels, particularly in the global 
context of the coronavirus disease 2019 (COVID-19) pandemic.

[[Page 33159]]

CDC anticipates that these factors are likely to continue into 2023.

I. Background and Authority

    Rabies, one of the deadliest zoonotic diseases, accounts for an 
estimated 59,000 human deaths globally each year.\1\ This equates to 
one human death every nine minutes.\2\ CRVV is responsible for 98 
percent of these deaths.\2\ The rabies virus can infect any mammal, and 
once clinical signs appear, the disease is almost always fatal.\3\ In 
September 2007, at the Inaugural World Rabies Day Symposium, CDC 
declared the United States to be free of CRVV.\4\ However, this rabies 
virus variant is still a serious public health threat in the more than 
100 countries where CRVV remains enzootic. Preventing the entry of 
animals infected with CRVV into the United States is a public health 
priority.
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    \1\ World Health Organization (2018). WHO Expert Consultation on 
Rabies (WHO Technical Report Series 1012). Retrieved from https://www.who.int/publications/i/item/WHO-TRS-1012.
    \2\ World Health Organization (2018). WHO Expert Consultation on 
Rabies (WHO Technical Report Series 1012). Retrieved from https://www.who.int/publications/i/item/WHO-TRS-1012.
    \3\ Fooks, A.R., Banyard, A.C., Horton, D.L., Johnson, N., 
McElhinney, L.M., and Jackson, A.C. (2014) Current status of rabies 
and prospects for elimination. Lancet, 384(9951), 1389-1399. doi: 
10.1016/S0140-6736(13)62707-5.
    \4\ Velasco-Villa, A., Mauldin, M., Shi, M., Escobar, L., 
Gallardo-Romero, N., Damon, I., Emerson, G. (2017) The history of 
rabies in the Western Hemisphere. Antiviral Res, 146, 221-232. 
doi:10.1016/j.antiviral.2017.03.013.
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    CDC subject matter experts review publicly available data and 
conduct an annual assessment to determine high-risk countries. This 
assessment considers the following factors: Presence or prevalence of 
domestically acquired cases of CRVV in humans and animals; efforts 
towards control of CRVV in dogs (such as dog vaccination coverage, dog 
population management, and existence and enforcement of legal codes to 
limit rabies transmission in dogs); and the quality of rabies 
surveillance systems and laboratory capacity. If data are not 
available, the most conservative determination is applied, and the 
country is not considered to have a robust control program. If a 
country has provided additional substantial data to support a CRVV-free 
status, CDC can review that information and re-assess the country's 
status.
    Under section 361 of the Public Health Service Act (PHS Act) (42 
U.S.C. 264), the Secretary of Health and Human Services may make and 
enforce such regulations as in the Secretary's judgment are necessary 
to prevent the introduction, transmission, or spread of communicable 
diseases from foreign countries into the United States and from one 
state or possession into any other state or possession.\5\ Such 
regulations may provide for inspection, fumigation, disinfection, 
sanitation, pest extermination, destruction of animals or articles 
found to be sources of dangerous infection to human beings, and other 
measures. Under section 362 of the PHS Act (42 U.S.C. 265), the 
Secretary, and by delegation the Director of CDC (CDC Director),\6\ may 
prohibit entries and imports from foreign countries into the United 
States ``in whole or in part'' if there is a serious risk of 
introducing communicable disease and when required in the interest of 
public health.
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    \5\ Although the statute assigns authority to the Surgeon 
General, all statutory powers and functions of the Surgeon General 
were transferred to the Secretary of HHS in 1966, 31 FR 8855, 80 
Stat. 1610 (June 25, 1966), see also Pub. L. 96-88, 509(b), October 
17, 1979, 93 Stat. 695 (codified at 20 U.S.C. 3508(b)). The 
Secretary has retained these authorities despite the reestablishment 
of the Office of the Surgeon General in 1987.
    \6\ See 42 CFR 71.51(e), 71.63.
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    Under 42 CFR 71.51, all dogs admitted into the United States must 
be accompanied by a valid rabies vaccination certificate,\7\ unless the 
dogs' owner or importer submits satisfactory evidence that dogs under 
six months of age have not been in a high-risk country or dogs older 
than six months have not been in a high-risk country for the six months 
before arrival.\8\ CDC maintains a publicly available list of high-risk 
countries \9\ and provides guidance for dog entry requirements based on 
the dog's country of import.
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    \7\ Centers for Disease Control and Prevention (2022). What is a 
valid rabies vaccination certificate? Retrieved from https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/vaccine-certificate.html.
    \8\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84,724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
    \9\ Centers for Disease Control and Prevention (2022). What is a 
valid rabies vaccination certificate? Retrieved from https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/rabies-vaccine.html.
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    Under 42 CFR 71.51(e), dogs may be subject to ``additional 
requirements as may be deemed necessary'' or ``to exclusion if coming 
from areas which the [CDC] Director has determined to have high rates 
of rabies.'' Based on the previously described criteria, CDC determined 
that high-risk countries constitute areas that have high rates of 
rabies and dogs imported from these countries are thus subject to 
additional requirements and/or exclusion.
    Under 42 CFR 71.63, CDC may also temporarily suspend the entry of 
animals, articles, or things from designated foreign countries and 
places into the United States when it determines there exists in a 
foreign country a communicable disease that threatens the public health 
of the United States and the entry of imports from that country 
increases the risk that the communicable disease may be introduced. 
When such a suspension is issued, CDC designates the period of time or 
conditions under which imports into the United States are suspended. 
CDC likewise determined that CRVV exists in high-risk countries and 
that, if reintroduced into the United States, CRVV would threaten the 
public health of the United States.
    Based on these legal authorities and determinations, on June 16, 
2021,\10\ CDC announced a temporary suspension of the importation of 
dogs from high-risk countries into the United States (86 FR 32041) (the 
temporary suspension). The temporary suspension went into effect on 
July 14, 2021. CDC issued the temporary suspension to protect the 
public health against the reintroduction of CRVV into the United States 
at a time when resources were being diverted to the agency-wide 
response to the COVID-19 pandemic.
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    \10\ Temporary Suspension of Dogs Entering the United States 
from High-Risk Rabies Countries. Federal Register, 86 FR 32041, June 
16, 2021.
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    At the time the temporary suspension was issued, CDC noted an 
increase in importers circumventing dog import regulations. Between 
January 1 and July 14, 2021, CDC documented more than 560 dogs arriving 
from high-risk countries with incomplete, inadequate, or fraudulent 
rabies vaccination certificates, resulting in the denial of entry for 
the dogs and subsequent return to their country of departure. This 
represented a 33 percent increase compared to all of 2020. Despite a 
decrease in international travel volumes due to the global COVID-19 
pandemic, there was a 52 percent increase in dogs ineligible for entry 
in 2020 as compared to 2018 and 2019. Additionally, four rabid dogs 
were imported into the United States between 2015 and 2021.
    The limited availability of public health resources due to the 
unprecedented global response to the COVID-19 pandemic resulted in 
reduced capacity at the Federal, State, and local levels to address the 
increased risk of the reintroduction of CRVV. For these reasons, CDC 
implemented a temporary suspension prohibiting the

[[Page 33160]]

importation of dogs from high-risk countries for rabies in July 2021.
    CDC implemented a CDC Dog Import Permit \11\ [(OMB Control Number 
0920-0134 Foreign Quarantine Regulations (exp. 06/30/2022), or as 
revised] during the temporary suspension to verify the documentation of 
imported dogs before they are flown to the United States. Eligibility 
to import dogs during the temporary suspension was limited to people 
relocating to the United States with their personal pets, service dog 
owners, United States Government or foreign Government employees 
traveling on official orders with their personal pets, and importers of 
dogs for science, education, exhibition, or bona fide law enforcement 
purposes.
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    \11\ https://www.cdc.gov/dogpermit.
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    Since the temporary suspension went into effect in July 2021, CDC 
has used its enforcement discretion to reduce the burden on eligible 
importers. Per the Federal Register notice announcing the temporary 
suspension, importers are required to enter the United States at a port 
of entry with a live animal facility with a Facilities Information and 
Resource Management System (FIRMS) code issued by U.S. Customs and 
Border Protection (CBP). At the time the Federal Register notice was 
published, there was one animal facility. However, from the beginning 
of the temporary suspension, CDC used its enforcement discretion to 
expand the list of the approved ports of entry to include 18 airports 
with a CDC quarantine station. CDC planned to narrow the list of 
approved ports of entry to only those with an animal facility on 
October 31, 2021, which would have been three ports of entry at that 
time. However, after considering the reduction in the number of dogs 
abandoned by their importers and the number of dogs arriving sick or 
dead at the 18 airports between the time the temporary suspension went 
into effect (July 14, 2021) and December 1, 2021, CDC determined that 
the 18 airports could continue serving as approved ports of entry 
through the remainder of the suspension.
    On December 1, 2021, following an evaluation of the latest 
scientific information on rabies serologic titer test results, CDC 
reduced the waiting period requirement, which is the number of days 
between when a dog's sample is taken for a serologic titer test and 
when the dog can be imported into the United States, from 90 days to 45 
days.
    Lastly, effective December 1, 2021, CDC has allowed importers whose 
dog is at least six months old, has a microchip, and a valid U.S.-
issued rabies vaccination certificate to enter the United States 
without a CDC Dog Import Permit at one of the 18 airports with a CDC 
quarantine station provided the dog appears healthy upon arrival. CDC 
made this change because of the reliability of the United States' 
rabies vaccine supply and to ease the burden on these importers.
    At this time, CDC is extending and modifying the temporary 
suspension due to the continued risk for the reintroduction of CRVV 
into the United States and the ongoing need to commit public health 
resources towards the COVID-19 pandemic. Based on improvements in CDC's 
ability to track and monitor dog imports from high-risk countries, and 
the significant decrease in the dog importation issues that existed 
prior to the suspension, CDC is modifying the terms of the temporary 
suspension to allow for more dog imports from a wider range of 
importers.

II. Public Health Rationale

A. Dog Importation Into the United States

    The United States was declared CRVV-free in 2007. Importing dogs 
from high-risk countries involves a significant public health risk. The 
importation of just one dog infected with CRVV risks re-introduction of 
the virus into the United States, resulting in a potential public 
health risk with consequent monetary cost and potential loss of human 
and animal life.12 13 14 CRVV has been highly successful at 
adapting to new host species, particularly wildlife.\15\ One CRVV-
infected dog could result in transmission to humans, domestic pets, or 
wildlife. In 2019, the importation of a single dog with rabies cost 
more than $400,000 for the public health investigations and rabies 
post-exposure prophylaxis (PEP) of exposed persons.16 17 To 
mitigate the risk of importing dogs with CRVV, CDC requires compliance 
with its public health entry requirements.
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    \12\ World Bank (2012). People, Pathogens and Our Planet: The 
Economics of One Health. Retrieved from https://openknowledge.worldbank.org/handle/10986/11892.
    \13\ Raybern, C., Zaldivar, A., Tubach, S., Ahmed, F., Moore, 
S., Kintner, C., Garrison, I. (2020) Rabies in a dog imported from 
Egypt-Kansas, 2019. Morbidity and Mortality Weekly Report, 69(38), 
1374-1377. Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6938a5-H.pdf.
    \14\ Jeon, S., Cleaton, J., Meltzer, M., Kahn, E., Pieracci, E., 
Blanton, J., Wallace, R. (2019). Determining the post-elimination 
level of vaccination needed to prevent re-establishment of dog 
rabies. PLoS Neglected Tropical Diseases, 13(12). https://doi.org/10.1371/journal.pntd.0007869.
    \15\ Velasco-Villa, A., Mauldin, M., Shi, M., Escobar, L., 
Gallardo-Romero, N., Damon, I., Emerson, G. (2017). The history of 
rabies in the Western Hemisphere. Antiviral Research, 146, 221-
232.doi:10.1016/j.antiviral.2017.03.013.
    \16\ Raybern, C., Zaldivar, A., Tubach, S., Ahmed, F., Moore, 
S., Kintner, C., Garrison, I. (2020) Rabies in a dog imported from 
Egypt-Kansas, 2019. Morbidity and Mortality Weekly Report, 69(38), 
1374-1377. Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6938a5-H.pdf.
    \17\ Centers for Disease Control and Prevention (2022). Rabies 
Postexposure Prophylaxis. Retrieved from https://www.cdc.gov/rabies/medical_care/index.html.
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    Although the U.S. Government does not track the total number of 
dogs imported each year, it is estimated that approximately 1 million 
dogs are imported into the United States annually, of which 100,000 
dogs are from high-risk countries.\18\ This estimate was based on 
information provided by airlines, the Department of Homeland Security's 
Customs and Border Protection (CBP) staff, and a study conducted at a 
U.S.-Mexico land border crossing.\19\
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    \18\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84,724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
    \19\ McQuiston, J.H., Wilson, T., Harris, S., Bacon, R.M., 
Shapiro, S., Trevino, J., Marano, N. (2008.) Importation of dogs 
into the United States: Risks from rabies and other zoonotic 
diseases. Zoonoses Public Health, 55(8-10),421-6. doi:10.1111/
j.1863-2378.2008.01117.
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    CBP does record, by country, the number of dogs imported with 
formal entry under Harmonized Tariff Schedule (HTS) code 0106199120 and 
HTS description: Other live animals, other, dogs. The total number of 
dogs imported into the United States from all countries under this HTS 
category varied from 25,232 in 2018 to 58,540 in 2020. The number of 
dogs from high-risk countries under this HTS category averaged 16,390 
per year and varied from 9,966 to 24,031 over this three-year period. 
The number of dogs reported under this HTS category does not include 
dogs imported as checked baggage, hand-carried in airplane cabins, or 
crossing at land borders without formal entry. Thus, the number 
underestimates the true number of dogs imported into the United States.
    Since 2015, there have been four known rabid dogs imported into the 
United States. All four dogs were imported by rescue organizations for 
the purposes of adoption. These four cases, discussed below, highlight 
the immense public health resources required to investigate, respond 
to, and mitigate the public health threat posed by the importation.

[[Page 33161]]

    In 2015, a rabid dog was part of a group of eight dogs and 27 cats 
imported from Egypt by a rescue group. The dog had an unhealed leg 
fracture and began showing signs of rabies four days after arrival. 
Following the rabies diagnosis, the rescue workers in Egypt admitted 
that the dog's rabies vaccination certificate had been intentionally 
falsified to evade CDC entry requirements.\20\ Eighteen people were 
recommended to receive rabies PEP, seven dogs underwent a six-month 
quarantine, and eight additional dogs housed in the same home as the 
rabid dog had to receive rabies booster vaccinations and undergo a 45-
day monitoring period.
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    \20\ Sinclair J., Wallace, R., Gruszynski K., Bibbs Freeman, M., 
Campbell, C., Semple, S., Murphy, J. (2015). Rabies in a dog 
imported from Egypt with a falsified rabies vaccination 
certificate--Virginia. Morbidity and Mortality Weekly Report, 64, 
1359-62. doi:10.15585/mmwr.mm6449a2.
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    In 2017, a ``flight parent'' (a person typically solicited through 
social media, often not affiliated with the rescue organization, and 
usually compensated with an airline ticket) imported four dogs on 
behalf of a rescue organization. One of the dogs appeared agitated at 
the airport and bit the flight parent prior to the flight. A U.S. 
veterinarian examined the dog one day after its arrival and then 
euthanized and tested the dog for rabies. A post-mortem rabies test 
showed that the dog was positive for the virus. Public health officials 
recommended that at least four people receive rabies PEP, and the 
remaining three dogs underwent quarantine periods ranging from 30 days 
to six months. An investigation revealed the possibility of falsified 
rabies vaccination documentation presented on entry to the United 
States.\21\
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    \21\ Hercules, Y., Bryant, N., Wallace, R., Nelson, R., Palumbo, 
G., Williams, J., Brown, C. (2018). Rabies in a dog imported from 
Egypt--Connecticut, 2017. Morbdity and Mortality Weekly Report 67, 
1388-91. doi:10.15585/mmwr.mm6750a3.
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    In 2019, a rescue group imported 26 dogs, all of which had rabies 
vaccination certificates and serologic documentation, indicating the 
development of rabies antibodies (in response to immunization), based 
on results from an Egyptian Government-affiliated rabies laboratory. 
However, one dog developed signs of rabies three weeks after arrival 
and had to be euthanized. The dog tested positive for rabies. Forty-
four people received PEP, and the 25 dogs imported on the same flight 
underwent re-vaccination and quarantines of four to six months. An 
additional 12 dogs had contact with the rabid dog and had to be re-
vaccinated and undergo quarantine periods ranging from 45 days to six 
months based on their previous vaccination status.\22\
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    \22\ Raybern, C., Zaldivar, A., Tubach, S., Ahmed, F., Moore, 
S., Kintner, C., Garrison, I. (2020) Rabies in a dog imported from 
Egypt-Kansas, 2019. Morbidity and Mortality Weekly Report, 69(38), 
1374-1377. Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6938a5-H.pdf.
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    On June 10, 2021, shortly before CDC published the temporary 
suspension, 33 dogs were imported into the United States from 
Azerbaijan by a rescue organization. All dogs had rabies vaccination 
certificates that appeared valid upon arrival in the United States. One 
dog developed signs of rabies three days after arrival and was 
euthanized. CDC confirmed the dog was infected with a variant of CRVV 
known to circulate in the Caucus Mountain region of Azerbaijan. The 
remaining rescue animals exposed to the rabid dog during travel were 
dispersed across nine states, leading to what is believed to be the 
largest, multi-state, imported rabid dog investigation in U.S. 
history.\23\
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    \23\ Whitehill F., Bonaparte S., Hartloge C., et al. Rabies in a 
Dog Imported from Azerbaijan-Pennsylvania, 2021. MMWR Morb Mortal 
Wkly Rep 2022; 71: 686-689.
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    Eighteen people received PEP to prevent rabies as a result of 
exposure to this one rabid dog. Post serologic monitoring and the 
public health investigation revealed that improper vaccination 
practices by the veterinarian in Azerbaijan likely contributed to the 
inadequate vaccination response documented in 48 percent of the 
imported animals, including the rabid dog.\24\ The 33 exposed animals 
were placed in quarantines ranging from 45 days to six months based on 
individual serologic titer test results and local jurisdictional 
requirements.\25\
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    \24\ Centers for Disease Control and Prevention (2021). CDC 
responds to a case of rabies in an imported dog. Retrieved from 
https://www.cdc.gov/worldrabiesday/disease-detectives/rabies-imported-dog.html.
    \25\ Whitehill F., Bonaparte S., Hartloge C., et al. Rabies in a 
Dog Imported from Azerbaijan-Pennsylvania, 2021. MMWR Morb Mortal 
Wkly Rep 2022; 71: 686-689.
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    CDC estimates costs for public health investigations and subsequent 
cost of care for people exposed to rabid dogs range from $220,897 to 
$521,828 per importation event, as summarized in the Appendix found at 
the end of this notice.26 27 This cost estimate does not 
account for the worst-case outcomes, which include: (1) Transmission of 
rabies to a person who dies from the disease and (2) ongoing 
transmission to other domestic and wildlife species in the United 
States. A previous campaign to eliminate domestic dog-coyote rabies 
virus variant jointly with gray fox (Texas fox) rabies virus variant in 
Texas over the period from 1995 through 2003 cost $34 
million,28 29 or $48 million in 2020 U.S. dollars. Re-
establishment of CRVV into the United States could result in costly 
efforts over several years to again eliminate the virus.
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    \26\ Raybern, C., Zaldivar, A., Tubach, S., Ahmed, F., Moore, 
S., Kintner, C., Garrison, I. (2020) Rabies in a dog imported from 
Egypt-Kansas, 2019. MMWR Morb Mort Wkly Rep, 69(38), 1374-1377. 
Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6938a5-H.pdf
    \27\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84,724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
    \28\ Thomas, S., Wilson, P., Moore, G., Oertli, E., Hicks, B., 
Rohde, R., Johnston, D. (2005). Evaluation of oral rabies 
vaccination programs for control of rabies epizootics in coyotes and 
gray foxes: 1995-2003. Journal of the American Veterinary Medicine 
Association, 227(5),785-92. doi: 10.2460/javma.2005.227.785.
    \29\ Sterner, R., Meltzer, M., Shwiff, S., Slate, D. (2009). 
Tactics and Economics of Wildlife Oral Rabies Vaccination, Canada 
and the United States. Emerging Infectious Diseases, 15(8), 1176-
1184. doi: 10.3201/eid1508.081061.
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B. COVID-19 Response Activities

    Since January 2020, public health resources globally have been 
dedicated to responding to COVID-19 response activities. This context 
caused a lapse in canine rabies vaccination efforts in high-risk 
countries.30 31 In the United States, the public health 
response to combatting the emergence of SARS-CoV-2 variants such as 
Delta and Omicron have required sustained Federal, State, and local 
public health resources.
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    \30\ Kunkel, A., Jeon, S., Joseph, H., Dilius, P., Crowdis, K., 
Meltzer, M., Wallace, R. (2021). The urgency of resuming disrupted 
dog rabies vaccination campaigns: A modeling and cost-effectiveness 
analysis. Scientific Reports, 11, 12476. doi:10.1038/s41598-021-
92067-5.
    \31\ Raynor, B., D[iacute]az, E., Shinnick, J., Zegarra, E., 
Monroy, Y., Mena. C., . . . Castillo-Neyra, R.(2021). The impact of 
the COVID-19 pandemic on rabies reemergence in Latin America: The 
case of Arequipa, Peru. PLoS Neglected Tropical Diseases, 15(5), 
e0009414. doi:10.1371/journal.pntd.0009414.
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    The importation of a rabid dog on June 10, 2021, diverted public 
health resources from CDC, the U.S. Department of Agriculture (USDA), 
and nine states away from critical COVID-19 response activities. Any 
increase in the number of dogs with inadequate or falsified rabies 
vaccination certificates arriving in the United States increases the 
likelihood of a CRVV-importation event and threatens the diversion of 
critical public health resources.\32\
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    \32\ Pieracci, E., Williams, C., Wallace, R., Kalapura, C., 
Brown, C. U.S. dog importations during the COVID-19 pandemic: Do we 
have an erupting problem? PLoS ONE,16(9), e0254287. doi: 10.1371/
journal.pone.0254287.

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[[Page 33162]]

C. Insufficient Veterinary Controls in High-Risk Countries To Prevent 
the Export of Inadequately Vaccinated Dogs

    Historically, approximately 60 to 70 percent of CDC's dog entry 
denials (or about 200 cases annually) have been based on fraudulent, 
incomplete, or inaccurate paperwork.\33\ This number is less than one 
percent of dog importations. However, between January and December 2020 
(i.e., during the COVID-19 pandemic), CDC documented more than 450 
instances of incomplete, inadequate, or fraudulent rabies vaccination 
certificates for dogs arriving from high-risk countries. This number 
increased for the first six months of 2021, during which time CDC 
documented more than 550 instances of incomplete, inadequate, or 
fraudulent rabies vaccination certificates for dogs arriving from high-
risk countries.\34\ These cases resulted in dogs being denied entry 
into the United States and ultimately returned to their country of 
origin. Additionally, because of fewer international flights worldwide, 
several dogs were denied entry and subsequently placed in conditions 
later found to be unsafe.
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    \33\ Centers for Disease Control and Prevention (2021). 
Quarantine Activity Reporting System (version 4.9.8.8.2.2A). Dog 
Importation data, 2010-2019. Accessed 15 February 2021.
    \34\ Pieracci, E., Williams, C., Wallace, R., Kalapura, C., 
Brown, C. U.S. dog importations during the COVID-19 pandemic: Do we 
have an erupting problem? PLoS ONE, 16(9), e0254287. doi: 10.1371/
journal.pone.0254287.
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    During the COVID-19 pandemic, canine rabies vaccination campaigns 
were suspended in many high-risk countries, which resulted in an 
increase in canine and human rabies cases.35 36 The pause in 
canine vaccination campaigns, combined with insufficient veterinary 
controls in place to prevent the exportation of inadequately vaccinated 
dogs with fraudulent rabies vaccination certificates, presents a 
significant public health risk.
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    \35\ The urgency of resuming disrupted dog rabies vaccination 
campaigns: A modeling and cost-effectiveness analysis. Scientific 
Reports, 11, 12476. doi:10.1038/s41598-021-92067-5.
    \36\ The urgency of resuming disrupted dog rabies vaccination 
campaigns: A modeling and cost-effectiveness analysis. Scientific 
Reports, 11, 12476. doi:10.1038/s41598-021-92067-5.
---------------------------------------------------------------------------

D. Potentially Unsafe Conditions for Dogs Arriving From High-Risk 
Countries Without Appropriate Rabies Vaccination Certificates

    Prior to the implementation of the suspension, dogs arriving from 
high-risk countries without appropriate rabies vaccination certificates 
were denied entry and returned to the country of origin on the next 
available flight.\37\ Airlines were required to house dogs awaiting 
return to their country of origin at a facility, preferably a live 
animal care facility with an active custodial bond and a Facilities 
Information and Resource Management System (FIRMS) code issued by CBP, 
which meets the USDA's Animal Welfare Act standards. If a live animal 
care facility with a CBP-issued FIRMS code was not available, the 
airline was required, at a minimum, to provide accommodation meeting 
the USDA's Animal Welfare Act standards.\38\
---------------------------------------------------------------------------

    \37\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84,724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
    \38\ U.S. Department of Agriculture (2020). Animal Welfare 
Regulations; Part 3, Subpart A: Transportation Standards. Sections 
3.14-3.20. Retrieved from https://www.aphis.usda.gov/animal_welfare/downloads/AC_BlueBook_AWA_508_comp_version.pdf.
---------------------------------------------------------------------------

    Some airlines housed dogs in cargo warehouses that created an 
unsafe environment for dogs due to the prolonged periods of time 
between flights, inadequate cooling and heating, poor cleaning and 
sanitization of crates, and inability to physically separate the 
animals from areas of the warehouse where other equipment, machinery, 
and goods are used and stored. Cargo warehouse staff who are not 
trained to house, clean, and care for live animals with appropriate 
personal protective equipment were at risk of bites, scratches, and 
exposures to potentially infectious bodily fluids from dogs left in 
cargo warehouses.
    During 2020, due to the COVID-19 pandemic, there were fewer 
international flights worldwide,39 40 resulting in delayed 
returns for dogs denied entry. While international flights in 2021-2022 
increased compared to 2020, the number of flights remain below pre-
pandemic levels with uncertainty regarding how quickly international 
passenger traffic will recover.\41\ In August 2020, a dog denied entry 
based on falsified rabies vaccination certificates later died while in 
the custody of an airline at Chicago O'Hare International Airport. 
Despite CDC's request to find appropriate housing at a local kennel or 
veterinary clinic, the airline left the dog, along with 17 other dogs, 
in a cargo warehouse without food and water for more than 48 hours.\42\
---------------------------------------------------------------------------

    \39\ Josephs, L. (2020). American Airlines cutting international 
summer schedule by 60% as coronavirus drives down demand. CNBC. 
Retrieved from https://www.cnbc.com/2020/04/02/coronavirus-update-american-airlines-cuts-summer-international-flights-by-60percent-as-demand-suffers.html.
    \40\ American Airlines (2020). American Airlines announces 
additional schedule changes in response to customer demand related 
to COVID-19. American Airlines Newsroom. Retrieved from https://news.aa.com/news/news-details/2020/American-Airlines-Announces-Additional-Schedule-Changes-in-Response-to-Customer-Demand-Related-to-COVID-19-031420-OPS-DIS-03/default.aspx.
    \41\ International Civil Aviation Organization (2022). Effects 
of novel coronavirus (COVID-19) on civil aviation: Economic impact 
analysis. Retrieved from https://www.icao.int/sustainability/Documents/Covid-19/ICAO_coronavirus_Econ_Impact.pdf.
    \42\ CBS Broadcasting (2020). Dog dies at O'Hare Airport 
warehouse, 17 others saved after being left without food or water 
for 3 days. CBS Chicago. Retrieved from https://www.cbsnews.com/chicago/news/dog-dies-at-ohare-airport-warehouse-17-others-saved-after-being-left-without-food-or-water-for-3-days.
---------------------------------------------------------------------------

    While airlines are ultimately responsible for finding appropriate 
housing for dogs denied entry (and paying the cost of housing if 
importers abandon the animal), the inconsistent number of flights and 
frequent changes to flight schedules due to the emergence of SARS-CoV-2 
variants in 2021 created significant administrative and financial 
burden for Federal, State, and local Governments. Uncertainty regarding 
the number of available international passenger flights is likely to 
continue through 2022, and possibly into 2023. The challenge of housing 
dogs denied entry pending their return to their country of origin is 
complicated by the limited numbers of animal care facilities with a 
CBP-issued FIRMS code for holding animals at ports of entry. In such 
cases, the Government may be required to find and pay the costs for 
individualized solutions to ensure appropriate accommodations for 
prolonged periods of time for these animals.
    During 2020, CDC observed a 52 percent increase in the number of 
dogs ineligible for entry compared to 2018 and 2019.\43\ The trend 
continued in the first half of 2021 when there was an 18 percent 
increase in the number of dogs ineligible for entry compared to full-
year 2020.\44\ From January 1, 2021, to July 13, 2021, prior to CDC's 
suspension taking effect, there were 16 sick dogs and 18 dead dogs 
reported to CDC upon arrival in the United States. From July 14, 2021, 
to December 31, 2021, since

[[Page 33163]]

the suspension was implemented, CDC has denied entry to 72 dogs, and 
only one sick dog and nine deaths have been reported to CDC. This 
significant decrease in the number of dogs denied entry since the 
implementation of the suspension and decrease in the number of sick and 
dead dogs arriving in the United States has resulted in an estimated 
$55,000 to $190,000 in cost savings to importers and $3,400 to $170,000 
in cost savings to Federal and State partners when comparing the two 
periods.
---------------------------------------------------------------------------

    \43\ Pieracci, E., Williams, C., Wallace, R., Kalapura, C., 
Brown, C. U.S. dog importations during the COVID-19 pandemic: Do we 
have an erupting problem? PLoS ONE, 16(9), e0254287. doi: 10.1371/
journal.pone.0254287.
    \44\ Centers for Disease Control and Prevention. Quarantine 
Activity Reporting System (version 4.9.8.8.2.2A). Dog Importation 
data, January 1, 2021-July 14, 2021. Accessed: 04 January 2022.
---------------------------------------------------------------------------

    During the timeframe of the current suspension, the number of dogs 
denied entry and the number of sick dogs has significantly decreased. 
Lifting the suspension at this time would likely result in a return to 
pre-suspension levels of dogs denied entry along with an associated 
large increase of sick, dead, or inadequately vaccinated dogs arriving 
in the United States that would quickly overwhelm an already strained 
public health system. Remedying this situation may involve more live-
animal care facilities to house dogs safely, and the ability and 
commitment by airline carriers to return dogs to the country of 
departure within one to two days of denial of entry.
    While costs associated with housing, caring for dogs, and returning 
dogs are the responsibility of the importer (or airline if the importer 
abandons the dog), some importers and airlines are reluctant to pay 
these costs, requiring the Federal Government to find appropriate 
interim housing facilities and veterinary care. The cost for housing, 
care, and returning improperly vaccinated dogs ranges between $1,000 
and $4,000 per dog, depending on the location and time required until 
the next available return flight. Because there is no reimbursement 
system in place, and seeking reimbursement is administratively 
challenging, the Federal Government is left to bear these costs when 
airlines and importers do not.
    The increasing demand to vaccinate and quarantine dogs that have 
been denied entry presents an increased burden to Federal, State, and 
local public health agencies still engaged in response activities 
related to the COVID-19 pandemic. The increased inspections, medical 
care, and appropriate quarantine of dogs inadequately vaccinated 
against rabies has financially burdened Federal and State public health 
agencies.
    From May through December 2020, CDC spent more than 3,000 
personnel-hours at an estimated cost of $270,000 to respond to the 
attempted importation of unvaccinated or inadequately vaccinated dogs 
from high-risk countries during these eight months. The time spent 
represented a substantial increase from previous years due to: (1) The 
increase in dogs with inadequate documentation; and (2) the additional 
time spent identifying interim accommodations for the dogs because of 
the reduced outbound international flight schedules due to the 
pandemic.
    Although the burden of U.S. COVID-19 cases, hospitalizations, and 
deaths decreased during the first four months of 2022, resources 
continue to be required for COVID-19 response efforts. The COVID-19 
response remains a priority for HHS/CDC and state, tribal, local, and 
territorial authorities, and CDC foresees the need to continue COVID-19 
public health response efforts into 2023. Because mitigating the 
current COVID-19 pandemic remains CDC's paramount objective and 
responding to imports of potentially rabid dogs would divert resources 
and personnel from CDC and other Federal, State, and local public 
health partners, completely lifting the suspension would be unwarranted 
at this time.
    Instead, CDC is modifying the temporary suspension to allow for a 
wider range of importers to import dogs into the United States from 
high-risk countries. Given that the conditions for dog importations 
under the suspension have decreased the number of issues that existed 
prior to the suspension (suspected fraudulent documentation, dogs 
abandoned by importers, sick and dead dogs arriving in the United 
States), increasing importer eligibility should not result in the 
diversion of public health resources from the COVID-19 pandemic 
response to dog importation issues. Additionally, because there are 
more flights now than during earlier stages of the pandemic, dogs 
denied entry can be returned more quickly to their country of 
departure, if needed.

III. Conditions for Dog Importation Under the Temporary Suspension

    During the temporary suspension, eligible importers, including 
owners of service dogs, U.S. and foreign-government personnel, and 
persons permanently relocating to the United States, could apply to 
import their personally owned pet dogs. People were also permitted to 
import dogs for science, education, or exhibition purposes. To receive 
a permit, eligible importers had to provide a rabies vaccination 
certificate prior to the dog's arriving in the United States that meets 
the criteria outlined below, as well as rabies serologic titers from an 
approved laboratory if the dog was vaccinated outside the United 
States. Dogs were also required to be at least six months of age and 
have a microchip implanted prior to arrival in the United States.
    For dogs arriving from high-risk countries, the rabies vaccination 
certificates had to include the following information to be considered 
complete and accurate:
     Name and address of owner;
     Breed, sex, date of birth (approximate age if date of 
birth unknown), color, markings, and other identifying information for 
the dog;
     Microchip number;
     Date of rabies vaccination and vaccine product 
information;
     Date the vaccination expires; and
     Name, license number, address, and signature of 
veterinarian who administered the vaccination.
    For a rabies vaccine to be effective, the dog must be at least 12 
weeks (84 days) of age at the time of administration. A dog's initial 
vaccine must also be administered at least four weeks (28 days) before 
arrival in the United States.

A. Modifications to Conditions for Dog Importation Under the Temporary 
Suspension

    CDC has been exercising its enforcement discretion to allow dogs 
six months of age or older that are microchipped and accompanied by 
valid U.S. rabies vaccination certificates to re-enter the United 
States without a CDC Dog Import Permit. Because these dogs had been 
previously vaccinated in the United States, CDC determined that 
allowing them to enter without a CDC Dog Import Permit would be 
unlikely to endanger the public's health. For dogs vaccinated outside 
the United States, consistent with public health standards of practice, 
CDC also expanded the number of approved rabies titer labs \45\ from 
five to 60 labs and reduced the timeframe between when a sample is 
collected and when a dog is eligible to enter the United States from 90 
days to 45 days for foreign-vaccinated dogs.
---------------------------------------------------------------------------

    \45\ Centers for Disease Control and Prevention (2022). Approved 
Rabies Serology Laboratories for Testing Dogs. Retrieved from 
https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/approved-labs.html.
---------------------------------------------------------------------------

    Additionally, CDC has allowed imported dogs to enter through any of 
the 18 CDC-staffed ports of entry listed below during the temporary 
suspension period, as opposed to only the four ports (and only one port 
in July 2021 when the suspension was first implemented) of entry with 
live animal care facilities. This decision was based on CDC's review of 
dog importation data during the temporary suspension period that noted 
a significant decrease in the

[[Page 33164]]

arrival of ill dogs or dogs denied entry, reducing the need for dogs to 
only enter through ports with a live animal care facility. CDC intends 
to continue to allow travelers importing two or fewer personally owned 
pet dogs from high-risk countries to enter the United States through 
any of the 18 ports of entry with CDC-staffed Quarantine Stations for 
the remainder of the suspension in accordance with sections IV and V of 
this Federal Register notice. The approved ports of entry include 
Anchorage (ANC), Atlanta (ATL), Boston (BOS), Chicago (ORD), Dallas 
(DFW), Detroit (DTW), Honolulu (HNL), Houston (IAH), Los Angeles (LAX), 
Miami (MIA), Minneapolis (MSP), New York (JFK), Newark (EWR), 
Philadelphia (PHL), San Francisco (SFO), San Juan (SJU), Seattle (SEA), 
and Washington DC (IAD).
    Table 1 compares the requirements in the June 2021 Federal Register 
notice with the current practice that has been in effect since December 
1, 2021.

 Table 1--Import Requirements for Dogs Outlined in the June 2021 Federal
      Register Notice and Current Practices During the Suspension.
------------------------------------------------------------------------
                                             Current practice (since
          June 2021 suspension                  December 1, 2021)
------------------------------------------------------------------------
Only eligible * importers may apply for  Only eligible * importers may
 a permit.                                apply for a permit.
Six-month age requirement..............  Six-month age requirement.
Microchip..............................  Microchip.
U.S. or foreign-issued rabies            U.S.** or foreign-issued rabies
 vaccination certificate.                 vaccination certificate.
Titer from approved lab (five labs)      Titer from approved lab (60
 drawn 90 days before planned entry.      labs) drawn at least 45 days
                                          before planned entry for dogs
                                          with a foreign-issued rabies
                                          vaccination certificate.
Entry only through approved port of      Entry only through approved
 entry with a live animal care facility   port of entry (18 ports of
 (one port of entry).                     entry).
------------------------------------------------------------------------
* Eligible importers include: U.S. citizens and lawful residents
  relocating to the United States (including U.S. and foreign government
  personnel); owners of service animals; and importers who wish to
  import dogs for purposes related to science, education, exhibition, or
  law enforcement.
** Dogs returning to the United States from high-risk countries with a
  valid U.S.-issued rabies vaccination certificate are allowed to enter
  the United States without a CDC Dog Import Permit provided that all
  requirements in Section IV were met.

IV. Conditions for Entry of U.S.-Vaccinated Dogs During the Extension

    Through this notice, CDC is modifying the conditions for entry of 
U.S.-vaccinated dogs to reduce the burden on importers. Dogs returning 
to the United States from high-risk countries with a valid U.S.-issued 
rabies vaccination certificate will be allowed to enter the United 
States without a CDC Dog Import Permit, if the dog:
     Is six months of age or older;
     Has a microchip;
     Arrives at one of 18 CDC-approved ports of entry with CDC 
quarantine stations; and
     Has a valid U.S. rabies vaccination certificate 
documenting that the dog was vaccinated against rabies by a U.S.-
licensed veterinarian in the United States on or after the date the dog 
was 12 weeks of age. The rabies vaccination certificate must include:
    [cir] Name and address of owner;
    [cir] Breed, sex, date of birth (approximate age if date of birth 
unknown), color, markings, and other identifying information for the 
dog;
    [cir] Microchip number;
    [cir] Date of rabies vaccination and date next vaccine is due 
(i.e., date the vaccination expires);
    [cir] Vaccine manufacturer, product name, lot number and product 
expiration date; and
    [cir] Name, license number, address, and signature of veterinarian 
who administered the vaccination.
    This is consistent with CDC's practices as of December 1, 2021, and 
is a modification to the terms of the original temporary suspension 
announced in the June 2021 Federal Register notice (86 FR 32041, June 
16, 2021).

V. Conditions for Entry of Foreign-Vaccinated Dogs With a CDC Dog 
Import Permit During the Extension

    CDC is further modifying the terms of the original temporary 
suspension published in the June 2021 Federal Register notice (86 FR 
32041, June 16, 2021). All importers are now eligible to import dogs; 
therefore, there are no longer eligibility criteria as to who may 
import dogs. Under the temporary suspension, importers who met the 
eligibility criteria could make a one-time request to import up to 
three dogs as part of a single importation. CDC is herein modifying the 
terms of the temporary suspension to allow importers of personal pet 
dogs the opportunity to receive up to two CDC Dog Import Permits (i.e., 
permits for two dogs) during the suspension. Further, under the 
modified temporary extension, personal pet owners no longer need to 
provide documentary proof of their eligibility (e.g., employment 
relocation letter or official orders). Commercial importers and 
personal pet owners who do not have a serologic titer result for their 
dog also now have an alternate pathway for importation.
    All importers of personal pet dogs (defined for the purpose of this 
notice as owners or importers attempting to import fewer than three 
dogs during the suspension) from high-risk countries are now eligible 
to apply for a CDC Dog Import Permit. Commercial dog importers (defined 
for the purpose of this notice as importing three or more dogs during 
the suspension) are not eligible for a CDC Dog Import Permit and must 
meet the requirements for entry outlined in Section VI below. In 
summary, CDC has removed the requirement to submit documentary proof of 
eligibility for personal pet owners to be able to receive permits and 
reduced the number of personal pets that can receive permits during the 
temporary suspension from three to two. Additionally, CDC is allowing 
importers of personal pets without serologic titer results and 
commercial importers to import dogs during the extension, as set forth 
in Section VI.
    Foreign-vaccinated dogs arriving from high-risk countries with a 
valid CDC Dog Import Permit will be allowed to enter the United States 
if the dogs:
     Are six months of age or older (photographs of the dog's 
teeth are required for age verification);
     Have a microchip;
     Have a valid rabies vaccination certificate from a non-
U.S.-licensed veterinarian. The certificate must state that the vaccine 
was administered on or after the date the dog was 12 weeks (84 days) of 
age and at least 28 days prior

[[Page 33165]]

to entry, if it was the dog's initial vaccine. The certificate must be 
in English or accompanied by a certified English translation;
     Have serologic evidence of rabies vaccination (titer) from 
an approved rabies serology laboratory \46\ (serologic titer results 
>=0.5 IU/mL are required) with the sample collected at least 45 days 
prior to entry and no greater than 365 days before entry; and
---------------------------------------------------------------------------

    \46\ Centers for Disease Control and Prevention (2022). Approved 
Rabies Serology Laboratories for Testing Dogs. Retrieved from 
https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/approved-labs.html.
---------------------------------------------------------------------------

     Arrive at one of the 18 CDC-approved ports of entry with 
CDC-staffed quarantine stations.
    To apply for a CDC Dog Import Permit, importers whose dogs meet the 
entry requirements listed above must submit the Application for Special 
Exemption for a Permitted Dog Import, [approved under OMB Control 
Number 0920-0134 Foreign Quarantine Regulations (exp. 06/30/2022), or 
as revised]. The permit application is available online at www.cdc.gov/dogpermit.
    The importer's request, with all supporting documentation, must be 
submitted at least 30 business days before the date on which the dog 
will enter the United States. Importers may submit an application 
electronically at www.cdc.gov/dogpermit. Applicants should submit all 
required materials with their permit application at least 30 business 
days prior to their planned arrival date in the United States. A 
request cannot be made at the port of entry upon the dogs' arrival in 
the United States; dogs that arrive without a CDC Dog Import Permit 
will be returned to their country of origin on the next available 
flight or quarantined at the importer's expense at a CDC-approved 
animal facility (see Section VI).
    Consistent with CDC's current policies but representing a 
modification of the terms of the original temporary suspension 
published in the June 2021 Federal Register notice (86 FR 32041, June 
16, 2021), dogs arriving from a high-risk country with a valid CDC Dog 
Import Permit must enter the United States at one of 18 CDC-approved 
ports of entry. This revision eases the burden on importers compared to 
the temporary suspension, which limited entry to one approved port of 
entry at the time the Federal Register notice was published.
    Within 10 days of arrival, foreign-vaccinated dogs with a CDC Dog 
Import Permit must receive a USDA-licensed rabies booster vaccination 
by a U.S. veterinarian.

VI. Conditions for Entry of Foreign-Vaccinated Dogs Without a CDC Dog 
Import Permit During the Extension

    CDC is also modifying the terms of the temporary suspension 
published in the June 2021 Federal Register notice (86 FR 32041, June 
16, 2021) to reduce the burden and provide a pathway for commercial dog 
importers to import dogs. While importers of commercial shipments of 
dogs cannot apply for a CDC Dog Import Permit, a separate entry 
process, as outlined below, has been established. All commercial dog 
importers from high-risk countries may now import dogs provided that 
the dogs, upon entering the United States, are examined, revaccinated, 
and have proof of an adequate titer from a CDC-approved laboratory upon 
arrival or are held in quarantine at a CDC-approved animal facility 
until they meet CDC entry requirements. Importers of personally owned 
pets may also choose to use this pathway in lieu of obtaining a CDC Dog 
Import Permit.
    Foreign-vaccinated dogs without a valid CDC Dog Import Permit must 
meet all other entry requirements (sections VI-VII) prior to arrival 
and also meet the following requirements:
     Dogs must enter at a port of entry with a CDC-approved 
animal facility.\47\
---------------------------------------------------------------------------

    \47\ Centers for Disease Control and Prevention (2022). Bringing 
a dog into the United States. Retrieved from www.cdc.gov/dogtravel.
---------------------------------------------------------------------------

     Dogs must be six months of age or older at the time of 
entry.
     Prior to arrival in the United States, importers must 
arrange for an examination date and time and reserve space with a CDC-
approved animal facility.
     Importers must arrange for transportation by a CBP-bonded 
transporter (i.e., provided by the airline carrier or a CDC-approved 
animal facility) to a CDC-approved animal facility immediately upon 
arrival.
     Dogs must undergo veterinary examination and revaccination 
against rabies at a CDC-approved animal facility upon arrival at the 
importer's expense.
    Dogs must also be held at the CDC-approved animal facility until 
the following entry requirements are completed:
     Veterinary health examination by a USDA-accredited 
veterinarian for signs of zoonotic or foreign disease. Suspected or 
confirmed zoonotic or foreign animal diseases must be reported to CDC, 
USDA, the state or territorial public health veterinarian. The state or 
territorial veterinarian and the CDC-approved animal facility must not 
release the dog without the written approval of CDC.
     Vaccination against rabies with a USDA-licensed rabies 
vaccine and administered by a USDA-accredited veterinarian.
     Confirmation of microchip number.
     Confirmation of age through dental examination by a USDA-
accredited veterinarian.
     Verification of adequate rabies titer from an approved 
lab. Serologic titer results of >=0.5IU/mL are required from a CDC-
approved laboratory, with the sample collected at least 45 days prior 
to entry and no greater than 365 days before entry. Dogs that arrive 
without documentation of an adequate rabies titer from an approved lab 
must be housed at the CDC-approved animal facility for a 28-day 
quarantine at the expense of the importer following administration of 
the U.S. rabies vaccine in addition to meeting the criteria listed 
above. Dogs cannot be released from quarantine unless all requirements 
have been met.
    Importers are responsible for all fees associated with the 
importation of dogs into the United States, including transportation, 
examination, vaccination, and quarantine fees.
    Foreign-vaccinated dogs arriving without a CDC Dog Import Permit 
must enter the United States through a CDC-approved port of entry with 
a CDC-approved animal facility. As of May 2022, these facilities are 
located at: Atlanta Hartsfield-Jackson International Airport, John F. 
Kennedy International Airport (New York), Los Angeles International 
Airport, and Miami International Airport. Importers are responsible for 
reserving examination times and space at the CDC-approved animal 
facility prior to arrival in the United States. Dogs that arrive at 
unapproved ports of entry or without reservations at the animal 
facility will be denied entry and returned to the country of departure.

VII. Continued Conditions for All Dogs From High-Risk Countries During 
the Extension

    Consistent with the terms of the original temporary suspension 
published in the June 2021 Federal Register notice (86 FR 32041, June 
16, 2021), all dogs arriving from high-risk countries must be 
microchipped prior to arrival in the United States. The microchip can 
be administered in any country and does not need to be a U.S.-issued 
microchip. The microchip number must be listed on the rabies 
vaccination certificate.
    Any dog from a high-risk country will be excluded from entering the 
United States and returned to its country of origin on the next 
available flight,

[[Page 33166]]

regardless of carrier or route, if the dog arrives under the following 
circumstances:
     A dog arrives in the United States and does not meet the 
minimum pre-arrival requirements (i.e., age greater than six months, 
microchip, valid rabies vaccination certificate).
     A dog presented does not match the description of the 
animal listed on the permit (if required) or rabies vaccination 
certificate.
     A dog arrives at an unapproved port of entry.
     A dog arrives at an airport with a CDC-approved animal 
facility without a reservation (if required) and no space at the 
facility is available.
     Importer refuses transportation to, or receipt of or 
payment for services at, a CDC-approved animal facility (if required).
    The importer shall be financially responsible for all housing, 
care, and return costs. If an importer abandons a dog while it is at a 
CDC-approved animal facility, the carrier shall become responsible for 
all costs associated with the care, housing, and return of the dog to 
the country of departure. In keeping with current practice, importers 
should continue to check with Federal, State, and local Government 
officials regarding additional requirements of the final destination 
prior to entry or re-entry into the United States.

VIII. Additional Determinations Relating to This Notice

    Pursuant to the terms of this notice, CDC is modifying the 
temporary suspension for the importation of dogs from high-risk rabies-
enzootic countries. This suspension includes dogs originating in CRVV 
low-risk or CRVV-free countries that have been in a high-risk country 
in the previous six months (not including animals transiting through 
high-risk countries).
    To enter the United States, dogs must meet certain entry 
requirements as described in Sections IV through VII of this notice, 
including, as applicable: having a valid U.S. rabies vaccination 
certificate; having a CDC Dog Import Permit; and being examined, 
vaccinated, and subject to quarantine at a CDC-approved animal 
facility.
    Importers wishing to import foreign-vaccinated dogs that are their 
personally owned pets from high-risk countries must:
    1. Submit a request for advanced written permission (i.e., 
Application for Special Exemption for a Permitted Dog Import, [approved 
under OMB Control Number 0920-0134 Foreign Quarantine Regulations (exp. 
06/30/2022, or as revised)] at least 30 business days prior to planned 
importation in the United States at www.cdc.gov/dogpermit.
    2. Submit all documentation listed above in Section V Application 
for Special Exemption for a Permitted Dog Import.
    The Application for Special Exemption for a Permitted Dog Import 
must include proof of the dog's identity, including pictures of the 
dog's teeth, other descriptive details, proof of rabies vaccination, 
serologic titer results, and microchip information. Dogs arriving from 
high-risk countries must enter the United States at a CDC-approved port 
of entry or a port of entry with a CDC-approved animal facility if they 
do not possess a valid U.S.-issued rabies vaccination certificate or 
CDC Dog Import Permit.
    Pursuant to the terms of this notice, CDC is not requiring U.S.-
vaccinated dogs returning to the United States from a high-risk country 
for dog rabies to apply for a CDC Dog Import Permit provided the dog 
meets the criteria outlined in Section IV. Additionally, CDC does not 
require a CDC Dog Import Permit for commercial dogs because they must 
be examined, vaccinated, and are subject to quarantine at a CDC-
approved animal facility upon arrival as outlined in Section VI.

                     Table 2--Entry Conditions for Dogs Under Modified Suspension Guidelines
----------------------------------------------------------------------------------------------------------------
                                    Dogs with valid     Dogs with valid     Dogs with valid     Dogs with valid
                                  foreign RVC (fewer  foreign RVC (fewer  foreign RVC (three  foreign RVC (three
   Dogs with valid U.S. rabies      than three dogs     than three dogs   or more dogs being  or more dogs being
  vaccination certificate (RVC)     being imported)     being imported)     imported) with     imported) without
                                      with titer         without titer           titer               titer
----------------------------------------------------------------------------------------------------------------
At least six months of age......  At least six        At least six        At least six        At least six
                                   months of age.      months of age.      months of age.      months of age.
Microchip.......................  Microchip.........  Microchip.........  Microchip.........  Microchip.
Entry allowed at 18 ports of      Entry allowed at    Entry allowed at    Entry allowed at    Entry allowed at
 entry with CDC quarantine         18 ports of entry   four ports of       four ports of       four ports of
 station.                          with CDC            entry with CDC-     entry with CDC-     entry with CDC-
                                   quarantine          approved animal     approved animal     approved animal
                                   station with        facility.           facility.           facility.
                                   valid CDC Dog
                                   Import Permit
                                   issued prior to
                                   arrival.
Titer not needed................  Serologic titer     Not applicable *..  Serologic titer     Not applicable *.
                                   (>=0.5 IU/mL)                           (>=0.5 IU/mL)
                                   from a CDC-                             from a CDC-
                                   approved                                approved
                                   laboratory.                             laboratory.
                                  Titer drawn at                          Titer drawn at
                                   least 45 days                           least 45 days
                                   before entry and                        before entry and
                                   not more than 365                       not more than 365
                                   days before entry.                      days before entry.
No quarantine...................  No quarantine.....  28-day quarantine   No quarantine.....  28-day quarantine
                                                       at CDC-approved                         at CDC-approved
                                                       animal facility.                        animal facility.
Veterinary exam, booster          Veterinary exam or  Veterinary          Veterinary          Veterinary
 vaccination or quarantine not     quarantine not      examination,        examination,        examination,
 required unless the animal        required with       booster             booster             booster
 appears ill upon arrival.         valid CDC Dog       vaccination, and    vaccination, and    vaccination, and
                                   Import Permit       paperwork           paperwork           paperwork
                                   unless the animal   verification at     verification at     verification at
                                   appears ill upon    CDC-approved        CDC-approved        CDC-approved
                                   arrival.            animal facility     animal facility     animal facility
                                  Booster              required upon       required upon       required upon
                                   vaccination is      arrival.            arrival.            arrival.
                                   required within
                                   10 days of
                                   arrival by U.S.
                                   veterinarian.
----------------------------------------------------------------------------------------------------------------
* This is an alternate pathway for importation in the event documentation of an adequate titer is not available
  upon arrival.


[[Page 33167]]

    The suspension will continue to reduce the risk of importation of 
CRVV, ensure public health safeguards are in place for the importation 
of dogs from high-risk countries, and preserve public health resources 
needed for the COVID-19 response. The terms of the suspension allow for 
sufficient safeguards to mitigate the public health risk. The 
suspension will also allow CDC to continue to work with Federal and 
State partners, airlines, and other affected parties to consider 
options for a more streamlined and efficient dog importation process 
that will be safer for pets. It will allow all importers, including 
commercial importers, a pathway to import dogs. Most importantly, it 
will ensure that U.S. public health remains protected.
    Therefore, pursuant to 42 CFR 71.51(e) and 42 CFR 71.63, CDC hereby 
excludes the entry and suspends (subject to the terms, conditions, and 
modifications outlined in this notice) the importation of dogs from 
high-risk countries, including dogs from CRVV low-risk and CRVV-free 
countries if the dogs have been present in a high-risk country in the 
previous six months.
    Additionally, under 42 CFR 71.63, CDC continues to find that CRVV 
exists in countries designated as high-risk countries and that, if 
reintroduced into the United States, CRVV would threaten the public 
health of the United States. The continued entry of dogs from high-risk 
countries in the context of the current limited CDC resources and 
personnel dedicated to COVID-19 response activities and the 
insufficient safeguards in place to prevent the exportation of 
inadequately vaccinated dogs from high-risk countries further increases 
the risk that CRVV may be introduced, transmitted, or spread into the 
United States. CDC has coordinated in advance with other Federal 
agencies as necessary to implement and enforce this notice.
    This notice is not a legislative rule within the meaning of the 
Administrative Procedure Act (APA), but rather a notice of an exclusion 
and temporary suspension taken under the existing authority of 42 CFR 
71.51(e) and 42 CFR 71.63, which were previously promulgated with full 
notice and comment. If this notice qualifies as a legislative rule 
under the APA, notice and comment and a delay in effective date are not 
required because there is good cause to dispense with prior public 
notice and the opportunity to comment on this notice. Considering the 
public health emergency caused by the virus associated with COVID-19, 
the insufficient safeguards in place to prevent the exportation of 
inadequately vaccinated dogs from high-risk countries, the ongoing 
diversion of global public health resources and personnel to respond to 
the pandemic, and the risk of reintroduction of CRVV from dogs being 
imported from high-risk countries, it would be impractical and contrary 
to the public's health, and by extension the public's interest, to 
delay the issuance and effective date of this notice. Notwithstanding, 
CDC is publishing this notice in advance of its effective date, to 
allow potential dog importers and other interested parties sufficient 
time to adjust their practices in accordance with the terms of this 
modified suspension.
    This temporary suspension will enter into effect on June 10, 2022, 
and remain in effect through January 31, 2023, unless modified or 
rescinded by the CDC Director based on public health or other 
considerations.

    Dated: May 26, 2022.
Sherri Berger,
Chief of Staff, Centers for Disease Control and Prevention.

APPENDIX

Economic Impact of this Temporary Suspension

    Executive Orders 12866: ``Regulatory Planning and Review'' and 
13563: ``Improving Regulation and Regulatory Review'' direct 
agencies to assess the costs and benefits of available regulatory 
alternatives and, if regulation is necessary, to select regulatory 
approaches that maximize net benefits (including potential economic, 
environmental, public health and safety effects, distributive 
impacts, and equity). Executive Order 13563 emphasizes the 
importance of quantifying both costs and benefits, reducing costs, 
harmonizing rules, and promoting flexibility.
    Although the extension of the temporary suspension of dogs from 
countries at high-risk for CRVV is expected to reduce the number of 
dogs imported into the United States, importers or dogs with valid 
rabies vaccination certificates administered in the United States 
should not be affected by the suspension. In addition, for dogs 
vaccinated outside the United States, eligible importers of dogs 
from high-risk countries will be able to apply for a CDC Dog Import 
Permit at least 30 business days prior to planned importation in the 
United States for two or fewer dogs. In addition, any importer can 
bring in dogs that are appropriately followed up in the United 
States at a CDC-approved facility. Appropriate follow up will depend 
on whether importers have obtained serologic evidence of rabies 
immunity from titer testing prior to arrival in the United States. 
For dogs with serologic evidence of immunity, such dogs will need to 
be transported to a CDC-approved facility, re-vaccinated, and 
undergo a veterinary examination. For dogs lacking serologic 
evidence, such dogs would need to be examined, re-vaccinated, and 
quarantined for 28 days. Thus, all importers will be able to import 
dogs from high-risk countries if they are willing to take 
appropriate precautions to protect public health. However, CDC 
assumes that the additional costs to comply with these requirements 
will reduce the number of dogs vaccinated outside the United States 
and imported from high-risk countries by 20 percent.
    CDC has previously estimated that between 87,000 and 116,000 
dogs are imported from high-risk countries each year.\48\ This 
estimate is significantly greater than the numbers recorded by CBP 
for formal entry under HTS code 0106199120 and HTS Description: 
Other live animals, other, dogs, which averaged 16,390 and varied 
from 9,966 to 24,031 over the 3-year period from 2018 through 2020.
---------------------------------------------------------------------------

    \48\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84,724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
---------------------------------------------------------------------------

    The number of dogs reported under this HTS category does not 
include hand-carried dogs traveling in airplane cabins or crossing 
at land borders without formal entry and, thus, are not inclusive of 
all dog imports. To account for the uncertainty in the number of 
dogs imported to the United States from high-risk countries without 
formal entry, CDC used the following assumptions in the analysis of 
this action: 1) Most likely estimate: three times the average number 
of dogs with formal entry from reported in 2020 was 60,696 dogs per 
year, 2) Lower bound: two times the average number of dogs with 
formal entry from 2020 (32,781), and 3) Upper bound: five times the 
number of dogs arriving in the highest year (2019) (120,155). These 
baseline estimates are used throughout the analysis (Table A1).
    The suspension will impact importers differently depending on 
whether their dogs were vaccinated in the United States or outside 
the United States. For dogs vaccinated in the United States, CDC 
assumed the extension of the suspension would have a negligible 
impact on the number of dogs imported. During the first four and a 
halfmonths of the temporary suspension, dogs with valid U.S. RVCs 
were required to apply for permits. During this period, about 61 
percent of dogs had U.S. RVCs among those for which permits were 
requested; however, the temporary suspension limited the categories 
of importers eligible to receive permits. Thus, these data have 
limited generalizability to a scenario in which all importers would 
be eligible for permits. Given this uncertainty, CDC assumed that 
about 50 percent of imported dogs have U.S. RVCs, while the other 50 
percent would have RVCs from other countries. To account for 
uncertainty, CDC also considered a range of 35 to 60 percent of 
imported dogs from high-risk countries would have U.S. RVCs.
    CDC assumed that the temporary suspension would reduce the 
number of dogs imported from high-risk countries with non-

[[Page 33168]]

U.S. RVCs by 20 percent and considered a range of 10-40 percent to 
calculate lower and upper bound estimates. This would result in 
estimates of 54,626 (range: 27,536 to 112,345 dogs) dogs imported 
per year with the suspension in place. The temporary suspension 
would reduce the estimated numbers of dogs imported per year by 
6,070 (range: 5,245 to 7,810 dogs). Among imported dogs, CDC 
estimated that about 12,139 dogs (range: 3,934 to 35,145 dogs) would 
have import permits. Another 11,896 dogs (range: 3,855 to 34,442 
dogs) would arrive with titers, but without permits. Finally, about 
243 dogs (range: 79 to 703 dogs) would arrive without titers and 
would require a 28-day quarantine period.
    CDC also estimated the numbers of dogs denied entry under the 
baseline and with the temporary suspension in effect (see Table A1 
below). An estimated 500 dogs (range: 300 to 750 dogs) would be 
denied entry under the baseline based on data from 2020 and previous 
years. The temporary suspension and CDC permit process are expected 
to reduce the number of dogs denied entry by 90 percent (range: 85 
to 100 percent) such that only 50 (range: 0 to 50) dogs would be 
denied entry with this temporary suspension. During the first six 
and a halfmonths of the previous temporary suspension, about 72 dogs 
were denied entry, corresponding to about 133 dogs over a full year. 
However, dogs would be allowed to undergo a 28-day quarantine at a 
CDC-approved facility in lieu of being returned to their countries 
of origin, provided space was available at the CDC-approved 
facility.

  Table A1--Estimated Numbers of Dogs From High-Risk Countries Imported or Denied Entry Under the Baseline And
                                          With The Temporary Suspension
----------------------------------------------------------------------------------------------------------------
                                                                    Most likely
                                                                     estimate       Lower bound     Upper bound
----------------------------------------------------------------------------------------------------------------
Estimated number of dogs imported from high-risk countries at             60,696          32,781         120,155
 baseline (A)...................................................
Estimated percent with U.S. rabies vaccination certificates                  50%            60%*             35%
 (RVCs) (B).....................................................
Number of dogs with U.S. RVCs at baseline and with temporary              30,348          19,669          42,054
 suspension (C) = (A) x (B).....................................
Number of dogs with non-U.S. RVCs at baseline (D) = (A) - (C)...          30,348          13,112          78,101
Assumed percent of dogs with non-U.S. RVCs that would not be                 20%            40%*             10%
 imported due to additional requirements under the temporary
 suspension (E).................................................
Assumed percent of dogs with non-U.S. RVCs that would be                     40%             30%             45%
 imported with CDC permits under the temporary suspension (F)...
Assumed percent of dogs imported with an adequate rabies titer               39%             29%             44%
 and requiring follow-up at CDC-approved facility under the
 temporary suspension (G).......................................
Assumed percent of dogs imported without titer and requiring 28-            0.8%            0.6%            0.9%
 day quarantine at CDC-approved facility under the temporary
 suspension (H).................................................
Estimated number of dogs Arriving with CDC permit (I) = (D) x             12,139           3,934          35,145
 (F)............................................................
Estimated number of dogs imported with titer, but no CDC permit           11,896           3,855          34,442
 (J) = (D) x (G)................................................
Estimated number of dogs without titer and requiring 28-day                  243              79             703
 quarantine (K) = (D) x (H).....................................
Total imported dogs with non-U.S. RVCs (L) = (I) + (J) + (K)....          24,278           7,867          70,291
Estimated number of dogs imported from high-risk countries with           54,626          27,536         112,345
 temporary suspension (M) = (C) + (L)...........................
Change in number of dogs imported from high-risk countries (N) =           6,070           5,245           7,810
 (A) - (M)......................................................
----------------------------------------------------------------------------------------------------------------
                                           Number of dogs denied entry
----------------------------------------------------------------------------------------------------------------
Estimated number of dogs denied entry from high-risk countries               500             300             750
 at baseline (O)................................................
Estimated % reduction in dogs denied entry with temporary                    90%             85%            100%
 suspension (P).................................................
Estimated number of dogs denied entry with temporary suspension               50              45               -
 (Q) = (O) x (1 - (P))..........................................
Change in numbers of dogs denied entry with temporary suspension             450             255             750
 (R) = (O) - (Q)................................................
----------------------------------------------------------------------------------------------------------------
* Although not a lower bound estimate for this parameter, the larger percentage results in smaller total cost
  estimates. As the percentage reduction in the number of dogs imported from high-risk countries increases, the
  estimated cost of the temporary suspension decreases. This results, in part, from the unknown cost per dog
  imported from a high-risk country that would otherwise not be imported due to the suspension. The revised
  suspension allows all dogs to enter if the importer complies with the entry requirements. Therefore, importers
  could determine whether the additional costs are greater than the value of importing dogs from high-risk
  countries. This would vary by importer depending on their own operating costs and CDC cannot estimate these
  costs.

    The estimated costs and benefits (in 2020 U.S. dollars) associated 
with the temporary suspension of dogs from countries at high-risk for 
CRVV are summarized in Table A2. CDC estimates that importers, CDC, and 
DHS/CBP will incur a total of about $22 million in costs (range: $4.6 
to $88 million) over a one-year period with the suspension. The large 
difference between the lower and upper bound is due to both uncertainty 
in the number of dogs imported from high-risk countries under the 
baseline as well as uncertainty in many of the costs associated with 
the suspension. Although the one-year costs are presented in the table, 
the expected costs (and benefits) of the extension will depend on the 
duration in which the extension is in effect. If the suspension ends on 
January 31, 2023 (approximately 0.64 years), the estimated total costs 
of the extension would be pro-rated to about $14 million (range: $3.0 
to $56 million).
    Most of the costs will be incurred by importers (most likely one-
year estimate of $21 million, or 93 percent of the total cost 
estimate), among whom most of the costs will be incurred by importers 
of dogs vaccinated outside the United States, who will have to: (1) 
Spend time completing the application for a CDC Dog Import Permit or 
incur costs for veterinary examination and revaccination after arrival 
at a CDC-approved facility; (2) pay for serologic testing; and (3) 
incur the potential economic costs of being unable to import a dog from 
a high-risk country (either the inability to travel with a pet from a 
high-risk country or the need to substitute the importation of a dog 
from CRVV-free or low-risk country instead of a dog from a high-risk 
country). In addition, all importers of dogs from high-risk countries 
will be required to have microchips implanted in their dogs.\49\ 
Finally, some importers will need to re-route travel to a port of entry 
with a CDC quarantine station (if they have a CDC permit or U.S. RVC) 
or to a smaller number of airports with a CDC-approved animal facility 
(if they do not have a CDC permit).
---------------------------------------------------------------------------

    \49\ In the cost estimate, CDC assumed that the majority of dogs 
(90%) would be implanted with microchips with or without this 
requirement.

---------------------------------------------------------------------------

[[Page 33169]]

    In addition, airlines will incur about 3.1 percent of the most 
likely total cost estimate (reported in Table A2) to spend additional 
time reviewing documentation of importers and due to the reduction in 
number of dogs transported. CDC will incur about 3.9 percent of the 
most likely total cost estimate, primarily for review of permit 
applications.
    The one-year benefits (averted costs) from the temporary suspension 
are estimated to be $1.2 million (range: $0.47 to $2.9 million). If the 
suspension extension ends on January 31, 2023, the estimated benefits 
over 0.64 years would be $740,000 (range: $300,000 to $1.9 million). 
About 31 percent of the benefits of the temporary suspension accrue to 
CBP due to the reduction in: The number of dogs imported from high-risk 
countries that require time for screening and review of RVCs; the 
number of dogs denied entry; and the time to review a CDC Dog Import 
Permit instead of the time required to review documentation under the 
baseline. Importers, CDC, and airlines also benefit from the costs 
averted by the reduction in the number of dogs denied entry with the 
suspension relative to baseline. The net cost of the temporary 
suspension is calculated as the difference between the annual costs and 
the annual benefits resulting in a net estimate cost of $21 million 
(range: $4.2 to $85 million).

       Table A2--Summary Table of Benefits and Costs, in 2020 U.S. Dollars, Over a One-Year Time Horizon *
----------------------------------------------------------------------------------------------------------------
                                                                    Most likely
                            Category                                 estimate       Lower bound     Upper bound
----------------------------------------------------------------------------------------------------------------
Benefits
    Annual monetized benefits to importers of dogs from high-           $481,281        $254,614      $2,173,957
     risk countries.............................................
Annual monetized benefits to airlines...........................         108,000          20,400         450,000
Annual monetized benefits to DHS/CBP............................         360,084         160,309         854,518
Annual monetized benefits to CDC................................         204,399          84,960         548,100
        Total annualized monetized benefits.....................       1,153,764         471,045       2,878,428
                                                                 -----------------------------------------------
    Quantified, but unmonetized, benefits.......................   The estimated costs associated with a public
                                                                      health response to a dog imported while
                                                                     infected with canine rabies virus variant
                                                                      (CRVV) are $323,742, range: $220,897 to
                                                                  $521,828. The permit requirement for high-risk
                                                                        countries should reduce the risk of
                                                                      importation of dogs infected with CRVV.
    Qualitative benefits........................................      Any importation of a dog with CRVV will
                                                                    require the reallocation of limited public
                                                                     health resources to support a response to
                                                                    mitigate the risk of transmission of CRVV.
                                                                   This could reduce the resources available for
                                                                   COVID-19 response activities and vaccination
                                                                      programs. In addition, these competing
                                                                   priorities may increase the risk of unlikely,
                                                                    but very costly outcomes associated with an
                                                                   importation of a dog with CRVV such as 1) the
                                                                  potential risk of death in a person who may be
                                                                  unaware of his/her exposure to a dog with CRVV
                                                                   and 2) the risk of re-introduction of CRVV in
                                                                                the United States.
                                                                 -----------------------------------------------
Costs
Category........................................................     Most Likely     Lower bound     Upper bound
                                                                        estimate
                                                                 -----------------------------------------------
    Annualized monetized costs to importers of dogs from high-       $20,525,815      $4,050,735     $83,458,642
     risk countries.............................................
    Annual monetized costs to airlines..........................         673,604         262,817       2,000,407
    Annualized monetized costs to DHS/CBP.......................               0               0               0
    Annual monetized costs to CDC...............................         853,956         320,538       2,270,323
                                                                 -----------------------------------------------
        Total annualized monetized costs........................      22,053,375       4,634,090      87,729,371
----------------------------------------------------------------------------------------------------------------
* Although the one-year costs are presented in the table, the expected costs and benefits of the extension will
  depend on the duration in which the extension is in effect. If the suspension ends on January 31, 2023
  (approximately 0.64 years), the estimated total costs of the extension would be pro-rated to about $14 million
  (range: $3.0 to $57 million). The expected benefits would be similarly pro-rated to $740,000 (range: $300,000
  to $1.9 million).

    The primary public health benefit of the temporary suspension is 
the reduced risk that a dog with CRVV will be imported from a high-risk 
country into the United States. Based on experience with previous 
importations, CDC estimated the cost per imported dog with CRVV to be 
$323,742 (range: $220,897 to $521,828).\50,51\ This cost estimate 
includes health department staff time for the public health response, 
payments for post-exposure prophylaxis

[[Page 33170]]

for exposed persons,\52,53\ and the costs associated with quarantining 
or euthanizing exposed animals.
---------------------------------------------------------------------------

    \50\ Raybern, C., Zaldivar, A., Tubach, S., Ahmed, F., Moore, 
S., Kintner, C. Garrison, I. (2020) Rabies in a dog imported from 
Egypt-Kansas, 2019. Morbidity and Mortality Weekly Report, 69(38), 
1374-1377. Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6938a5-H.pdf.
    \51\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84,724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
    \52\ Raybern, C., Zaldivar, A., Tubach, S., Ahmed, F., Moore, 
S., Kintner, C. Garrison, I. (2020) Rabies in a dog imported from 
Egypt-Kansas, 2019. Morbidity and Mortality Weekly Report, 69(38), 
1374-1377. Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6938a5-H.pdf.
    \53\ Centers for Disease Control and Prevention (2022). Rabies 
Postexposure Prophylaxis. Retrieved from https://www.cdc.gov/rabies/medical_care/index.html.
---------------------------------------------------------------------------

    The most likely estimates of the net cost ($21 million) and the 
most likely estimate of the potential benefits of averting the 
importation of a dog with CRVV from a high-risk country ($324,000) can 
be used to calculate how many dogs with CRVV would need to be imported 
under the baseline for the benefits to equal costs. The net cost ($21 
million) divided by the cost per importation ($324,000) suggests that 
at least 65 dogs with CRVV would need to be imported under the baseline 
for benefits to exceed costs. This would require an increase in the 
number of dogs imported into the United States while infected with 
CRVV, which could occur because of failures of rabies control programs 
in multiple high-risk countries.
    The above estimate of the cost of an importation of a dog with CRVV 
does not account for the worst-case outcomes, which include (1) 
transmission of rabies to a person who dies from the disease or (2) 
ongoing transmission to other domestic and wildlife species in the 
United States. While the risk of re-establishing CRVV into the United 
States is low, it would result in costly efforts over several years to 
re-eliminate the virus.
    The cost of re-introduction could be especially high if CRVV 
spreads to other species of U.S. wildlife. Both worst-case outcomes may 
be more likely to occur during the COVID-19 pandemic because public 
health resources in countries where CRVV is endemic are likely to have 
been diverted to COVID-19 response activities and vaccination programs. 
These countries would already have limited resources available to 
mitigate CRVV and the prevalence of CRVV in dogs may increase relative 
to the pre-COVID-19 period in those countries.
    Human deaths from rabies continue to occur in the United States 
after exposures to wild animals. However, no U.S. resident has died 
after exposure to an imported dog with CRVV in at least 20 years. CDC 
uses the value of statistical life (VSL) to assign a value to 
interventions that can result in mortality risk reductions. For 2020, 
the estimated VSL is $11.6 million, with a range of $5.5 to $17.7 
million.\54\ CDC is unable to estimate the potential magnitude of the 
mortality risk reduction associated with the temporary suspension. If 
three deaths were averted because of the suspension extension, the 
potential benefits would exceed costs.
---------------------------------------------------------------------------

    \54\ U.S. Department of Health and Human Services (2016). 
Guidelines for Regulatory Impact Analysis. Office of the Assistant 
Secretary for Planning and Evaluation, U.S. Department of Health and 
Human Services. Retrieved from https://aspe.hhs.gov/system/files/pdf/242926/HHS_RIAGuidance.pdf.
---------------------------------------------------------------------------

    Re-establishment of CRVV into the United States would also result 
in costly efforts over several years to re-eliminate the virus. A 
previous campaign to eliminate domestic dog-coyote rabies virus variant 
jointly with gray fox (Texas fox) rabies virus variant in Texas over 
the period from 1995 through 2003 cost $34 million,\55,56\ or $48 
million, in 2020 U.S. dollars. The costs to contain any reintroduction 
would depend on the time period before the reintroduction was realized, 
the wildlife species in which CRVV was transmitted, and the geographic 
area over which reintroduction occurs. The above estimate is limited to 
the cost of rabies vaccination programs for targeted wildlife and does 
not include the costs to administer post-exposure prophylaxis to any 
persons exposed after the reintroduction has been identified.
---------------------------------------------------------------------------

    \55\ Thomas, S., Wilson, P., Moore, G., Oertli, E., Hicks, B., 
Rohde, R., Johnston, D. (2005). Evaluation of oral rabies 
vaccination programs for control of rabies epizootics in coyotes and 
gray foxes: 1995-2003. Journal of the American Veterinary Medicine 
Association, 227(5),785-92. doi: 10.2460/javma.2005.227.785.
    \56\ Sterner, R., Meltzer, M., Shwiff, S., Slate, D. (2009). 
Tactics and Economics of Wildlife Oral Rabies Vaccination, Canada 
and the United States. Emerging Infectious Diseases, 15(8), 1176-
1184. doi: 10.3201/eid1508.081061.
---------------------------------------------------------------------------

    Relative to the previously published Federal Register notice 
announcing the temporary suspension,\57\ this version allows more dogs 
to be imported. If importers are willing to absorb the additional costs 
for pre-arrival titers and for the other requirements to obtain a CDC 
permit or to pay for the post-arrival costs for veterinary examination 
and revaccination at a CDC-approved facility (in lieu of obtaining a 
CDC permit), there may not be a large reduction in the number of 
imported dogs. In the previous analysis, CDC estimated that only about 
15,174 dogs would be imported over one year with the suspension in 
effect. With this suspension extension, CDC estimated that 54,626 dogs 
may be imported over a one-year period.
---------------------------------------------------------------------------

    \57\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84, 724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
---------------------------------------------------------------------------

    A significant source of uncertainty in the analysis for the 
previous suspension was due to assigning a value to the reduction in 
the number of imported dogs. CDC lacked data to estimate this value, 
which was likely to vary considerably depending on the relationships 
between importers and imported dogs. CDC assumed a marginal cost of 
$100 per dog.
    The estimated annual costs for this extension of the suspension 
($21 million) have increased relative to the annual estimate for the 
previous suspension ($12 million) because CDC assumed that a most non-
U.S.-vaccinated dogs (80 percent) would be imported with the provisions 
of this suspension extension in place. In general, the original 
requirements to import dogs from high-risk countries in the temporary 
suspension were stricter than what is proposed in this notice 
announcing the extension. Specifically, dogs with U.S. RVCs will be 
allowed to be imported without permits. This change will greatly 
increase the number of dogs eligible to enter the United States without 
a CDC permit or the need for post-arrival follow-up at a CDC-approved 
facility. In addition, the original Federal Register notice indicated 
that all dogs would have to arrive ports of entry with a live animal 
care facility with a CBP-issued FIRMS code (currently only available at 
four airports). However, this requirement was relaxed to allow dogs 
from high-risk countries to arrive at the 18 airports with CDC 
quarantine stations if the importer has a CDC permit. The additional 
costs result primarily from the increased number of dogs imported with 
non-U.S. RVCs, about half of which were assumed to require post-arrival 
follow-up at a CDC-approved facility and a smaller fraction would 
require a 28-day quarantine period.
    The expected benefits to CBP associated with a reduction in the 
number of dog imports and the time spent on screening dogs with U.S. 
RVCs are reduced relative to the previous analysis for the 2021 
suspension. This is because CDC assumed more dogs would be imported 
into the United States during the extension and because CDC

[[Page 33171]]

assumed it would require more CBP time per dog to review U.S. RVCs and 
for dogs transported to a CDC-approved facility than to review 
information in CDC Dog Import Permits. The estimated benefits to CBP 
are reduced by about 76 percent. There is also an increased risk that a 
dog infected with CRVV may be imported because of the increase in the 
number of dog imports and because CDC would not review documentation 
for dogs with U.S. RVCs prior to arrival.
Assumptions Used to Estimate Costs and Benefits
    CDC estimated costs and benefits to importers, CDC, CBP, and 
airlines under the baseline and with the extension in place. All cost 
estimates were converted to 2020 U.S. dollars. The costs to importers 
with the extension were calculated using the following assumptions:
     The opportunity costs for importer time were estimated at 
$37.09 (range: $27.07 to $47.10) per hour based on the average U.S. 
wage rate and a Department of Transportation estimate specific to 
international travelers.58 59
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    \58\ Bureau of Labor Statistics (2020). May 2020 National 
Occupational Employment and Wage Estimates: United States. Retrieved 
from https://www.bls.gov/oes/current/oes_nat.htm.
    \59\ U.S. Department of Transportation, Office of Transportation 
Policy (2016). The Value of Travel Time Savings: Departmental 
Guidance for Conducting Economic Evaluations Revision 2 (2016 
Update), ``Table 4 (Revision 2--2016 Update): Recommended Hourly 
Values of Travel Time Savings.'' Retrieved from https://www.transportation.gov/sites/dot.gov/files/docs/2016%20Revised%20Value%20of%20Travel%20Time%20Guidance.pdf.
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     Importers seeking advance written permission (CDC Dog 
Import Permits) for 12,139 (range: 3,934 to 35,145) dogs.
    [cir] An assumption of 1 hour (range 0.5 to 2 hours) to submit 
advance written approval for a CDC Dog Import Permit and fulfill the 
informational and testing requirements for a permit.
    [cir] Estimated costs of $80 per dog (range: $60 to $100) for a 
rabies titer test at an approved rabies serology 
laboratory.60 61 62 63 64 65 66 67 68 69 70
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    \60\ Kansas State University (2021). RFFIT test cost. Retrieved 
from https://vetview2.vet.k-state.edu/LabPortal/catalog/list?CatalogSearch=RFF. Accessed November 2021.
    \61\ Kansas State University Veterinary Diagnostic Lab (2021). 
FAVN test cost. Retrieved from https://vetview2.vet.k-state.edu/LabPortal/catalog/list?CatalogSearch=favn&lab=&section=.
    \62\ Auburn University Bacteriology and Mycology Lab (2021) 
RFFIT test cost, Retrieved from https://www.vetmed.auburn.edu/academic-departments/dept-of-pathobiology/diagnostic-services/serology-virology/. Accessed November 2021.
    \63\ Auburn University Bacteriology and Mycology Lab (2021) FAVN 
test cost, Retrieved from https://www.vetmed.auburn.edu/academic-departments/dept-of-pathobiology/diagnostic-services/serology-virology/. Accessed November 2021.
    \64\ Instituto de Salud Publica de Chile, Laboratorio de Rabia 
(2021). RFFIT test cost. Retrieved from https://www.ispch.cl/biomedico/enfermedades-transmisibles/virus/rabia/.
    \65\ Pasteur Institute of Cambodia (2021). FAVN test cost. 
Retrieved from https://www.pasteur-kh.org/rabies-prevention-centers/rabies-serology-for-pets/.
    \66\ Sciensano (2021) RFFIT test cost, Retrieved from https://www.sciensano.be/en. Accessed November 2021.
    \67\ INOVALYS Le Mans (2021) FAVN test cost, Retrieved from 
https://analyses.inovalys.fr/en/rage-rabies/21-je-souhaite-verifier-que-mon-animal-est-protege-contre-la-rage.html. Accessed November 
2021.
    \68\ Australian Animal Health Laboratory (2021). FAVN test cost. 
Retrieved from https://aahllabservices.csiro.au/info/companion_and_equine_testing.aspx.
    \69\ Xe.com (2021) Xe Currency Converter. Retrieved from.
    \70\ Bureau of Labor Statistics (2022) CPI inflation calculator. 
https://www.bls.gov/data/inflation_calculator.htm. Accessed Feb 5, 
2022.
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    [cir] Assumed cost of $150 per dog shipment (range: $100 to $200) 
for a veterinarian to draw blood samples and ship them to an approved 
rabies serology laboratory.71 72 73
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    \71\ Pieracci, E. (2021). Personal communication, December 2, 
2021.
    \72\ Fedex (2021). Cold Shipping Solutions. Retrieved on https://orderboxesnow.com/.
    \73\ Fedex (2021). Packaging UN 3373 Shipments. Retrieved from 
https://www.fedex.com/content/dam/fedex/us-united-states/services/
UN3373_fxcom.pdf#:~:text=If%20you%20use%20any%20of%20the%20following%
20clinical,Large%20Cold%20Box%20%282%E2%80%938%C2%B0%29%20Extended%20
Duration%20%2896%20Hours%29.
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    [cir] Estimated cost of $35 (range: $20 to $50) to implant a 
microchip.74 75 76 77 78 79 80 
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    \74\ Spend on Pet (2021). How Much Does it Cost to Microchip a 
Dog? Retrieved from https://spendonpet.com/cost-to-microchip-a-dog/.
    \75\ Hanson, M. (2022). Cost of Microchipping a Pet. Spots.com. 
Retrieve.
    \76\ Invest Foresight (019) Pet microchipping to be compulsory 
in Russia. Retrieved from https://investforesight.com/pet-microchipping-to-be-compulsory-in-russia/.
    \77\ Xia, H. (2021) Turkey's dog owners rush to microchip pets 
after approval of new animal rights law. XinhuaNet. Retrieved from 
http://www.news.cn/english/2021-11/16/c_1310314878.htm.
    \78\ K. (2012). Fit a microchip, identify your lost pet pooch. 
DNA India. Retrieved from https://www.dnaindia.com/pune/report-fit-a-microchip-identify-your-lost-pet-pooch-1690440.
    \79\ Internal Revenue Service (2022). Yearly Average Currency 
Exchange Rates. Retrieved from https://www.irs.gov/individuals/international-taxpayers/yearly-average-currency-exchange-rates.
    \80\ World Bank (2022). Consumer price index (2010 = 100). 
Retrieved from https://data.worldbank.org/indicator/FP.CPI.TOTL?end=2020&start=1960.
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    [ssquf] Assumed that 10 percent of imported dogs would receive a 
microchip solely due to the requirements included in the temporary 
suspension.\81\
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    \81\ Pieracci, E. (2021). Personal communication, December 2, 
2021.
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    [cir] An assumption that 50 percent (range: 35 to 60 percent) of 
importers will already have a valid rabies vaccination certificate 
issued by a U.S.-licensed veterinarian and will not need permits or 
testing from an approved rabies serology laboratory.
    [cir] An assumption that there would be a 20 percent reduction in 
the number of imported dogs with non-U.S. RVCs due to the additional 
cost of obtaining a CDC permit or for post-arrival follow-up by a 
veterinarian at a CDC-approved facility.
    [cir] An assumption that 40 percent (range: 30 to 45 percent) of 
non-U.S. vaccinated dogs would arrive with a CDC permit.
    [ssquf] An assumption that 39 percent (range: 29 to 44 percent) of 
non-U.S. vaccinated dogs would arrive without a CDC permit but would 
receive a serologic test for rabies immunity prior to arrival. These 
dogs would require transportation to a CDC-approved facility, 
revaccination, and a veterinary exam at an estimated cost of $500 per 
dog (range: $300 to $600). It was also estimated to require about 17 
minutes of importer time (range: 14 to 20 minutes) to make a 
reservation with the facility.
    [ssquf] In addition, there may be additional delays for importers 
to wait for their dogs to be seen by a veterinarian at a CDC-approved 
animal facility. However, CDC was unable to predict how likely this 
would be to occur.
    [cir] An assumption that 0.8 percent (range: 0.6 to 0.9 percent) of 
non-U.S. vaccinated dogs would arrive without a CDC permit or serologic 
test result and would require quarantine.
    [ssquf] These dogs would require transportation to a CDC-approved 
facility, revaccination, a veterinary exam, and would need to be 
quarantined for 28 days at an estimated cost of $4,700 per dog (range: 
$3,100 to $5,500). It was also estimated to require about 51 minutes of 
importer time (range: 41 to 61 minutes) to make a reservation with the 
facility and to make arrangements during the quarantine.
    [cir] An assumption that 35 percent of importers of dogs from high-
risk countries would need to re-route travel to a port of entry with a 
CDC quarantine station, which would incur an increased ticket cost of 
$200 and 4 additional hours of travel time.
     Importers who are unable to import a dog from a high-risk 
country because of the temporary suspension (6,070, range: 5,425 to 
7,810 dogs) would incur an assumed cost of $100 (range: $50 to $150) 
per dog because owners would be unable to bring their dog(s) to a 
country at high risk for CRVV or if importers incurred increased costs 
associated with substitution of imported dog(s) from CRVV-free or low-
risk countries.

[[Page 33172]]

    The costs for CDC were estimated based on:
     An assumed staff time cost of 20 minutes (range: 15 to 30 
minutes) per permit issued by a GS-13, step 5 reviewer.
     Oversight of the permit process by two GS-13, step 5 
veterinarians to support communications, policy, and decision-making 
during the suspension.
     CDC staffing costs are estimated using the GS pay scale 
for the Atlanta area and multiplying by two to account for non-wage 
benefits and overhead.
    CBP has reported the fully loaded wage rate for CBP officers at the 
GS-12, step 3 average wage level ($57.85 in 2020 USD) as part of their 
analysis of the costs associated with reviewing import information for 
formal entry.\82\ CDC assumed that this fully loaded wage rate included 
non-wage benefits but did not include agency overhead. In the absence 
of other information, CDC assumed that overhead may add another 33 
percent to the average hourly cost for CBP officer time. This would 
result in a total cost to CBP of $76.94 per hour for CBP staff engaged 
in screening dogs at ports of entry.
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    \82\ U.S. Customs and Border Protection (2021). Supporting 
Statement: Application to Use Automated Commercial Environment (ACE) 
1651-0105. Retrieved from https://www.reginfo.gov/public/do/PRAViewDocument?ref_nbr=202106-1651-002.
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    CDC assumed that airlines would incur additional costs for this 
temporary suspension associated with the time required to review 
documentation for dogs imported from high-risk countries. This would 
require 10 minutes (range: 7 to 15) of airline staff time. CDC assumed 
that this additional time would be spent by aircraft cargo handling 
supervisors whose average hourly wage was reported to be $28.66 on 
average.\83\ To account for non-wage benefits and overhead, CDC 
multiplied this wage rate by 2.\84\ There may be some reduction in 
cargo fees revenue associated with the reduction in dogs imported from 
countries at high risk for CRVV (range: 5,425 to 7,810 dogs), which was 
assumed to result in lost revenue of $25 per dog transported since CDC 
does not have any data on the profit to airlines for transporting dogs.
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    \83\ Bureau of Labor Statistics (2020). May 2020 National 
Occupational Employment and Wage Estimates, Job category 53-1041. 
Retrieved from https://www.bls.gov/oes/current/oes_nat.htm.
    \84\ U.S. Department of Health and Human Services (2016). 
Guidelines for Regulatory Impact Analysis. Office of the Assistant 
Secretary for Planning and Evaluation, U.S. Department of Health and 
Human Services. Retrieved from https://aspe.hhs.gov/system/files/pdf/242926/HHS_RIAGuidance.pdf.
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    The expected annual benefits (averted costs) were estimated for 
importers, CDC, CBP, and airlines based on the reduced numbers of dogs 
delayed entry and the reduced time spent by CBP officers to screen dogs 
from high-risk countries.
    The estimated benefits (averted costs) for importers were estimated 
based on:
     An estimated reduction in time spent by CBP to review 
documentation for dogs from high-risk countries arriving with CDC 
permits (i.e., dogs that were vaccinated outside the United States) 
assuming an estimate of 17 minutes (range: 13.6 to 20.4 minutes) per 
dog to review documentation under the baseline \85\ to five minutes 
(range: 3 to 8 minutes) per dog to review permits during the 
suspension.
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    \85\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84, 724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
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     An estimated two hours per dog denied entry (estimated at 
450 fewer dogs denied entry, range: 255 to 750) with the suspension 
relative to baseline.
     CDC assumed that 60 percent of dogs denied entry would be 
re-imported to the United States at a round-trip cost of $1,200 per dog 
to the importer.\86\
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    \86\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84, 724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
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     CDC assumed that 40 percent of dogs denied entry would be 
abandoned by importers at a cost of $600 per dog to the importer.
    The estimated benefits (averted costs) to CDC were estimated based 
on:
     An estimated four hours of CDC staff time per dog denied 
entry at an average GS-level 13, step 5 at CDC Headquarters and an 
average of 30 minutes of CDC quarantine station staff time per dog 
denied entry at an average GS-level 11, step 5. The actual mix of staff 
at CDC Headquarters who need to support denials of entry would vary 
from GS-11 through Senior Executive Staff and varies depending on time 
spent on appeals and finding shelter for abandoned dogs.
    The estimated benefits (averted costs) to CBP were estimated based 
on:
     An estimated reduction in the number of dogs imported from 
high-risk countries due to the temporary suspension: 6,070 (range: 
5,245 to 7,810) relative to baseline.
     Under the baseline, CDC estimated that each dog imported 
from a high-risk country requires 17 minutes (range: 13.6 to 20.4 
minutes) of CBP officer time to review documents.\87\
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    \87\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84,724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
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     With the temporary suspension in place, CDC estimates that 
the time required to review CDC-issued permits would decrease from the 
above to five minutes (range: 3 to 8 minutes) per dog for the estimated 
12,139 (range: 3,934 to 35,145) dogs arriving with permits. The amount 
of time required for dogs with US RVCs or for dogs transported to a 
CDC-approved facility would be unchanged.
     An estimated reduction in the number of dogs denied entry 
because of the temporary suspension: (estimated at 450 fewer dogs 
denied entry, range: 255 to 750).
     An estimate of 71 (range: 47 to 95) minutes of CBP staff 
time required per dog denied entry (GS-12, step 5).\88\
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    \88\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84,724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
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    The estimated benefits (averted costs) for airlines were estimated 
based on:
     The reduction in the estimated numbers of dogs denied 
entry and abandoned by importers (200 under the baseline vs. 20 with 
the suspension of entry).
     An assumed cost of $600 per dog for airlines to fly 
abandoned dogs back to their countries of origin.\89\
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    \89\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84,724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
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    The costs associated with an importation of a dog with CRVV include 
health department staff time for the public health response, payments 
for post-exposure prophylaxis for exposed persons, and the costs 
associated with quarantining or euthanizing exposed animals. CDC 
estimated the response cost per imported dog with CRVV to be $323,742 
(range: $220,897 to $521,828) based on the following assumptions:
     An estimate of 800 hours of health department staff time 
per importation.\90\
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    \90\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84,724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.

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[[Page 33173]]

     The public health response time is split evenly among 
veterinarians (code 29-1131, $52.09 per hour), epidemiologists (19-
1041, $40.20 per hour), registered nurses (29-1141, $38.47 per hour), 
licensed practical nurses (29-2061, $24.08 per hour), and office and 
administrative assistants (43-0000, $20.38 per hour).\91,92\ These wage 
estimates are multiplied by two to account for non-wage benefits and 
overhead.
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    \91\ Bureau of Labor Statistics (2020). May 2020 National 
Occupational Employment and Wage Estimates: United States. Retrieved 
from https://www.bls.gov/oes/current/oes_nat.htm.
    \92\ Bureau of Labor Statistics (2020). May 2020 National 
Occupational Employment and Wage Estimates: United States. Retrieved 
from https://www.bls.gov/oes/current/oes_nat.htm.
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     An average of 25 (range: 16 to 44) individuals will 
require post-exposure prophylaxis because of exposure to the dog with 
CRVV.93 94
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    \93\ Raybern, C., Zaldivar, A., Tubach, S., Ahmed, F., Moore, 
S., Kintner, C., Garrison, I. (2020) Rabies in a dog imported from 
Egypt-Kansas, 2019. Morbidity and Mortality Weekly Report, 69(38), 
1374-1377. Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6938a5-H.pdf.
    \94\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84,724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
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     The average cost of post-exposure prophylaxis was 
estimated to be $9,524 per person.\95\
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    \95\ Raybern, C., Zaldivar, A., Tubach, S., Ahmed, F., Moore, 
S., Kintner, C., Garrison, I. (2020) Rabies in a dog imported from 
Egypt-Kansas, 2019. Morbidity and Mortality Weekly Report, 69(38), 
1374-1377. Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6938a5-H.pdf.
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     An estimated 29.6 animals would need to be quarantined or 
euthanized due to exposure to the dog with CRVV.
     Public health follow-up of each exposed animal would incur 
economic costs of $1,000 for quarantine or euthanasia.\96\
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    \96\ Centers for Disease Control and Prevention (2019). Guidance 
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to 
the Importation of Dogs Into the United States. Federal Register, 
Vol. 84,724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
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[FR Doc. 2022-11752 Filed 5-26-22; 4:15 pm]
BILLING CODE 4163-18-P