Notice of Extension

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121), ACOT was established pursuant to
42 U.S.C. 217a and, in accordance with
Public Law 92–463, was first chartered
on September 1, 2000. ACOT meets up
to three times during the fiscal year.
Nominations: HRSA is requesting
nominations for voting members to
serve as Special Government Employees
(SGEs) on ACOT. The Secretary
appoints ACOT members with the
expertise needed to fulfill the duties of
the Advisory Committee. Nominees
sought are individuals involved in organ
procurement, organ transplantation
(including, but not limited to, transplant
candidates, recipients, living organ
donors, and families of deceased organ
donors), bioethics, and other medical
specialties involved in organ
transplantation and in the identification
and referral of donors. Interested
applicants may self-nominate or be
nominated by another individual or
organization.
Individuals selected for appointment
to the Committee will be invited to
serve for a term up to 3 years. Members
appointed as SGEs receive a stipend and
reimbursement for per diem and travel
expenses incurred for attending ACOT
meetings and/or conducting other
business on behalf of ACOT, as
authorized by 5 U.S.C. 5703 of the
Federal Advisory Committee Act for
persons employed intermittently in
government service.
The following information must be
included in the package of materials
submitted for each individual being
nominated for consideration: (1) A letter
of nomination stating the name,
affiliation, and contact information for
the nominee, the basis for the
nomination (e.g., what specific
attributes, perspectives, and/or skills
does the individual possess that would
benefit the workings of ACOT), and the
nominee’s field(s) of expertise; (2) a
biographical sketch of the nominee; (3)
the name, address, daytime telephone
number, and email address at which the
nominator can be contacted; and (4) a
current copy of the nominee’s
curriculum vitae. Nomination packages
may be submitted directly by the
individual being nominated or by the
person/organization recommending the
candidate. HRSA requests that
applicants who submitted a nomination
or a self-nomination in the past please
resubmit the required candidate forms.
HHS endeavors to ensure that the
membership of ACOT is fairly balanced
in terms of points of view represented
and that individuals from a broad
representation of geographic areas,
gender, and ethnic and minority groups,
as well as individuals with disabilities,
are considered for membership.

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Appointments shall be made without
discrimination on the basis of age,
ethnicity, gender, sexual orientation, or
cultural, religious, or socioeconomic
status.
Individuals who are selected to be
considered for appointment will be
required to provide detailed information
regarding their financial holdings,
consultancies, and research grants or
contracts. Disclosure of this information
is required for HRSA ethics officials to
determine whether there is a conflict
between the SGE’s public duties as a
member of ACOT and their private
interests, including an appearance of a
loss of impartiality as defined by federal
laws and regulations, and to identify
any required remedial action needed to
address the potential conflict.
Authority: In accordance with 42 CFR
121.12, the Secretary established ACOT
pursuant to 42 U.S.C. 217a. The
Committee is governed by the Federal
Advisory Committee Act (5 U.S.C.
appendix 2), which sets forth standards
for the formation and use of advisory
committees.
Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2023–14502 Filed 7–7–23; 8:45 am]
BILLING CODE 4165–15–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
Extension of Temporary Suspension of
Dogs Entering the United States From
Countries With a High Risk of Rabies
Centers for Disease Control and
Prevention (CDC), Department of Health
and Human Services (HHS).
ACTION: Notice.
AGENCY:

In order to protect the United
States against the potential
reintroduction of the dog-maintained
rabies virus variant (DMRVV) into the
United States, the Centers for Disease
Control and Prevention (CDC), within
the Department of Health and Human
Services (HHS), announces an extension
of the current temporary suspension of
the importation into the United States of
dogs from countries at high-risk for
enzootic rabies (DMRVV high-risk
countries). This suspension includes
dogs that have been in any DMRVV
high-risk countries during the previous
six months.
DATES: The extension of the temporary
suspension of the importation of dogs
into the United States from DMRVV
high-risk countries will be implemented
SUMMARY:

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on August 1, 2023, when the current
suspension expires, and will remain in
effect through July 31, 2024.
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 H16–4, Atlanta, GA
30329. Telephone: 1–800–232–4636.
SUPPLEMENTARY INFORMATION: CDC is
extending, but not modifying, the terms
of the current temporary suspension of
the importation into the United States of
dogs from countries at high-risk for
enzootic rabies (DMRVV high-risk
countries), including dogs that have
been in any DMRVV high-risk countries
during the previous six months. A
suspension remains necessary to protect
the public’s health against the
reintroduction of the dog-maintained
rabies virus variant (DMRVV) into the
United States. There is a continued
threat posed by dogs from DMRVV highrisk countries which are unvaccinated
or inadequately vaccinated against
rabies. This continued threat is due to
various factors, including: a high
volume of dogs being imported into the
United States contemporaneous with
insufficient veterinary controls in
DMRVV high-risk countries to prevent
the export of inadequately vaccinated
dogs, inadequate global veterinary
supply chains for vaccines and related
materials, and persistent workforce
capacity shortages, particularly in
DMRVV high-risk countries that export
dogs to the United States. CDC
anticipates that these factors are likely
to continue over the course of the next
12 months. Considering these factors,
CDC has determined that it is necessary
to extend the temporary suspension
through July 31, 2024, to ensure dogs
imported into the United States do not
pose a public health threat of
reintroducing DMRVV into the United
States.1
1 In consideration of both the anticipated needs
for global rabies vaccine campaigns to return to prepandemic levels and to avoid disruption to
importers’ and the travel industry’s operations, CDC
has determined that a one-year extension of the
temporary suspension is required to protect the
public’s health and is therefore in the public’s
interest. In the absence of a further extension of the
temporary suspension or the adoption of an
alternate framework to mitigate the importation of
dogs infected with rabies, dog importation
requirements would return to procedures that

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Federal Register / Vol. 88, No. 130 / Monday, July 10, 2023 / Notices
Additionally, CDC is publishing a
proposed rule as a companion
document, published elsewhere in this
issue of the Federal Register, that
outlines requirements regarding an
importation system to reduce fraud and
improve the U.S. government’s ability to
verify U.S. entry requirements and
mitigate the introduction of dogs
infected with rabies. If adopted, this
proposed rule would mitigate the need
for further extensions of the temporary
suspension.
I. Background and Authority

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Rabies is one of the deadliest zoonotic
diseases and accounts for an estimated
59,000 human deaths globally each
year.2 This equates to one human death
every nine minutes.3 DMRVV is
responsible for 98 percent of these
deaths.4 The rabies virus can infect any
mammal and, once clinical signs
appear, the disease is almost always
fatal.5 In September 2007, at the
Inaugural World Rabies Day
Symposium, CDC declared the United
States to be free of DMRVV.6 However,
DMRVV is still a serious public health
threat in the more than 100 countries
where it remains enzootic. Preventing
the entry of animals infected with
DMRVV into the United States is a
public health priority.
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.7 Such
proved inadequate to prevent the import of rabid
dogs into the United States.
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 Id.
4 Hampson K, Coudeville L, Lembo T, et al.;
Global Alliance for Rabies Control Partners for
Rabies Prevention. Estimating the global burden of
endemic canine rabies. PLoS Negl Trop Dis
2015;9:e0003709. https://doi.org/10.1371/
journal.pntd.0003709.
5 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.
6 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.
7 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

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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),8 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.
Under 42 CFR 71.51, all dogs
admitted into the United States must be
accompanied by a valid rabies
vaccination certificate,9 unless the dogs’
owners or importers submit satisfactory
evidence that dogs under six months of
age have not been in a DMRVV high-risk
country or dogs older than six months
have not been in a DMRVV high-risk
country during the six months prior to
arrival.10 CDC maintains a publicly
available list of DMRVV high-risk
countries 11 and provides guidance for
dog entry requirements based on the
dog’s country of origin.
CDC subject matter experts review
publicly available data and conduct an
annual assessment to determine which
countries have high risk of DMRVV.12
This assessment considers the following
factors: presence or prevalence of
domestically acquired cases of DMRVV
in humans and animals; efforts towards
control of DMRVV in dogs (such as dog
vaccination coverage, dog population
management, and existence and
enforcement of legal codes to limit
(June 25, 1966), see also Public Law 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.
8 See 42 CFR 71.51(e), 71.63.
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-unitedstates/vaccine-certificate.html.
10 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-agencyinterpretation-of-rabies-free-as-it-relates-to-theimportation-of-dogs.
11 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-unitedstates/rabies-vaccine.html.
12 Henry RE, Blanton JD, Angelo KM, Pieracci EG,
Stauffer K, Jentes ES, Allen J, Glynn M, Brown CM,
Friedman CR, Wallace R. A country classification
system to inform rabies prevention guidelines and
regulations. J Travel Med. 2022 Jul 14;29(4):taac046.
doi: 10.1093/jtm/taac046. PMID: 35348741.

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rabies transmission in dogs); and the
quality of rabies surveillance systems,
rate of testing, and laboratory capacity.
If data are not available, the country is
not considered to have a robust rabies
control program. If a country has
provided additional substantial data to
support a DMRVV-free or DMRVV lowrisk status, CDC can review that
information and reassess the country’s
status.
Under 42 CFR 71.51(e), dogs may be
subject to ‘‘additional requirements as
may be deemed necessary’’ or
‘‘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 DMRVV high-risk
countries constitute areas that have high
rates of DMRVV, and dogs imported
from these countries are thus subject to
additional requirements and/or
exclusion.13
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 DMRVV
exists in countries designated as
DMRVV high-risk countries and that, if
reintroduced into the United States,
DMRVV would threaten the public
health of the United States.
Pursuant to these legal authorities and
determinations made thereunder, on
June 16, 2021, CDC announced a
temporary suspension of the
importation of dogs from DMRVV highrisk countries into the United States to
protect the public health against the
reintroduction of DMRVV into the
United States (the temporary
suspension).14 The temporary
suspension went into effect on July 14,
2021.
CDC found that the temporary
suspension prohibiting the importation
of dogs from DMRVV high-risk
countries for rabies was especially
necessary due to the diversion of public
health resources to respond to the
COVID–19 pandemic. The limited
13 Id.
14 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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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 DMRVV. Despite a
decrease in international travel volumes
due to the global COVID–19 pandemic,
CDC noted an increase in importers
circumventing dog import regulations—
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.
For these reasons, CDC implemented the
temporary suspension in July 2021. In
addition, CDC implemented a CDC Dog
Import Permit 15 during the temporary
suspension to verify the documentation
of imported dogs before they are flown
to the United States.
Since the temporary suspension first
went into effect in July 2021, CDC has
modified the terms of the suspension to
allow for more dog imports as the public
health situation has gradually improved
and as more public health resources
have become available globally. On June
1, 2022, CDC announced a modified and
extended temporary suspension,
effective June 10, 2022 through January
31, 2023.16 The extension and
modification of the temporary
suspension permitted all categories of
importers to import dogs from DMRVV
high-risk countries, while requiring
commercially imported dogs to enter the
United States at a port of entry with a
CDC-approved animal care facility with
a Facilities Information and Resource
Management System (FIRMS) code
issued by U.S. Customs and Border
Protection (CBP).17 CDC also expanded
the list of the approved ports of entry to
include 18 airports 18 with a CDC
quarantine station for importers with a
valid U.S.-issued rabies vaccination
certificate or a CDC Dog Import Permit.
On January 27, 2023, CDC announced
an extension of the temporary
suspension through July 31, 2023,
15 Approved under OMB Control Number 0920–
1383 Importation Regulations (42 CFR 71 Subpart
F) (exp. 1/31/2026, or as revised).
16 Id.
17 Centers for Disease Control and Prevention
(2023). CDC Approved Animal Care Facilities.
Retrieved from https://www.cdc.gov/importation/
bringing-an-animal-into-the-united-states/
approved-care-facilities.html.
18 The 18 approved ports of entry are: 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).

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without modifications.19 The extension
took effect February 1, 2023, and
continues to allow dogs from DMRVV
high-risk countries to enter the United
States under one of the options outlined
in the June 10, 2022, extension.
At this time, CDC is extending the
temporary suspension through July 31,
2024, because of the continued risk for
the reintroduction of DMRVV into the
United States. This extension is based
on the increasing number of dogs being
purchased internationally,20 21 22 23 often
from DMRVV high-risk countries, and
imported into the United States and
other rabies-free countries. This increase
in international purchases of dogs is
occurring contemporaneous with a high
volume of dogs being imported into the
United States and continued disruptions
to rabies vaccination campaigns globally
as a lingering effect of the diversion of
public health resources during the
COVID–19 pandemic. The rate of rabies
in imported dogs is higher than the rate
of domestically acquired rabies in dogs.
Disruptions to rabies vaccination
campaigns globally further elevate that
risk, and CDC anticipates it will take at
least two years, and possibly longer, for
global vaccination campaigns to recover
to pre-pandemic levels. This timeframe
is based on modeling data which
suggest that when rabies vaccination
coverage is disrupted in rabies-free
countries and cases begin occurring,
countries can prevent reestablishment of
the disease in as little as 2 years if 38–
56% of the dog population is vaccinated
annually.24 Additionally, constraints on
the global veterinary workforce capacity
and global veterinary supply chain
shortages have led to delayed or
disrupted care for dogs, which also
increases the likelihood dogs imported
FR 5348 (Jan. 27, 2023).
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.
21 Wynne E. Dog lovers find prices rise steeply
amid COVID-fueled demand. Australian
Broadcasting Corporation News. 20 May 2021.
22 Morgan L, Protopopova A, Birkler RID, ItinShwatz B, Sutton G, Gamliel A, et al. Human-dog
relationships during the COVID–19 pandemic:
booming dog adoption during social isolation.
Humanities and Social Science Communications.
2021; 7(150): 1–11.
23 British Broadcasting Corporation. Illegal puppy
trade warning as sales boom during the COVID
pandemic. 18 NOV 2020. British Broadcasting
Corporation News.
24 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.

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20 Pieracci,

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into the United States may pose a public
health risk.25 26 27 28 29 30
CDC will continue to review and
reassess its list of DMRVV high-risk
countries annually and as additional
substantial data become available.31
Such reviews are consistent with CDC
practices. In conducting this review,
CDC will consider DMRVV high-risk
countries’ rabies control programs, the
latest scientific data, and international
recommendations for rabies control. For
example, in January 2023, CDC
reviewed the list of DMRVV high-risk
rabies countries and determined that
Brunei and Bhutan had documented
sufficient levels of canine rabies
surveillance, canine vaccination, and
laboratory testing over a multi-year
timespan and demonstrated success in
controlling DMRVV within their
respective countries; as a result of this
review Brunei and Bhutan were
removed from the CDC list of DMRVV
high-risk countries.
II. Public Health Rationale
A. Dog Importation Into the United
States
The United States was declared
DMRVV-free in 2007. Importing dogs
from countries at high-risk for rabies
involves a significant public health risk.
The importation of just one dog infected
with DMRVV risks re-introduction of
the virus into the United States; such a
public health threat could result in loss
of human and animal life and
25 Zhang S. The great veterinary shortage. The
Atlantic. July 6, 2022. https://www.theatlantic.com/
health/archive/2022/07/not-enough-veterinariansanimals/661497/.
26 Martin D. Is the veterinarian shortage real or
regional? AGCanada.com July 16, 2021. https://
www.agcanada.com/2021/07/is-the-veterinarianshortage-real-or-regional.
27 The Business Research Company. Companion
animal veterinary vaccines global market report
2023 (. . .). https://
www.thebusinessresearchcompany.com/report/
companion-animal-veterinary-vaccines-globalmarket-report.
28 Lewin R. Aussie dog owners warned of national
vaccine shortage as deadly bacterial disease
spreads. 7 News.com.au. October 17, 2022. https://
7news.com.au/lifestyle/pets/aussie-dog-ownerswarned-of-national-vaccine-shortage-as-deadlybacterial-disease-spreads-c-8568550.
29 Mathew R. Vaccine Shortage, Excess Workload
of Vets Hamper Anti-rabies Vaccination
Programme. Manorama. September 24, 2022.
https://www.onmanorama.com/news/kerala/2022/
09/24/kerala-anti-rabbies-vaccinationprogramme.html.
30 Rabies is Likely to Spread in Sri Lanka in 2023
due to Vaccine Shortages. Business Standard.
January 4, 2023. https://www.businessstandard.com/article/international/rabies-is-likelyto-spread-in-sri-lanka-in-2023-due-to-vaccineshortages-123010400640_1.html.
31 The web page that describes how CDC conducts
the annual assessment of individual countries’
rabies status worldwide is available at https://
www.cdc.gov/rabies/resources/countries-risk.html.

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consequential economic impact.32 33 34
Of additional concern is the fact that
DMRVV has been highly successful at
adapting to new host species,
particularly wildlife. One imported
DMRVV-infected dog could result in a
new variant with potential to become
established within new host species in
the United States.35
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 DMRVV high-risk countries.36 This
estimate was based on information
provided by airlines, CBP staff, and a
study conducted at a U.S.-Mexico land
border crossing.37 Combined import
data from CDC, CBP, and the U.S.
Department of Agriculture (USDA)
suggest that adoptions, rescues,
purchases, and international movement
of dogs from overseas have remained
high since 2018.38 39 40 Demand for
puppies and dogs imported for rescue,
adoption, or resale has remained high
32 World Bank (2012). People, Pathogens and Our
Planet: The Economics of One Health. Retrieved
from https://openknowledge.worldbank.org/handle/
10986/11892.
33 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.
34 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.
35 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.
36 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-agencyinterpretation-of-rabies-free-as-it-relates-to-theimportation-of-dogs.
37 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.
38 Better Business Bureau. Online puppy scams
rising sharply in 2020, BBB warns. 2020 December
2. Available from: https://www.bbb.org/article/
news-releases/23354-bbb-studyupdate-puppyscams-rising-in-2020.
39 Centers for Disease Control and Prevention.
Internal dog import data. August 2021–May 2023.
40 U.S. Customs and Border Protection. Live
animal imports FY 2022 report to congress. Nov 4,
2022.

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since 2021.41 42 43 44 In light of the higher
rate of rabies among imported dogs
compared to dogs in the United States,
the continued high volume of
importations of dogs to the United
States, and the contemporaneous
insufficient veterinary controls,
inadequate veterinary supply chains,
and persistent workforce capacity
shortages in DMRVV high-risk
countries, the risk of rabies importation
into the United States and reintroduction of DMRVV remains
heightened.
The rate of rabies is 14 times higher
in imported dogs when compared to the
rate of rabies acquired domestically by
dogs in the United
States.45 46 47 48 49 50 51 52 During 2015–
2021 there were approximately 700,000
dogs imported from DMRVV high-risk
41 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.
42 Wynne E. Dog lovers find prices rise steeply
amid COVID-fueled demand. Australian
Broadcasting Corporation News. 20 May 2021.
43 Morgan L, Protopopova A, Birkler RID, ItinShwatz B, Sutton G, Gamliel A, et al. Human-dog
relationships during the COVID–19 pandemic:
booming dog adoption during social isolation.
Humanities and Social Science Communications.
2021; 7(150): 1–11.
44 British Broadcasting Corporation. Illegal puppy
trade warning as sales boom during the COVID
pandemic. 18 NOV 2020. British Broadcasting
Corporation News.
45 Centers for Disease Control and Prevention.
Guidance regarding agency interpretation of
‘‘rabies-free’’ as it relates to the importation of dogs
into the United States. Federal Register Notice; 84
FR 724: 724–30. January 31, 2019. Available at:
http://www.federalregister.gov/documents/2019/01/
31/2019-00506/guidance-regarding-agencyinterpretation-of-rabies-free-as-it-relates-to-theimportation-of-dogs.
46 Ma X, Bonaparte S, Toro M, Orciari L, Gigante
C, et al. Rabies surveillance in the United States
during 2020. Journal of the American Veterinary
Medical Association. 2022; 260 (10).
47 Birhane M, Cleaton J, Monroe BP, Wadhwa A,
et al. Rabies surveillance in the United States
during 2015. Journal of the American Veterinary
Medical Association. 2017; 250 (10).
48 Ma X, Monroe BP, Cleaton J, Orciari L, Yager
P, et al. Rabies surveillance in the United States
during 2016. Journal of the American Veterinary
Medical Association. 2018; 252 (8).
49 Ma X, Monroe BP, Cleaton J, Orciari L, Yu L,
et al. Rabies surveillance in the United States
during 2017. Journal of the American Veterinary
Medical Association. 2018; 253 (12).
50 Ma X, Monroe BP, Wallace R, Orciari L, Gigante
C, et al. Rabies surveillance in the United States
during 2019. Journal of the American Veterinary
Medical Association. 2021; 258 (11).
51 Ma X, Bonaparte S, Corbett P, Orciari L,
Gigante C, et al. Rabies surveillance in the United
States during 2021. Journal of the American
Veterinary Medical Association. 2023. DOI: https://
doi.org/10.2460/javma.23.02.0081.
52 Ma X, Monroe BP, Cleaton J, Orciari L, Gigante
C, et al. Public veterinary medicine: Public health:
Rabies surveillance in the United States during
2018. Journal of the American Veterinary Medical
Association. 2020; 256 (2).

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countries of which four were found to
have rabies upon entry into the United
States—an annual incidence rate of 5.7
per 1 million dogs imported. In
comparison, there were an estimated
cumulative 616 million dogs in the
United States during that same time
period,53 of which approximately 240
were found infected with an endemic
wildlife variant of rabies during the
same time—an annual incidence rate of
0.4 per 1 million.
All four rabid dogs imported into the
United States during the 2015–2021
period 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
of a rabid dog.
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.54 Eighteen people
were recommended to receive rabies
post-exposure prophylaxis (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.
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
53 American Veterinary Medical Association. U.S.
pet statistics. Available at: ebusiness.avma.org/files/
ProductDownloads/eco-pet-demographic-report-22low-res.pdf.
54 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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falsified rabies vaccination
documentation presented on entry to
the United States.55
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 Governmentaffiliated rabies laboratory. However,
one dog developed signs of rabies three
weeks after arrival and had to be
euthanized. The dog tested positive for
rabies. As a result, forty-four people
received rabies 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.56 The public health
investigations and rabies PEP of
exposed persons in this case cost more
than $400,000 in state resources.57 58
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 DMRVV 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 investigation of
imported rabid dogs in U.S. history.59
Eighteen people received PEP to prevent
rabies as a result of exposure to this one
rabid dog. Post-vaccination serologic
monitoring of the remaining dogs and
the public health investigation revealed
that improper vaccination practices by
55 Hercules, Y., Bryant, N., Wallace, R., Nelson,
R., Palumbo, G., Williams, J., Brown, C. (2018).
Rabies in a dog imported from Egypt—Connecticut,
2017. Morbidity and Mortality Weekly Report 67,
1388–91. doi:10.15585/mmwr.mm6750a3.
56 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.
57 Id.
58 Centers for Disease Control and Prevention
(2022). Rabies Postexposure Prophylaxis. Retrieved
from https://www.cdc.gov/rabies/medical_care/
index.html.
59 Whitehill F, Bonaparte S, Hartloge C, et al.
Rabies in a Dog Imported from AzerbaijanPennsylvania, 2021. MMWR Morb Mortal Wkly Rep
2022; 71: 686–689.

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the veterinarian in Azerbaijan likely
contributed to the inadequate
vaccination response documented in 48
percent of the imported animals,
including the rabid dog.60 The 33
exposed animals were placed in
quarantine periods ranging from 45 days
to six months based on individual
serologic titer test results and local
jurisdictional requirements.61
CDC estimates that 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
an economic analysis found on CDC’s
website.62 63 64 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 animals
and wildlife species in the United
States. The U.S. National Rabies Control
Program was started in 1944 and
required decades of consistent dog
vaccination and animal control
programs to eliminate DMRVV from the
United States. While the cost has never
been published it is estimated to
approach 1 billion USD in direct rabies
control costs.65
Re-establishment of DMRVV in the
United States would result in costly,
years’ long efforts to eliminate the virus
again. The extraordinary cost of reintroduction of DMRVV is demonstrated
by an instance of reintroduction that
occurred in Texas, where DMRVV had
been previously eliminated. The
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-importeddog.html.
61 Whitehill F, Bonaparte S, Hartloge C, et al.
Rabies in a Dog Imported from AzerbaijanPennsylvania, 2021. MMWR Morb Mortal Wkly Rep
2022; 71: 686–689.
62 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.
63 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-agencyinterpretation-of-rabies-free-as-it-relates-to-theimportation-of-dogs.
64 Centers for Disease Control and Prevention
(2023). What is a Valid Rabies Vaccination
Certificate? Retrieved from https://www.cdc.gov/
importation/bringing-an-animal-into-the-unitedstates/vaccine-certificate.html.
65 Based on assessments made by CDC Rabies
Subject Matter Experts from annual operating costs
to fund the U.S. national rabies control program
including dog vaccination and post exposure
prophylaxis costs.

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reintroduction lasted from 1995–2003
and resulted in several human deaths;
the subsequent re-elimination of
DMRVV cost $60 million (in 2022 USD)
and required over 10 years of effort.66 67
B. Insufficient Canine Vaccination Rates
and Veterinary Controls in DMRVV
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.68 This number is
less than one percent of dog
importations. However, between
January 2020 and July 2021 (i.e., during
the COVID–19 pandemic, prior to the
temporary suspension taking effect),
CDC documented more than 1000
instances of incomplete, inadequate, or
fraudulent rabies vaccination
certificates for dogs arriving from
DMRVV high-risk countries.69 These
cases resulted in dogs being denied
entry into the United States and
ultimately returned to their country of
origin.
The significant increase in the
number of dogs from DMRVV high-risk
countries arriving with incomplete,
inadequate, or fraudulent rabies
vaccination certificates observed in
2020 and 2021 coincided with increased
interest in purchasing dogs from the
international rescues and breeders
during the COVID–19 pandemic.70 71 72
One study noted a global increase in
66 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.
67 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.
68 Centers for Disease Control and Prevention
(2021). Quarantine Activity Reporting System
(version 4.9.8.8.2.2A). Dog Importation data, 2010–
2019. Accessed 1 October 2022.
69 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.
70 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.
71 Wynne E. Dog lovers find prices rise steeply
amid COVID-fueled demand. Australian
Broadcasting Corporation News. 20 May 2021.
72 Morgan L, Protopopova A, Birkler RID, ItinShwatz B, Sutton G, Gamliel A, et al. Human-dog
relationships during the COVID–19 pandemic:
booming dog adoption during social isolation.
Humanities and Social Science Communications.
2021; 7(150): 1–11.

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internet searches on Google regarding
dog adoption during the pandemic.73
Since 2021, the demand for puppies and
rescue dogs has remained high. The
trend in purchasing and rescuing dogs
from abroad has been noted in many
countries, including the United
States.74 75 76 77 Internationally, there has
been significant growth within the
companion animal breeding industry
with increasing international trade.78
Multiple international and U.S.
investigations have identified
importations of puppies that were too
young to meet rabies vaccination
requirements.79 80 81 82 There is growing
evidence that criminal networks are
becoming involved in the lucrative dog
trade, and illegal puppy trade was
reported to have increased during the
pandemic.83 84 85

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73 Id.
74 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.
75 Wynne E. Dog lovers find prices rise steeply
amid COVID-fueled demand. Australian
Broadcasting Corporation News. 20 May 2021.
76 Morgan L, Protopopova A, Birkler RID, ItinShwatz B, Sutton G, Gamliel A, et al. Human-dog
relationships during the COVID–19 pandemic:
booming dog adoption during social isolation.
Humanities and Social Science Communications.
2021; 7(150): 1–11.
77 Velez M. I adopted my dog Cannoli from
overseas. It’s easier than you think. 9/20/2020.
Available at: https://www.thedailybeast.com/iadopted-my-dog-cannoli-from-overseas-its-easierthan-you-think.
78 Maher J, Wyatt T. European illegal puppy trade
and organized crime. Trends in Organized Crime.
2021; 24(4) 506–525.
79 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.
80 Zucca P, Rossman MC, Osorio JE, Karem K, De
Benedictis P, Haifsl J, et al. The ‘bio-crime model’
of cross-border cooperation among veterinary
public health, justice, law enforcements, and
customs to tackle the illegal animal trade/bioterrorism and to prevent the spread of zoonotic
diseases among human population. Frontiers in
Veterinary Science. 2020; 7: 1–13.
81 Cocchi M, Danesi P, DeZan G, Leati M,
Gagliazzo L, et al. A three-year biocrime sanitary
surveillance on illegally imported companion
animals. Pathogens. 2021; 10(80):1–12.
82 Houle MK. Perspective from the field: Illegal
puppy imports uncovered at JFK airport. 2017.
Available at: www.cdc.gov/ncezid/dgmq/featurestories/operation-dog-catcher.html.
83 Maher J, Wyatt T. Rural-urban dynamics in the
UK illegal puppy trade: trafficking and trade in
man’s best friend. International Journal of Rural
Law and Policy. 2019; 9 (2): 1–20.
84 Zucca P, Rossman MC, Osorio JE, Karem K, De
Benedictis P, Haifsl J, et al. The ‘bio-crime model’
of cross-border cooperation among veterinary
public health, justice, law enforcements, and
customs to tackle the illegal animal trade/bioterrorism and to prevent the spread of zoonotic
diseases among human population. Frontiers in
Veterinary Science. 2020; 7: 1–13.

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Additionally, reports of international
movement of animals with missing
microchips, no proof of rabies
vaccination, or underage dogs with
fraudulent vaccination records have
been documented in the United States
and abroad.86 87 The increases in
international dog movement and
fraudulent or questionable paperwork
have raised concerns among state and
local animal and health departments,
breeders and dog organizations, and
veterinary associations. A rabies
serological (antibody) titer is an
estimation of an immune response
against rabies virus (either through
exposure or vaccination). While there is
no ‘‘protective’’ titer against rabies
virus, survival against rabies virus
infection is often more likely to occur
the higher the animal’s titer at the time
of infection.88 The World Organisation
for Animal Health considers a level of
0.5 IU/mL a ‘‘passing’’ antibody titer
level.
A 2015 study found that 53% of
imported rescue dogs arriving in
Norway with rabies vaccinations
administered at least 21 days before
arrival had titers less than 0.5 IU/mL.89
Nineteen percent of dogs in the study
had titers less than 0.1 IU/mL, ‘‘raising
concerns as to whether they had been
vaccinated against rabies at all.’’ 90 Two
rabid dog importation events in the
United States were also extensively
evaluated, including serological
evaluation of all dogs that were
transported together. In these two
events, one in 2019 and one in 2021,
44% (25 of 57) of dogs failed to mount
an anamnestic response to booster
vaccination; an indication that they
were unvaccinated or inappropriately
vaccinated prior to arrival in the US.91 92
85 British Broadcasting Corporation. Illegal puppy
trade warning as sales boom during the COVID
pandemic. 18 NOV 2020. British Broadcasting
Corporation News.
86 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.
87 Zucca P, Rossman MC, Osorio JE, Karem K, De
Benedictis P, Haifsl J, et al. The ‘bio-crime model’
of cross-border cooperation among veterinary
public health, justice, law enforcements, and
customs to tackle the illegal animal trade/bioterrorism and to prevent the spread of zoonotic
diseases among human population. Frontiers in
Veterinary Science. 2020; 7: 1–13.
88 CDC. Rabies Serology. Available at:
www.cdc.gov/rabies/specific_groups/hcp/
serology.html#What%20Does%20A
%20Rabies%20Virus%20Titer%20Mean?
89 Klevar S, Hogasen HR, Davidson RK, Hammes
IS, Treiberg Berndtsson L, LundA. Cross-border
transport of rescue dogs may spread rabies in
Europe. The Veterinary Record. 2015; 176 (26): 672.
90 Id.
91 Raybern, C., Zaldivar, A., Tubach, S., Ahmed,
F., Moore, S., Kintner, C., Garrison, I. (2020) Rabies

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During the COVID–19 pandemic,
canine rabies vaccination campaigns
were suspended in many DMRVV highrisk countries, which resulted in an
increase in canine and human rabies
cases.93 94 The pause in canine
vaccination campaigns and the delay in
re-establishing pre-COVID rabies
vaccination rates in dogs in many
DMRVV high-risk countries, combined
with insufficient veterinary controls to
prevent or eliminate DMRVV within a
country,95 as well as prevent the
exportation of inadequately vaccinated
dogs with fraudulent paperwork,
presents an ongoing and significant
public health risk.
A survey of global, regional, national,
and local partners from the network of
the United Against Rabies Forum 96 and
rabies practitioners found that the global
COVID–19 pandemic impacted rabies
control efforts in many DMRVV highrisk countries during 2020. The study
authors reported that dog vaccinations
were administered as planned in just
four percent of the countries for which
data were available. Around half of
respondents reported that funds for
rabies control were diverted to COVID–
19 activities. Among respondents who
reported diversion of rabies control
funds to COVID–19 responses, they
reported that animal rabies vaccines and
dog vaccination campaigns were often
the first rabies control activities to be
cut.97
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.
92 Whitehill F, Bonaparte S, Hartloge C, et al.
Rabies in a Dog Imported from AzerbaijanPennsylvania, 2021. MMWR Morb Mortal Wkly Rep
2022; 71: 686–689.
93 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 costeffectiveness analysis. Scientific Reports, 11, 12476.
doi:10.1038/s41598–021–92067–5.
94 Raynor, B., Dı
´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.
95 WHO Expert Consultation on Rabies, third
report. Geneva: World Health Organization; 2018
(WHO Technical Report Series, No. 1012). License:
CC BY–NC–SA 3.0 IGO.
96 A forum supported by the Food and
Agriculture Organization of the United Nations, the
World Organisation for Animal Health, and the
World Health Organization (the Tripartite), which
takes a multi-sectoral, One Health approach
bringing together governments, vaccine producers,
researchers, non-governmental organizations and
development partners to end human deaths from
dog-mediated rabies.
97 Nadal D, Abela-Ridder B, Beeching S,
Cleaveland S, Cronin K, Steenson R and Hampson
K (2022). The Impact of the First Year of the

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Additionally, global veterinary
workforce capacity and global
veterinary supply chain shortages that
have led to delayed or disrupted care for
dogs (and other pets) have been
exacerbated by the COVID–19
pandemic. The lack of veterinarians,
veterinary technicians, and other animal
care staff who are available to provide
care for dogs prior to travel, combined
with a lack of veterinary supplies such
as drugs and vaccines, increase the
likelihood dogs imported into the
United States may pose a public health
threat. 98 99 100 101 Challenges with rabies
vaccine administration, distribution,
potency, quality, and storage in many
countries also contributed to inadequate
protection against rabies prior to the
pandemic; these challenges continue as
public health infrastructure recovers
post-pandemic.102 103 104 105 The
extension of the temporary suspension
is intended to provide time for CDC and
its partners to build a robust dog
importation system that better protects
U.S. public health from these
challenges.

COVID–19 Pandemic on Canine Rabies Control
Efforts: A Mixed-Methods Study of Observations
About the Present and Lessons for the Future. Front
Trop Dis 3:866811.doi: 10.3389/fitd.2022.866811.
98 Zhang S. The great veterinary shortage. The
Atlantic. July 6,2022. https://www.theatlantic.com/
health/archive/2022/07/not-enough-veterinariansanimals/661497/.
99 Martin D. Is the veterinarian shortage real or
regional? AGCanada.com July 16, 2021. https://
www.agcanada.com/2021/07/is-the-veterinarianshortage-real-or-regional.
100 The Business Research Company. Companion
animal veterinary vaccines global market report
2023 (. . .). https://
www.thebusinessresearchcompany.com/report/
companion-animal-veterinary-vaccines-globalmarket-report.
101 Lewin R. Aussie dog owners warned of
national vaccine shortage as deadly bacterial
disease spreads. 7 News.com.au. October 17,2022.
https://7news.com.au/lifestyle/pets/aussie-dogowners-warned-of-national-vaccine-shortage-asdeadly-bacterial-disease-spreads-c-8568550.
102 Hu RL, Fooks AR, Zhang SF, Liu Y, Zhang F.
Inferior rabies vaccine quality and low
immunization coverage in dogs in China. Epidemiol
Infect. 2008; 136: 1556–63.
103 Yale G, Sudarshan S, Taj S, Patchimuthu GI,
Mangalanathan BV, et al. Investigation of protective
level of rabies antibodies in vaccinated dogs in
Chennai, India. VetRecord. 2021; 8: e8.
104 Whitehill F, Bonaparte S, Hartloge C, et al.
Rabies in a Dog Imported from AzerbaijanPennsylvania, 2021. MMWR Morb Mortal Wkly Rep
2022; 71: 686–689.
105 Rota Modari E, Alonso S, Mancin M, De Nardi
M, Hudson-Cooke S, Veggiato C, et al. Rabies
vaccination: higher failure rates in imported dogs
than those vaccinated in Italy. Zoonoses and Public
Health 2022; 64 (2): 146–55.

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C. Potentially Unsafe Conditions for
Dogs Arriving From DMRVV High-Risk
Countries Without Appropriate Rabies
Vaccination Certificates
Prior to the implementation of the
temporary suspension of the
importation of dogs from countries at
high-risk for rabies in July 2021, dogs
arriving from DMRVV high-risk
countries without appropriate rabies
vaccination certificates were denied
entry to the United States and returned
to the country of origin on the next
available flight.106 Airlines were
required to house dogs awaiting return
to their country of origin at a facility
meeting the USDA’s Animal Welfare
Act standards, preferably a live animal
care facility with an active custodial
bond and a FIRMS code issued by CBP.
If a live animal care facility with a CBPissued FIRMS code was not available,
the airline was required to, at a
minimum, provide accommodation
meeting the USDA’s Animal Welfare
Act standards.107
However, due to the prolonged
periods of time between flights, some
airlines housed dogs in cargo
warehouses. These accommodations
created an unsafe environment for dogs
because of 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.
Because of the COVID–19 pandemic,
there were fewer international flights
worldwide in 2020,108 109 resulting in
106 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-agencyinterpretation-of-rabies-free-as-it-relates-to-theimportation-of-dogs.
107 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.
108 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-cutssummer-international-flights-by-60percent-asdemand-suffers.html.
109 American Airlines (2020). American Airlines
announces additional schedule changes in response
to customer demand related to COVID–19.

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delayed returns for dogs denied entry.
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.110
While costs associated with housing,
caring for, 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 U.S.
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 U.S.
Government is left to bear these costs
when airlines and importers do not.
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 DMRVV high-risk
countries. 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.
During 2020, CDC observed a 52
percent increase (from an average of 300
to 450) in the number of dogs found to
be ineligible for entry compared to 2018
and 2019.111 The trend continued in the
first half of 2021 when there was a 24
percent increase (from 450 to 560) in the
number of dogs ineligible for entry
American Airlines Newsroom. Retrieved from
https://news.aa.com/news/news-details/2020/
American-Airlines-Announces-AdditionalSchedule-Changes-in-Response-to-CustomerDemand-Related-to-COVID-19-031420-OPS-DIS-03/
default.aspx.
110 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-17others-saved-after-being-left-without-food-or-waterfor-3-days.
111 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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Federal Register / Vol. 88, No. 130 / Monday, July 10, 2023 / Notices
compared to the whole of 2020.112 From
January 1, 2021, to July 13, 2021, prior
to CDC’s temporary 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,
when the temporary suspension was
initially implemented, to March 1, 2023,
CDC has denied entry to 185 dogs, and
12 sick dogs and 34 deaths have been
reported to CDC. This substantial
decrease in the number of dogs denied
entry (average of 93 dogs/month presuspension compared to 8 dogs/month
during the suspension) since the
implementation of the temporary
suspension and reduced number of sick
and dead dogs (average of 3 sick dogs/
month pre-suspension compared to 0.6
sick dogs/month during the suspension;
3 dead dogs/month compared to 1.6
dead dogs/month during the
suspension) arriving in the United
States has resulted in an estimated
$46,000 to $154,000 in cost savings to
importers and $2,400 to $120,000 in
cost savings to Federal, state, and local
public health and animal health
agencies when comparing the two
periods. The risk of dogs dying while
being held in unsafe conditions
continues however and, in the absence
of a return to pre-pandemic global
vaccination campaigns and public
health resources, would likely be
exacerbated if the temporary suspension
were to be lifted at this time. For
example, in March 2023, a dog arrived
at a port of entry without a CDCapproved animal care facility and was
housed by the airline in a cargo
warehouse where it was later found
dead.
Since the temporary suspension
initially took effect in mid-July 2021,
the number of dogs denied entry and the
number of sick and dead dogs has
decreased substantially despite the
increased communicable disease risk
due to pandemic-related disruptions to
vaccination programs in DMRVV highrisk countries and veterinary supply
chain and staffing shortages worldwide.
These data constitute strong evidence
that the suspension has been effective at
preventing the importation of dogs that
present a communicable disease risk
that would otherwise require significant
U.S. resources to address. Prior to the
temporary suspension, an increasing
number of dogs were denied entry into
the United States in 2020 and 2021, and
there were fewer international flights in

2020 and 2021 compared to 2022.113 If
the increased number of international
flights in 2023 corresponds with
numbers of dogs denied entry per flight
in 2020 and 2021, then lifting the
temporary suspension at this time,
absent other public health measures,
could result in a number of dogs denied
entry equal to or greater than presuspension numbers. A concomitant
increase in the number of sick, dead, or
inadequately vaccinated dogs arriving in
the United States could quickly
overwhelm local public health and
veterinary healthcare systems which do
not have resources to provide long-term
care or quarantine for imported dogs.
Because there remains an elevated
level of risk of a rabid dog being
imported into the United States and
responding to imports of potentially
rabid dogs or dogs with other
communicable illnesses of public health
concern requires significant veterinary
and public health resources, lifting the
temporary suspension would be
unwarranted at this time.
Instead, CDC is extending the
temporary suspension for dogs arriving
into the United States from DMRVV
high-risk countries. Given that
temporary suspension has proven
successful in preventing the
reintroduction of DMRVV into the
United States and has resulted in a
decrease in the number of issues with
imported dogs (i.e., suspected
fraudulent documentation, dogs
abandoned by importers, sick and dead
dogs arriving in the United States)
compared to the period prior to the
temporary suspension, maintaining the
current requirements for dog
importation should not result in an
increased need for veterinary and public
health resources to address dog
importation issues. As noted above, in
a companion document published
elsewhere in this Federal Register, CDC
is proposing a rule revising entry
requirements that outlines a framework
and set of operations that would
mitigate the need for further extensions
of the temporary suspension, should
these procedures be adopted.

112 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.

113 U.S. Bureau of Transportation Statistics.
(2022) August 2022 U.S. Airline Traffic Data.
https://www.bts.gov/newsroom/august-2022-usairline-traffic-data.

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III. Conditions for Entry of U.S.Vaccinated Dogs During the Extension
CDC is extending without
modification the terms of the current
temporary suspension, which was
effective February 1, 2023. Dogs
returning to the United States from
DMRVV high-risk countries with a valid

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43577

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 an International Standards
Organization (ISO)-compatible
microchip;
• Arrives at one of 18 CDC-approved
ports of entry with CDC-staffed
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 (84 days) of age and at least
four weeks (28 days) before the date of
arrival in the United States if it was the
dog’s first rabies vaccine. The rabies
vaccination certificate must include:
Æ Name and address of owner;
Æ Breed, sex, date of birth
(approximate age if date of birth
unknown), color, markings, and other
identifying information for the dog;
Æ Microchip number;
Æ Date of rabies vaccination and date
next vaccine is due (i.e., date the
vaccination expires);
Æ Vaccine manufacturer, product
name, lot number, and product
expiration date; and
Æ Name, license number, address,
and signature of veterinarian who
administered the vaccination.
U.S. veterinarians, at their option,
may choose to include the above
information on the CDC Rabies
Vaccination and Microchip Record 114
for U.S.-vaccinated dogs prior to
traveling outside the United States, but
completion of the form is not required
for a U.S.-vaccinated dog’s re-entry into
the United States if all other necessary
information has been provided.
U.S.-vaccinated dogs with expired
U.S. rabies vaccination certificates must
meet the requirements for foreignvaccinated dogs after being revaccinated
prior to U.S. entry.
There is no limit on the number of
U.S.-vaccinated dogs with valid U.S.issued rabies vaccination certificates
that an importer can import.
These requirements are consistent
with CDC’s practices as of December 1,
2021 and are a continuation of the terms
of the extended temporary suspension
announced in the January 27, 2023
Federal Register notice.115
114 (OMB No. 0920–1383); the form is available
for download online at: www.cdc.gov/dogpermit.
115 88 FR 5348 (Jan. 27, 2023), effective February
1, 2023.

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Federal Register / Vol. 88, No. 130 / Monday, July 10, 2023 / Notices

IV. Conditions for Entry of ForeignVaccinated Dogs With a CDC Dog
Import Permit During the Extension

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CDC is continuing to require foreignvaccinated dogs to meet the terms of the
temporary suspension published in the
January 27, 2023 Federal Register
notice.116 Importers of personal pet dogs
may receive up to two CDC Dog Import
Permits (i.e., permits for two dogs)
during the temporary suspension
period.117 Commercial importers and
personal pet owners who do not have
serologic titer results or CDC Dog Import
Permits for their dogs will also continue
to have an alternate pathway for
importation as outlined in Section V.
All importers of personal pet dogs
(defined for the purpose of this notice
as owners or importers who are not
importing for the purpose of resale,
rescue, or adoption and who are
attempting to import fewer than three
dogs total between August 1, 2023-July
31, 2024) from DMRVV high-risk
countries are 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 or those
being imported for resale, rescue, or
adoption) are not eligible to apply for a
CDC Dog Import Permit and their dogs
must meet the alternate pathway
requirements for entry outlined in
Section V below.
Foreign-vaccinated dogs arriving from
DMRVV 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 an ISO-compatible microchip;
• Have a CDC Rabies Vaccination and
Microchip Record 118 completed by the
veterinarian who administered the
rabies vaccine. The record must state
that the vaccine was administered on or
after the date the dog was 12 weeks (84
days) of age. The record must be in
English;

116 Id.
117 The two-permit limit is for the effective date
of this notice from August 1, 2023–July 31,2024.
118 Approved under OMB Control Number 0920–
1383 Importation Regulations (42 CFR 71 subpart F)
(exp. 1/31/2026, or as revised).

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• Have serologic evidence of rabies
vaccination (titer) from an approved
rabies serology laboratory 119 (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
• Arrive at one of the 18 CDCapproved ports of entry with CDCstaffed 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.120
The importer’s application, with all
supporting documentation, must be
submitted at least 30 business days (i.e.,
excluding weekends and U.S. Federal
holidays) before the date on which the
dog will enter the United States.
Importers may submit an application
electronically at www.cdc.gov/
dogpermit. An application 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
departure on the next available flight or
if the dog meets the requirements
outlined in Section V, the dog may be
quarantined at the importer’s expense at
a CDC-approved animal care facility (if
one is located at the port of entry where
the dog arrived) pending availability
and payment of all associated
examination, revaccination, and
quarantine fees upfront.
Within 10 days of arrival, foreignvaccinated dogs with a CDC Dog Import
Permit must receive a USDA-licensed
rabies booster vaccination administered
by a U.S. veterinarian.
V. Conditions for Entry of ForeignVaccinated Dogs Without a CDC Dog
Import Permit During the Extension
CDC is continuing the requirements of
the temporary suspension published in
the January 27, 2023, Federal Register
notice 121 that provide an alternate
pathway for importers of personally
owned pets who do not have a CDC Dog
Import Permit and for commercial dog
importers to import dogs. While
importers of commercial shipments of
dogs cannot apply for a CDC Dog Import
119 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-unitedstates/approved-labs.html.
120 Approved under OMB Control Number 0920–
1383 Importation Regulations (42 CFR 71 Subpart
F) (exp. 1/31/2026, or as revised). The permit
application is available online at www.cdc.gov/
dogpermit.
121 88 FR 5348 (Jan. 27, 2023), effective February
1, 2023.

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Permit, a separate entry process, as
outlined below, has been established.
All commercial dog importers from
DMRVV high-risk countries may import
dogs provided that the dogs, upon
entering the United States, are
examined, revaccinated, and have proof
of an adequate titer from a CDCapproved laboratory upon arrival or are
held in quarantine at a CDC-approved
animal care 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 of the following requirements:
• Dogs must enter at a port of entry
with a CDC-approved animal care
facility; 122
• Dogs must be six months of age or
older at the time of entry;
• Dogs must have an ISO-compatible
microchip; and
• Dogs must have a CDC Rabies
Vaccination and Microchip Record 123
completed by the veterinarian who
administered the rabies vaccine. The
record must be complete and state that
the vaccine was administered on or after
the date the dog was 12 weeks (84 days)
of age. The record must be in English;
• Importers must provide all required
entry documents (CDC Rabies
Vaccination and Microchip Record,
serologic titer results if available, photos
of dogs’ teeth) to the CDC-approved
animal care facility at least 10 days
before the dogs’ arrival;
• Importers must arrange for an
examination date and time and reserve
space with a CDC-approved animal care
facility;
• Importers must arrange for
transportation by a CBP-bonded
transporter (i.e., provided by the airline
carrier or a CDC-approved animal care
facility) to a CDC-approved animal care
facility immediately upon the dogs’
arrival to the United States; and
• Dogs must undergo veterinary
examination and revaccination against
rabies at a CDC-approved animal care
facility upon arrival at the importer’s
expense.
Dogs must also be held at the CDCapproved animal care facility until the
following entry requirements are
completed:
• Veterinary health examination by a
USDA-accredited veterinarian for signs
of illness, including zoonotic or foreign
122 Centers for Disease Control and Prevention
(2022). Bringing a dog into the United States.
Retrieved from www.cdc.gov/dogtravel.
123 Approved under OMB Control Number 0920–
1383 Importation Regulations (42 CFR 71 Subpart
F) (exp. 1/31/2026, or as revised).

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animal diseases. Suspected or
confirmed zoonotic or foreign animal
diseases must be reported to CDC,
USDA, the state or territorial public
health veterinarian, and the state or
territorial veterinarian;
• The CDC-approved animal care
facility must report all signs of illness or
parasitism to CDC and may 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; and
• Verification of adequate rabies titer
from a CDC-approved laboratory.124
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
laboratory must be housed at the CDCapproved animal care facility for a 28day 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,
revaccination, and quarantine fees.
Foreign-vaccinated dogs arriving
without a CDC Dog Import Permit must
enter the United States through a CDCapproved port of entry with a CDCapproved animal care facility. As of May
1, 2023, these facilities are located at:
Atlanta Hartsfield-Jackson International
Airport, John F. Kennedy International
Airport (New York), Los Angeles

International Airport, Miami
International Airport, and Washington
Dulles International Airport (outside
Washington, DC). Importers are
responsible for reserving examination
times and space at the CDC-approved
animal care facility prior to arrival in
the United States. Dogs that arrive at
unapproved ports of entry or without
reservations at a CDC-approved animal
care facility will be denied entry and
returned to the country of departure.
VI. Continued Conditions for All Dogs
From DMRVV High-Risk Countries
During the Extension
Consistent with the terms of the
original temporary suspension
published in the June 16, 2021, Federal
Register notice,125 all dogs arriving from
DMRVV 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 CDC Rabies Vaccination and
Microchip Record or U.S.-issued rabies
vaccination certificate. The microchip
must be ISO-compatible.
Any dog from a DMRVV high-risk
country not otherwise meeting the
requirements outlined in Sections III–V
above will be excluded from entering
the United States and returned to its
country of departure on the next
available flight, regardless of carrier or
route, if the dog arrives under any of the
following circumstances:
• A dog arrives in the United States
and does not meet the minimum prearrival requirements (i.e., age greater
than six months, microchip, and either
valid U.S.-issued rabies vaccination
certificate or complete and accurate
CDC Rabies Vaccination and Microchip
Record);
• A dog presented does not match the
description of the animal listed on the
permit (if required), U.S. rabies

43579

vaccination certificate, or CDC Rabies
Vaccination and Microchip Record;
• A dog arrives at an unapproved port
of entry;
• A dog arrives at an airport with a
CDC-approved animal care facility
without a reservation and no space at
the facility is available; or
• Importer refuses transportation to,
or receipt of, or payment for services at,
a CDC-approved animal care facility (if
required). CDC may consider the dog
abandoned and transfer custody of the
dog to the airline carrier for final
disposition.
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 care 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.
VII. Additional Determinations
Relating to This Notice
Pursuant to the terms of this notice,
CDC is extending the temporary
suspension for the importation of dogs
from DMRVV high-risk countries. This
suspension includes dogs originating in
DMRVV low-risk or DMRVV-free
countries that have been in a DMRVV
high-risk country in the previous six
months (not including animals
transiting through DMRVV high-risk
countries).
To enter the United States, dogs
imported from a DMRVV high-risk
country must meet certain entry
requirements as described in Sections III
through V of this notice.

TABLE 1—ENTRY CONDITIONS FOR DOGS UNDER EXTENDED TEMPORARY SUSPENSION
Dogs with valid U.S. rabies vaccination
certificate (RVC)

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At least six months of age .....................
Microchip ................................................
Entry allowed at 18 ports of entry with
CDC quarantine station.

Titer not needed .....................................

Dogs with valid CDC
Dog ImportPermit
(fewer than three dogs being imported
with titer)

Dogs with valid CDC Rabies
Vaccination and Microchip Record
without titer

Dogs with valid CDC Rabies
Vaccination and Microchip Record
with titer

At least six months of age ....................
Microchip ...............................................
Entry allowed at 18 ports of entry with
CDC quarantine station with valid
CDC Dog Import Permit issued prior
to arrival.
Serologic titer (≥0.5 IU/mL) from a
CDC-approved laboratory. Titer
drawn at least 45 days before entry
and not more than 365 days before
entry.

At least six months of age ....................
Microchip ...............................................
Entry allowed at five ports of entry with
CDC-approved animal care facility.

At least six months of age.
Microchip.
Entry allowed at five ports of entry with
CDC-approved animal care facility.

Not applicable * .....................................

Serologic titer (≥0.5 IU/mL) from a
CDC-approved laboratory. Titer
drawn at least 45 days before entry
and not more than 365 days before
entry.

124 Approved laboratories can be found at:
www.cdc.gov/importation/bringing-an-animal-intothe-united-states/approved-labs.html.

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125 86 FR 32041 (June 16, 2021), effective July 14,
2021.

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Federal Register / Vol. 88, No. 130 / Monday, July 10, 2023 / Notices
TABLE 1—ENTRY CONDITIONS FOR DOGS UNDER EXTENDED TEMPORARY SUSPENSION—Continued

Dogs with valid U.S. rabies vaccination
certificate (RVC)

Dogs with valid CDC
Dog ImportPermit
(fewer than three dogs being imported
with titer)

Dogs with valid CDC Rabies
Vaccination and Microchip Record
without titer

No quarantine ........................................

No quarantine .......................................

Veterinary exam, booster vaccination or
quarantine not required unless the
animal appears ill upon arrival.

Veterinary exam or quarantine not required with valid CDC Dog Import
Permit unless the animal appears ill
upon arrival. Booster vaccination is
required within 10 days of arrival by
U.S. veterinarian.

28-day quarantine at CDC-approved
animal care facility.
Veterinary examination, booster vaccination, and paperwork verification
at CDC-approved animal care facility
required upon arrival.

Dogs with valid CDC Rabies
Vaccination and Microchip Record
with titer
No quarantine.
Veterinary examination, booster vaccination, and paperwork verification
at CDC-approved animal care facility
required upon arrival.

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* This is an alternate pathway for importation in the event documentation of an adequate titer is not available upon arrival.

The temporary suspension will
continue to reduce the risk of
importation of DMRVV and ensure
public health safeguards are in place for
the importation of dogs from DMRVV
high-risk countries. The terms of the
temporary suspension allow for
sufficient safeguards to mitigate the
public health risk. The temporary
suspension will also allow CDC to
continue to work with Federal partners
and the animal transportation industry
to implement more streamlined
processes for verification of vaccination
records prior to travel. The proposed
rule issued as a companion document
published elsewhere in this Federal
Register reflects these streamlined
processes. CDC will also continue to
identify additional animal care facilities
for the safe housing of animals arriving
at ports of entry. Most importantly, it
will ensure that U.S. public health
remains protected.
Therefore, pursuant to 42 CFR
71.51and 42 CFR 71.63, CDC hereby
excludes the entry and suspends
(subject to the terms and conditions
outlined in this notice) the importation
of dogs from DMRVV high-risk
countries, including dogs from DMRVV
low-risk and DMRVV-free countries if
the dogs have been present in a DMRVV
high-risk country in the previous six
months.
Additionally, under 42 CFR 71.63,
CDC continues to find that DMRVV
exists in countries designated as
DMRVV high-risk countries and that, if
reintroduced into the United States,
DMRVV would threaten the public
health of the United States. The
continued entry of dogs from DMRVV
high-risk countries in the context of
rabies vaccination campaign disruptions
and veterinary supply and veterinary
workforce shortages as a result of the
COVID–19 pandemic, as well as the
insufficient safeguards in place to
prevent the exportation of inadequately
vaccinated dogs from DMRVV high-risk
countries, further increases the risk that
DMRVV may be introduced,

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transmitted, or spread into the United
States. CDC has coordinated in advance
with other Federal agencies as necessary
to implement and enforce this notice.
CDC further clarifies through this
notice that there is no agency policy of
using the ‘‘least restrictive means’’ (as
that concept is typically understood and
applied in cases involving interests
protected by the U.S. Constitution) in
regard to animal importations under 42
CFR part 71. ‘‘The Due Process Clause
of the Fourteenth Amendment imposes
procedural constraints on governmental
decisions that deprive individuals of
liberty or property interests.’’ Nozzi v.
Hous. Auth. Of City of Los Angeles, 806
F.3d 1178, 1190 (9th Cir. 2015).
However, ‘‘[d]ue process protections
extend only to deprivations of protected
interests.’’ Shinault v. Hawks, 782 F.3d
1053, 1057 (9th Cir. 2015). Because
individuals have no protected property
or liberty interest in importing dogs into
the United States, it is CDC’s policy to
not employ a constitutional analysis of
‘‘least restrictive means’’ in regard to
animal imports under 42 CFR part 71.
See Ganadera Ind. v. Block, 727 F.2d
1156, 1160 (D.C. Cir. 1984) (‘‘no
constitutionally-protected right to
import into the United States’’); see also
Arjay Assoc. v. Bush, 891 F.2d. 894, 896
(Fed. Cir. 1989) (‘‘It is beyond cavil that
no one has a constitutional right to
conduct foreign commerce in products
excluded by Congress.’’).
Notwithstanding, to the extent that
any court determines that an analysis of
‘‘least restrictive means’’ is necessary,
CDC finds and asserts that the measures
contained in this notice constitute the
least restrictive means of protecting the
public’s health from the reintroduction
of DMRVV. Although a complete ban on
all dog imports would arguably provide
a greater level of public health
protection, it would deprive individuals
of the many benefits arising from dog
imports including the companionship
offered by pet dogs. Similarly, removing
all restrictions at this time (as has been
explained in this notice) would

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endanger the public’s health and risk
the reintroduction of DMRVV based on,
among other things, the high volume of
imported dogs contemporaneous with
insufficient veterinary controls in
DMRVV high-risk countries to prevent
the export of inadequately vaccinated
dogs as well as inadequate veterinary
supply chains and persistent workforce
capacity shortages in DMRVV high-risk
countries that export dogs to the United
States. Accordingly, in establishing the
terms and conditions of this notice, CDC
has carefully balanced the need to
protect the public’s health against the
potential burden on importers and
determined that the measures in this
notice constitute the least restrictive
means.
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
high volume of imported dogs
contemporaneous with insufficient
veterinary controls in DMRVV high-risk
countries to prevent the export of
inadequately vaccinated dogs,
inadequate veterinary supply chains,
and persistent workforce capacity
shortages in DMRVV high-risk countries
that export dogs to the United States, 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
assure potential dog importers and other
interested parties that the terms of the
temporary suspension have not
changed, and therefore does not require

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Federal Register / Vol. 88, No. 130 / Monday, July 10, 2023 / Notices

lotter on DSK11XQN23PROD with NOTICES1

changes to their current operations and
will remain in effect through July 31,
2024.
CDC has further determined that good
cause exists for a one-year extension of
the temporary suspension through July
31, 2024, to address public health
concerns regarding importation of dogs
infected with rabies. Moreover, in
parallel to this notice announcing the
extension of the temporary suspension,
CDC is proposing a rule revising entry
requirements to address these concerns
regarding importation of rabid dogs and
fraudulent vaccination documentation.
The proposed rule outlines a framework
and set of operations that would
mitigate the need for further extensions
of the temporary suspension, should
these procedures be adopted. In
consideration of both the anticipated
needs for global rabies vaccine
campaigns to return to pre-pandemic
levels and to avoid disruption to
importers’ and the travel industry’s
operations, CDC has determined that a
one-year extension of the temporary
suspension through July 31, 2024, is
required to protect the public’s health
and is therefore in the public’s interest.
In the absence of further extension of
the temporary suspension, dog
importation requirements would return
to procedures that proved inadequate to
prevent the import of rabid dogs into the
United States. A one-year extension
provides time for CDC to continue to
build a robust dog importation system
while global rabies vaccination efforts
continue to rebound. It will also avoid
potential public confusion regarding
changing dog importation requirements
and better address the needs of
importers, the animal care and transport
industry, and Federal partners who have
indicated they would need time to
adequately prepare for any changes to
their current operations. The proposed
rule published in parallel with this
extension provides an opportunity for
public comment and input on any new
procedures.
This temporary suspension will enter
into effect on August 1, 2023, and
remain in effect through July 31, 2024,
unless modified or rescinded by the
CDC Director based on public health or
other considerations.
Kathryn Wolff,
Chief of Staff, Centers for Disease Control
and Prevention.
[FR Doc. 2023–14342 Filed 7–6–23; 4:15 pm]
BILLING CODE 4163–18–P

DEPARTMENT OF HOMELAND
SECURITY
[CIS No. 2751–23; DHS Docket No. USCIS–
2023–0008]
RIN 1615–ZC01

Implementation of a Family
Reunification Parole Process for
Guatemalans
Department of Homeland
Security.
ACTION: Notice of implementation of a
family reunification parole process for
Guatemalans.
AGENCY:

This notice announces the
U.S. Department of Homeland Security’s
(DHS) creation and implementation of a
family reunification parole process
(FRP) for Guatemalans. Under this
process, certain Guatemalan principal
beneficiaries of an approved Form I–
130, Petition for Alien Relative, and
their immediate family members, will
be issued advance authorization to
travel to the United States to seek a
discretionary grant of parole into the
United States for a period of up to three
years, rather than remain outside the
United States while awaiting
availability of their immigrant visas.
This process will allow family members
to reunite in the United States while
they wait for their immigrant visas to
become available. This process is
voluntary and intended to provide an
additional lawful, safe, and orderly
avenue for migration from Guatemala to
the United States as an alternative to
irregular migration to help relieve
pressure at the Southwest Border (SWB)
and reunite families, consistent with
U.S. national security interests and
foreign policy priorities. The process
complements other efforts to
collaboratively manage migration in the
Western Hemisphere and at the SWB as
the U.S. Government (USG) continues to
implement its broader, multi-pronged,
and regional strategy to address the
challenges posed by irregular migration.
DATES: DHS will begin using the Form
I–134A, Online Request to be a
Supporter and Declaration of Financial
Support, for this process on July 10,
2023.
SUMMARY:

FOR FURTHER INFORMATION CONTACT:

Rena´ Cutlip-Mason, Chief,
Humanitarian Affairs Division, Office of
Policy and Strategy, U.S. Citizenship
and Immigration Services, Department
of Homeland Security, by mail at 5900
Capital Gateway Drive, Camp Springs,
MD 20746, or by phone at 800–375–
5283.
SUPPLEMENTARY INFORMATION:

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43581

I. Background
This notice describes the
implementation of a new parole process
for certain Guatemalan nationals and
their immediate family members,1
including the eligibility criteria and
filing process. The parole process is
intended to reunite families more
quickly and offer an alternative to
dangerous irregular migration routes
through North and Central America to
the United States by providing a process
for certain Guatemalans and their
immediate family members to lawfully
enter the United States in a safe and
orderly manner.
The USG is committed to
implementing a comprehensive
framework to manage migration through
North and Central America.2 Executive
Order (E.O.) 14010 called for a fourpronged approach, including:
addressing the root causes of irregular
migration; managing migration
throughout the region collaboratively
with other nations and stakeholders;
restoring and enhancing the U.S. asylum
system and the process for migrants at
the SWB to access this system; and
creating and expanding lawful pathways
for migrants to enter the United States
and seek protection.3
In July 2021, the National Security
Council (NSC) published the U.S.
Strategy for Addressing the Root Causes
of Migration in Central America.4 This
strategy outlined a comprehensive
framework within which federal
government agencies would work
collaboratively to address the root
causes of irregular migration through
Central America, noting long-standing
political instability, insecurity, and
climate change in the region. Also in
July 2021, the NSC published the
Collaborative Migration Management
Strategy, which described U.S. strategy
to collaboratively manage migration
1 Throughout this notice, ‘‘immediate family
members’’ is used as a shorthand for the derivative
beneficiary spouse and children of a principal
beneficiary. See INA sec. 203(d), 8 U.S.C. 1153(d);
see also INA sec. 101(b)(1), 8 U.S.C. 1101(b)(1)
(defining ‘‘child,’’ in general, as meaning ‘‘an
unmarried person under twenty-one years of age’’).
2 See generally Executive Order 14010, Creating a
Comprehensive Regional Framework to Address the
Causes of Migration, To Manage Migration
Throughout North and Central America, and To
Provide Safe and Orderly Processing of Asylum
Seekers at the United States Border (Feb. 2, 2021).
https://www.govinfo.gov/content/pkg/FR-2021-0205/pdf/2021-02561.pdf; see also NSC, Collaborative
Migration Management Strategy (July 2021), https://
www.whitehouse.gov/wp-content/uploads/2021/07/
Collaborative-Migration-Management-Strategy.pdf.
3 See E.O. 14010 at secs. 2–4.
4 See NSC, U.S. Strategy for Addressing the Root
Causes of Migration in Central America (July 2021)
https://www.whitehouse.gov/wp-content/uploads/
2021/07/Root-Causes-Strategy.pdf.

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