Public Health Guidance for Potential COVID-19 Exposure Associated with Travel
Cruise ships in U.S. waters or intending to return to U.S. waters must continue to follow CDC’s Temporary Extension and Modification of the Conditional Sailing Order and the Technical Instructions for Mitigation of COVID-19 Among Cruise Ship Crew.
Summary of Recent Changes
- Aligned with updated CDC quarantine and isolation guidance
- Removed information about CDC’s November 30, 2021, Directive to airlines to provide passenger contact information
Individuals who travel may be at risk for exposure to SARS-CoV-2, the virus that causes COVID-19, before, during, or after travel. This could result in travelers spreading the virus to others at their destinations or upon returning home.
As part of a broader strategy to limit continued new introduction of SARS-CoV-2 and the emergence of new SARS-CoV-2 variants in U.S. communities, all travelers should remain vigilant for signs and symptoms of COVID-19 and take precautions to protect themselves and others from exposure during travel. Travelers should also take precautions to limit community spread after traveling. CDC has issued requirements and recommendations to prevent travel-associated exposure to and transmission of SARS-CoV-2.
As vaccination efforts continue across the United States and internationally, the proportion of travelers who are fully vaccinated against COVID-19 and have received a booster dose will continue to increase. However, emergence and global circulation of SARS-CoV-2 variants of concern, vaccine performance against emerging variants, and global vaccination coverage remain concerns. Travel poses a risk of COVID-19 exposure because of the large number of people from many regions coming together in densely populated environments. CDC encourages all travelers to be fully vaccinated against COVID-19 before travel, and stay up to date with their vaccines to reduce the risk of severe disease, hospitalization, and death.
For the purpose of this guidance, “fully vaccinated against COVID-19” is defined in Technical Instructions for Implementing Presidential Proclamation Advancing Safe Resumption of Global Travel During the COVID-19 Pandemic and CDC’s Order.
This page provides U.S. public health officials with an overview of CDC’s requirements, recommendations, and considerations for management of vaccinated and unvaccinated domestic and international travelers.
CDC’s requirements and recommendations for public health management of international and domestic travelers are provided below. Health departments have the authority to take actions that exceed CDC recommendations in their jurisdictions. Travelers should additionally follow guidance and requirements of destination countries for international travel, or state, Tribal, local, and territorial authorities when arriving in a U.S. jurisdiction after international or domestic travel.
As of February 2, 2021, CDC requires wearing masks on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and while indoors at U.S. transportation hubs such as airports and stations. Travelers are not required to wear a mask in outdoor areas of a conveyance (like a ferry or top deck of a bus). See more information about this requirement.
Predeparture Testing Requirement for International Air Passengers Traveling to the United States
CDC issued an Order (amended December 2, 2021) that requires all air passengers aged two years or older, including U.S. citizens and those who are fully vaccinated, to present a negative COVID-19 test result from a nucleic acid amplification test (NAAT) or antigen test (“viral test”) before boarding a flight to the United States from a foreign country. This test must be conducted no more than 1 day before their flight’s departure. Passengers who have had a positive viral test in the past 90 days and have met the criteria to discontinue isolation may travel with documentation of recovery from COVID-19. This documentation of recovery must include their positive viral test result from a specimen collected in the 90 days before the flight, and a letter from a licensed healthcare provider or a public health official that states the individual is cleared for travel. More information about this requirement is available in the Frequently Asked Questions for air passengers arriving in the United States.
On October 25, 2021, the President issued a Proclamationexternal icon titled “Advancing the Safe Resumption of Global Travel During the COVID-19 Pandemic” to suspend and restrict the entry of noncitizen nonimmigrants who are not fully vaccinated against COVID-19 and seeking to enter the United States by air travel. The Proclamation directs the CDC Director to implement the Proclamation as it applies to public health in accordance with appropriate public health protocols. CDC’s Order and accompanying Technical Instructions implement the President’s direction. As a condition of entering the United States by air, noncitizen nonimmigrants must present proof of being fully vaccinated against COVID-19 before boarding a flight to the United States. The Proclamation excepts certain categories of noncitizen nonimmigrants who are not fully vaccinated. These individuals must agree to obtain a viral test for COVID-19 after arrival and self-isolate if they test positive or develop COVID-19 symptoms; depending on the type of exception, some must also self-quarantine and become fully vaccinated after arrival. For more information about these requirements, see the Frequently Asked Questions.
The following are CDC’s recommendations for travelers arriving in a U.S. jurisdiction based on vaccination status.
Fully vaccinated travelers
Domestic travel (within the United States or to a U.S. territory):
- Fully vaccinated travelers are not recommended to get a SARS-CoV-2 viral test after domestic travel, unless they are symptomatic or testing is required by local, state, or territorial health authorities.
- Fully vaccinated travelers do not need to self-quarantine following domestic travel.
- Fully vaccinated travelers should isolate and get tested if they develop symptoms of COVID-19.
- Fully vaccinated international travelers arriving in the United States are recommended to get a SARS-CoV-2 viral test 3-5 days after travel.
- Fully vaccinated travelers do not need to self-quarantine in the United States following international travel.
- Fully vaccinated travelers should isolate if the viral test is positive or they develop symptoms of COVID-19.
Travelers of any age who are not fully vaccinated and have not recovered from COVID-19 (tested positive for SARS-CoV-2 and met criteria to discontinue isolation) in the past 90 days (domestic and international):
- These travelers are recommended to have a post-arrival test 3-5 days after arrival at destination, combined with self-monitoring and a 5-day period of self-quarantining, i.e., staying home or in a comparable location such as a hotel room.
- Travelers should isolate if the viral test is positive or they develop symptoms of COVID-19.
- Travelers are recommended to have a post-arrival test 3-5 days after arrival at destination, combined with self-monitoring and a 5-day period of staying home (or in a comparable location such as a hotel room) or otherwise self-quarantining.
- Travelers should isolate if the viral test is positive or they develop symptoms of COVID-19.
- However, under CDC’s Order implementing the Presidential Proclamation, excepted noncitizen nonimmigrants arriving by air who are not fully vaccinated against COVID-19 may be required to agree to the following, based on the category of the exception:
- Have a post-arrival viral test 3-5 days after arrival at their U.S. destination, unless they have documentation of having recovered from COVID-19 in the past 90 days;
- Self-quarantine for 7 days, even if the test is negative, unless they have documentation of having recovered from COVID-19 in the past 90 days;
- Self-isolate if the viral test is positive or they develop symptoms of COVID-19; and
- If they intend to stay in the United States longer than 60 days, become fully vaccinated against COVID-19 within 60 days of arriving in the United States, or as soon as thereafter as is medically appropriate, unless they are ineligible because of age or have a medical contraindication to receiving a COVID-19 vaccine.
Excepted noncitizen nonimmigrants are expected to comply with the requirements set out in the Order as applicable to their category.
Travelers who recovered from COVID-19 in the past 90 days
- Travelers who tested positive for SARS-CoV-2 in the past 90 days and have met criteria to discontinue isolation do not need to get a SARS-CoV-2 viral test or self-quarantine after travel.
Those who develop COVID-19 symptoms should self-isolate and consult with a healthcare provider for testing recommendations.
Airport testing sites may also be a convenient option for some travelers. However, for logistical reasons (e.g., rebooking of travel and avoiding potential exposures in airport terminals where social distancing may be challenging), CDC recommends departing air travelers whose destinations require testing get tested before they initiate travel, rather than at the airport immediately prior to their flight. If testing is offered in airport settings, all results (positive or negative) must be reported in real time to the health department of the jurisdiction, and positive results in departing air travelers should be reported immediately to both the local health department and the CDC quarantine station for that jurisdiction. Plans should also be in place to prevent travel of persons who test positive and their travel companions who are not fully vaccinated or have COVID-19 symptoms, who in most cases would be considered close contacts, including request by the health department to CDC for use of federal public health travel restrictions and denial of boarding by the airline (see section below). Testing sites should also have plans to manage individuals who test positive and their travel companions, including temporary isolation or quarantine and safe private transportation home that does not involve public transportation.
Individuals for Whom Isolation or Quarantine is Recommended
CDC currently recommends a 5-day isolation period for most persons who have a positive viral test for COVID-19, regardless of whether or not they have symptoms, and for people with symptoms of COVID-19, including those who are awaiting test results or have not been tested. CDC also recommends a 5-day quarantine period for those with close contact exposures depending on vaccination and booster status or history of recovery from COVID-19 in the past 90 days. For individuals who are unable to wear a mask, the period of isolation should be extended to 10 days after symptom onset or date of positive test if asymptomatic, and the quarantine period extended until 10 days after the last known exposure. CDC recommends an isolation period of at least 10 and up to 20 days for people who were severely ill with COVID-19 and for people with weakened immune systems.
For travel, CDC recommends the following:
- People should not travel during their 5-day isolation period.
- After they end isolation, avoiding travel is recommended until 10 days after symptom onset or the date of specimen collection for a positive viral test result if asymptomatic.
- If they must travel during days 6-10, these travelers should properly wear a well-fitting mask when around others for the entire duration of travel. If they are unable to wear a mask, they should not travel during the 10 days.
- People should not travel during their 5-day quarantine period.
- They should get tested with a viral test at least 5 days after their last close exposure and make sure their test result is negative and they remain without symptoms before traveling. If they don’t get tested, they should delay travel until 10 days after their last close contact with a person with COVID-19.
- If people must travel before the 10 days are completed, they should properly wear a well-fitting mask when around others for the entire duration of travel during the 10 days. If they are unable to wear a mask, they should not travel during the 10 days.
Health departments may request use of federal public health travel restrictions for individuals with confirmed COVID-19 or with known exposure if they intend to travel before they have completed the recommended period of isolation or quarantine, by contacting the CDC quarantine station with jurisdiction for the area where the person is located.
If travel is necessary during the period of isolation or quarantine (e.g., to obtain medical care that is not available locally), transportation should be conducted in a manner that does not expose conveyance operators (e.g., air crews, bus drivers) or other travelers. The mode of transportation should be guided by distance (e.g., ground vs. air transportation) to the final destination as well as the clinical condition of the traveler (i.e., whether medical care may be needed en route).
- Options for travelers with confirmed or probable COVID-19 are private vehicles, chartered or private aircraft, or medical transport (i.e., ground or air ambulance) with infection control precautions in place to protect vehicle operators and medical personnel.
- Options for travelers with known exposure to someone with COVID-19 are private vehicles or chartered or private aircraft with precautions in place to protect air crews.
For international transport with a destination within the United States, per CDC regulations (42 Code of Federal Regulations, Section 71.21: Foreign Quarantineexternal icon), the conveyance operator must notify CDC in advance through the CDC quarantine station with jurisdiction for the port of entry or the CDC Emergency Operations Center (770-488-7100 or firstname.lastname@example.org). The aircraft operator should also coordinate with the U.S. embassy or consulateexternal icon for the country where the individual is located, CDC, the Federal Aviation Administration, and U.S. Customs and Border Protection, as well as appropriate foreign, state, local, territorial, and tribal governments to ensure compliance with all applicable laws and regulations. For more information see Guidance for Transporting or Arranging Transportation by Air of People with COVID-19 or COVID-19 Exposure.
International Air Passenger Contact Information
CDC supports domestic COVID-19 control efforts by making contact information (e.g., physical address in the United States, telephone number, email address) for international air passengers available to state and local health departments for the purpose of public health follow-up, as needed. On October 25, 2021, CDC issued an Order requiring airlines and other aircraft operators to collect designated contact information for all air passengers before they board a flight to the United States from a foreign country and to provide the data to CDC within 24 hours of a request. CDC will share these data with appropriate health departments for the purpose of conducting aircraft contact investigations or as indicated to mitigate risk of SARS-CoV-2 importation associated with international travel.
Follow-up with travelers may include establishing communications with travelers, providing instructions for what travelers should do if they develop illness compatible with COVID-19, follow-up of test results, and intermittent check-ins during the post-arrival period. Mobile applications or automated text messaging may be useful to provide information to travelers. Follow-up with travelers is at the discretion of health departments and may be considered by jurisdictions that are implementing containment measures. Decisions about whether to conduct follow-up and what it would involve could be based on the status of the COVID-19 outbreak in the jurisdiction, status of the COVID-19 outbreak in travelers’ countries or states of origin, the volume of travelers, available resources, competing priorities of public health officials, and other factors, as applicable.
Crews on Passenger or Cargo Flights
CDC and the Federal Aviation Administration have jointly provided Updated Interim Occupational Health and Safety Guidance for Air Carriers and Crewspdf iconexternal icon. Please refer to the document for up-to-date recommendations.
As of December 2, 2021
- Aligned with testing requirements of CDC’s December 2, 2021, Amended Order
- Added information about CDC’s November 30, 2021, Directive to airlines to provide passenger contact information
- Clarified that some modeling data may not apply to Omicron variant
As of October 25, 2021
- Added updated requirements for air passengers traveling to the United States from a foreign country
- Added modeling results incorporating the epidemiology of the Delta variant and its effect on measures for fully vaccinated travelers and those who are not fully vaccinated
As of June 9, 2021
- Added scientific rationale for the guidance for fully vaccinated domestic and international travelers
As of April 27, 2021
- Added vaccines with emergency approval from the World Health Organization to the definition of “fully vaccinated”
As of April 1, 2021
- Added CDC’s recommendations for fully vaccinated travelers and those who recently recovered from COVID-19.
As of February 2, 2021
- Added CDC’s requirement for wearing masks on public transportation conveyances and in transportation hubs
- Added CDC’s requirement for predeparture testing of arriving international air passengers
- Aligned with updated CDC messaging to travelers
As of January 19, 2021
- Updated Individuals with Confirmed or Probable COVID-19 or Known Exposure to Someone with COVID-19 section and added a link to new guidance.
As of December 2, 2020
- Added recommendations for predeparture and post-arrival testing and new considerations for post-arrival management of international travelers
As of October 19, 2020
- Added information about transport of individuals with confirmed or probable COVID-19 or known exposure to someone with COVID-19.
As of August 3, 2020
- Added section for Individuals with Confirmed or Probable COVID-19 or Known Exposure to Someone with COVID-19.
- Added Traveler Contact Information section.