# Vaccine Attestation

                -       English    
                -  Kreyòl Ayisyen 

**The information here is a preview of the required vaccine attestations in your account.**

**Pretravel attestations:**

**Measles Vaccine (Select one):**
                - I have received at least 1 dose of measles vaccine.
                - I am not vaccinated against measles, but qualify for an exception to this requirement because I am younger than 12 months old or was born prior to 1957.
                - I am not vaccinated against measles, but qualify for an exception to this requirement because I:	                   - Have a history of a severe (anaphylactic) reaction to a previous dose or to any component of the vaccine (such as gelatin or neomycin);
                  - Am pregnant;
                  - Had a recent blood transfusion or other blood products;
                  - Have a known severe immunodeficiency; or
                  - Have a family member (parent, brother, or sister) with a history of hereditary or congenital immune system problem.

**Polio Vaccine (Select one):**
                - I have received at least 1 dose of polio vaccine.
                - I am not vaccinated against polio, but qualify for an exception to this requirement because I am younger than 6 weeks old.
                - I am not vaccinated against polio, but qualify for an exception to this requirement because I have a history of a severe (anaphylactic) reaction to a previous dose or to any component of the vaccine.
                - I am not vaccinated against polio because the vaccine is not approved or licensed for use in my age group, but I will get vaccinated within 90 days of arrival in the US.

**COVID-19 Vaccine (Select one):**
                - I  have  received at least 1 dose of a US Food and Drug Administration (FDA) approved or authorized COVID-19 vaccine or a COVID-19 vaccine with World Health Organization Emergency Use Listing (WHO EUL). If not fully vaccinated, I will complete a recommended COVID-19 vaccine series within 90 days after arrival. If the COVID-19 vaccine I received cannot be determined or is not available in the United States, I will receive at least 1 dose of an FDA approved or authorized COVID-19 vaccine according to the guidelines:  https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html
                - I  have not  received at least 1 dose of an US Food and Drug administration (FDA) approved or authorized COVID-19 vaccine or a COVID-19 vaccine with World Health Organization Emergency Use Listing (WHO EUL) but qualify for an exception to this requirement because I am too young. I will start a COVID-19 vaccine series within 90 days of arrival to the United States or reaching the eligible age, whichever is later, and will complete my recommended primary vaccine series in accordance with current CDC guidelines:  https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html
                - I am older than 6 months of age, but I am  not vaccinated  against COVID-19 because the vaccine is not approved or licensed for use in my age group where I have been residing. I will start a COVID-19 vaccine series within 90 days of arrival to the United States and will complete my recommended primary vaccine series in accordance with current CDC guidelines:  https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html
                - I  have not  received at least 1 dose of an US Food and Drug Administration (FDA) approved or authorized COVID-19 vaccine or a COVID-19 vaccine with World Health Organization Emergency Use List (WHO EUL) but qualify for an exception to this requirement because I have a history of a known medical contraindication to the COVID-19 vaccine. Contraindications are listed at:  https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html#contraindications

**Attestation required within 90 days after U.S. arrival:**

**Tuberculosis Screening (Select one):**
                - My test result is negative. I have undergone tuberculosis screening starting with an IGRA (interferon-gamma release assay) blood test, and my result is negative. I have and will retain my IGRA test result documentation.
                - My test result is indeterminate. I have undergone tuberculosis screening starting with an IGRA (interferon-gamma release assay) blood test and my results are indeterminate. An indeterminate IGRA result means additional testing is needed because I may have a tuberculosis infection which has not yet resulted in a positive IGRA test. I will follow up with a state or local public health office or doctor’s office and will complete any additional recommended testing to include further IGRA blood testing, chest x-ray, or other testing and treatment. I have and will retain my IGRA test result documentation.
                - My test result is positive. I have undergone tuberculosis screening starting with an IGRA (interferon-gamma release assay) blood test and this screening was positive for tuberculosis. I understand that prior Bacillus Calmette-Guerin (BCG) vaccination does not cause a positive IGRA result, thus a positive IGRA test must be taken seriously. I will receive a chest x-ray, and if abnormal, or other signs or symptoms of active tuberculosis disease are present, I will comply with isolation and treatment measures as determined by a state or local public health office or doctor’s office. I have and will retain my IGRA test result documentation as well as documentation that I followed up for additional testing and treatment.
                - I have not undergone tuberculosis screening but qualify for an exception to this requirement because I am younger than 2 years old.

**Select if Applicable:**
                - I did not receive a polio vaccine prior to arriving in the United States because it was not approved or licensed for my age group, but I have now been vaccinated against polio.
                - I did not receive a COVID-19 vaccination prior to arrival in the United States because it was not approved or licensed for my age group or was only partially vaccinated prior to arriving in the United States. I have completed or will complete my COVID-19 primary series to become fully vaccinated within 90 days of arrival or within 90 days of reaching the eligible age for vaccination according to the current guidelines:  https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html

01/06/2023

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