Federal Register / Vol. 86, No. 114 / Wednesday, June 16, 2021 / Notices 32041 

1WHO Technical Report Series 1012, 2018; Page 

6. 

2Fooks AR, Banyard AC, Horton DL, Johnson N, 

McElhinney LM, Jackson AC. Current status of 

rabies and prospects for elimination. Lancet 

2014;384:1389–99. 

3Although the statute assigns authority to the 

Surgeon General, all statutory powers and functions 

of the Surgeon General were transferred to the 

Secretary of HHS in 1966, 31 FR 8855, 80 Stat. 1610 

(June 25, 1966), see also 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. 

4https://www.cdc.gov/importation/bringing-ananimal-into-the-united-states/vaccinecertificate.html. 

D That the information security 

program contain safeguards that are 

based on the volume and sensitivity of 

the personal information at risk; 

D That testing and monitoring of the 

safeguards are conducted regularly but 

no less often than once a year; and 

D That the information security 

program be documented, evaluated, and 

adjusted in light of any changes to 

business operations or new 

technological advancements. 

Æ Parts III and IV respectively require 

the three respondents (1) to obtain an 

initial and then biennial third-party 

information security assessments and 

(2) to cooperate with the third parties 

conducting the assessments. 

Æ Part V requires the three 

respondents to report to the 

Commission any event involving 

consumers’ personal information that 

constitutes a reportable event to any 

U.S. federal, state, or local government 

authority. 

Æ Part VI mandates that the three 

respondents submit an annual 

certification regarding their compliance 

with the Proposed Order’s data security 

requirements. 

• Parts VII through XI are reporting 

and compliance provisions. Part VII 

mandates that all Respondents 

acknowledge receipt of the Proposed 

Order and, for 20 years, distribute the 

Proposed Order to certain employees 

and agents and secure acknowledgments 

from recipients of the Proposed Order. 

Part VIII requires that Respondents 

submit compliance reports to the FTC 

one year after the order’s issuance and 

submit additional reports when certain 

events occur. Part IX requires that, for 

20 years, Respondents create certain 

records and retain them for at least 5 

years. Part X provides for the FTC’s 

continued compliance monitoring of 

Respondents’ activity during the 

Proposed Order’s effective dates. Part XI 

is a provision ‘‘sunsetting’’ the Proposed 

Order after 20 years, with certain 

exceptions. Respondents MoviePass, 

Inc. and Helios are exempt from 

Sections II–X of the Proposed Order 

until their bankruptcy cases are closed, 

and these bankruptcies led the FTC to 

not seek a monetary judgment in this 

matter. 

The purpose of this analysis is to 

facilitate public comment on the 

Proposed Order. It is not intended to 

constitute an official interpretation of 

the complaint or Proposed Order, or to 

modify in any way the Proposed Order’s 

terms. 

By direction of the Commission. 

Joel Christie, 

Acting Secretary. 

[FR Doc. 2021–12701 Filed 6–15–21; 8:45 am] 

BILLING CODE 6750–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

Temporary Suspension of Dogs 

Entering the United States From HighRisk Rabies Countries 

AGENCY: Centers for Disease Control and 

Prevention (CDC), Department of Health 

and Human Services (HHS). 

ACTION: Notice. 

SUMMARY: The Centers for Disease 

Control and Prevention (CDC) within 

the Department of Health and Human 

Services (HHS) announces a temporary 

suspension in the importation of dogs 

from high-risk rabies-enzootic countries 

(hereinafter referred to as high-risk 

country or countries) into the United 

States. Due to the unprecedented global 

response to the Coronavirus Disease 

2019 (COVID–19) pandemic and limited 

availability of public health resources at 

the Federal, state, and local level, this 

action is necessary to protect the public 

health against the reintroduction of 

canine rabies virus variant (CRVV) into 

the United States and to ensure the 

welfare of dogs being imported into the 

U.S. This suspension, with limited 

exceptions, includes dogs imported 

from low-risk or CRVV-free countries if 

the dogs have been in any high-risk 

countries during the previous six 

months. 

DATES: This notice is effective July 14, 

2021. 

FOR FURTHER INFORMATION CONTACT: For 

information regarding this notice 

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 or 404– 

498–1600. 

For information regarding HHS/CDC 

regulations for the importation of dogs, 

please contact: Dr. Emily Pieracci, 

D.V.M., Division of Global Migration 

and Quarantine, Centers for Disease 

Control and Prevention, 1600 Clifton 

Road NE, MS–V–18–2, Atlanta, GA 

30329 or 404–498–1600. Either Mrs. 

Altenburger or Dr. Pieracci may also be 

reached by email at 

CDCAnimalImports@cdc.gov. 

SUPPLEMENTARY INFORMATION: 

I. Background and Authority 

Rabies, one of the deadliest zoonotic 

diseases, accounts for an estimated 

59,000 human deaths globally each 

year 1—which equates to one human 

death every 9 minutes. Canine rabies 

virus variant (CRVV) is responsible for 

98% of these deaths.2 The rabies virus 

can infect any mammal, and once 

clinical signs appear, the disease is 

almost always fatal.2 In September 2007, 

at the Inaugural World Rabies Day 

Symposium, HHS/CDC declared the 

United States to be free of CRVV. 

However, this rabies virus variant is still 

a serious public health threat in the 

more than 120 countries where CRVV 

remains enzootic. Preventing the entry 

of animals infected with CRVV 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.3 Since at least 

1956, Federal quarantine regulations 

(currently found at 42 CFR 71.51) have 

controlled the entry of dogs into the 

United States. See 21 FR 9870, Dec. 12, 

1956. One of the principal goals of these 

regulations is to prevent the 

reintroduction and spread of CRVV into 

the United States. While the United 

States continues to have bat rabies 

lyssavirus (rabies viruses that are 

enzootic to bat populations) and 

multiple terrestrial variants of rabies 

circulating in wildlife species (e.g. fox, 

raccoon, skunk), it has been free of 

CRVV since 2007 and now focuses its 

regulatory efforts on preventing the 

reintroduction of this rabies variant. 

Under 42 CFR 71.51, all dogs 

admitted into the United States must be 

accompanied by a valid rabies 

vaccination certificate.4 This 


jbell on DSKJLSW7X2PROD with NOTICES
32042 Federal Register / Vol. 86, No. 114 / Wednesday, June 16, 2021 / Notices 

5CDC. Guidance Regarding Agency Interpretation 

of ‘‘Rabies-Free’’ as It Relates to the Importation of 

Dogs Into the United States. Fed Register 

2019;84:724–730. https://www.federalregister.gov/ 

documents/2019/01/31/2019-00506/guidanceregarding-agency-interpretation-of-rabies-free-as-itrelates-to-the-importation-of-dogs. 

6https://www.cdc.gov/importation/bringing-ananimal-into-the-united-states/rabies-vaccine.html. 

7HHS/CDC. Guidance Regarding Agency 

Interpretation of ‘‘Rabies-Free’’ as It Relates to the 

Importation of Dogs Into the United States. (January 

31, 2019) 84 FR 724: 724–730. 

8McQuiston, J.H., et al., Importation of dogs into 

the United States: risks from rabies and other 

zoonotic diseases. Zoonoses Public Health, 2008. 

55(8–10): p. 421–6. 

9Smith J, le Gall F, Stephenson S, et al. People, 

pathogens and our planet. The Economics of One 

Health 2012;2. 

10Raybern, C et al. Rabies in a dog imported from 

Egypt-Kansas, 2019. Morb Mort Wkly 2020; 69 (38): 

1374–1377. 

11 Jeon S, Cleaton J, Meltzer M, et al. Determining 

the post-elimination level of vaccination needed to 

prevent re-establishment of dog rabies. PLoS Neg 

Trop Dis 2019; 13 (12): e0007869. 

12 Velasco-Villa A, Mauldin MR, Shi M, et al. The 

history of rabies in the Western Hemisphere. 

Antiviral Res. 2017;146:221–232. doi:10.1016/ 

j.antiviral.2017.03.013. 

13Raybern, C et al. Rabies in a dog imported from 

Egypt-Kansas, 2019. Morb Mort Wkly 2020; 69 (38): 

1374–1377. 

14https://www.cdc.gov/rabies/medical_care/ 

index.html. 

15Sinclair JR, Wallace RM, Gruszynski K, et al. 

Rabies in a dog imported from Egypt with a falsified 

rabies vaccination certificate—Virginia, 2015. 

MMWR Morb Mortal Wkly Rep 2015;64:1359–62. 

https://doi.org/10.15585/mmwr.mm6449a2. 

16Hercules Y, Bryant NJ, Wallace RM, et al. 

Rabies in a dog imported from Egypt—Connecticut, 

2017. MMWR Morb Mortal Wkly Rep 

2018;67:1388–91. https://doi.org/10.15585/ 

mmwr.mm6750a3. 

requirement applies unless the dog’s 

owner or importer submits satisfactory 

evidence that the dog is less than 6 

months old and has only been in a 

CRVV-free or low-risk country, or has 

only been in a CRVV-free or low-risk 

country for the 6 months before arrival 

if it is older than 6 months.5 CDC 

maintains a current, publicly available 

list of countries with high risk of 

CRVV 6 and provides guidance for dog 

entry requirements based on the dog’s 

country of import. 

Additionally, under 42 CFR 71.51(e), 

CDC may exclude dogs coming into the 

United States from areas determined to 

have high rates of rabies. 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 may be 

suspended. CDC bases this temporary 

suspension on these legal authorities. 

II. Public Health Rationale 

The United States was declared 

CRVV-free in 2007. Importing dogs from 

high-risk CRVV countries involves a 

significant public health risk. CDC 

requires strict compliance with all its 

public health entry requirements. 

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 U.S. annually, of 

which 100,000 dogs are from countries 

at high- risk of CRVV.7 This estimate 

was based on information provided by 

airlines, the Department of Homeland 

Security’s Customs and Border 

Protection (CBP) staff, and a study 

conducted at a U.S.-Mexico land border 

crossing.8

CBP does record, by country, the 

number of dogs imported with formal 

entry under Harmonized Tariff 

Schedule (HTS) code 0106199120 and 

HTS Description: Other live animals, 

other, dogs. The total number of dogs 

imported into the United States from all 

countries under this HTS category 

varied from 25,232 in 2018 to 58,540 in 

2020. The number of dogs from highrisk countries under this HTS category 

averaged 16,390 and varied from 9,966 

to 24,031 over this 3-year period. The 

number of dogs reported under this HTS 

category does not include dogs imported 

as checked baggage, hand-carried in 

airplane cabins, or crossing at land 

borders without formal entry. Thus, the 

number underestimates the true number 

of dogs imported into the United States. 

The importation of just one dog 

infected with CRVV risks reintroduction of the virus into the United 

States resulting in a potential public 

health risk with consequent monetary 

cost and potential loss of human and 

animal life.9 10 11 CRVV has been highly 

successful at adapting to new host 

species, particularly wildlife.12 One 

CRVV-infected dog could result in 

transmission to humans, domestic pets 

or wildlife. The importation in 2019 of 

a single dog with rabies cost more than 

$400,000 USD for the public health 

investigations and rabies port-exposure 

prophylaxis (PEP) of exposed 

persons.13 14

Since 2015 there have been three 

known rabid dogs imported into the 

United States. All three dogs were 

rescue dogs imported by different rescue 

organizations for the purposes of 

adoption. These three cases, discussed 

below, highlight the immense public 

health resources required to investigate, 

respond to, and mitigate the public 

health threat posed by the importation. 

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.15 Eighteen persons 

were recommended to receive rabies 

PEP, seven dogs underwent a six-month 

quarantine, and eight additional dogs 

housed in the same home as the rabid 

dog had to receive rabies booster 

vaccinations and undergo a 45-day 

monitoring period. 

In 2017, a ‘‘flight parent’’ (a person 

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. The dog also had tooth fractures 

from reportedly having been hit by a 

car. 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 4 months. An 

investigation revealed the possibility of 

falsified rabies vaccination 

documentation presented on entry to 

the United States.16

In 2019, twenty-six dogs were 

imported into the United States by a 

rescue organization. All dogs 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. Forty-four persons received PEP, 

and the 25 dogs imported on the same 

flight underwent re-vaccination and 

quarantines of 4–6 months. An 

additional 12 dogs had contact with the 

rabid dog and had to be re-vaccinated 

and undergo quarantine periods ranging 


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Federal Register / Vol. 86, No. 114 / Wednesday, June 16, 2021 / Notices 32043 

17Raybern, C et al. Rabies in a dog imported from 

Egypt-Kansas, 2019. Morb Mort Wkly 2020; 69 (38): 

1374–1377. 

18Raybern, C et al. Rabies in a dog imported from 

Egypt-Kansas, 2019. Morb Mort Wkly 2020; 69 (38): 

1374–1377. 

19CDC. Guidance Regarding Agency 

Interpretation of ‘‘Rabies-Free’’ as It Relates to the 

Importation of Dogs Into the United States. Fed 

Register 2019;84:724–730. https://

www.federalregister.gov/documents/2019/01/31/ 

2019-00506/guidance-regarding-agencyinterpretation-of-rabies-free-as-it-relates-to-theimportation-of-dogs. 

20TJ Sidwa et al. (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. 

21R.T. Sterner et al. (2009) Tactics and Economics 

of Wildlife Oral Rabies Vaccination, Canada and the 

United States. Emerging Infectious Diseases; 15(8), 

1176–1184. 

22Centers for Disease Control and Prevention. 

Quarantine Activity Reporting System (version 

4.9.8.8.2.2A). Dog Importation data, 2018–2020. 

Accessed: 15 February 2021. 

23https://www.cdc.gov/coronavirus/2019-ncov/ 

cdcresponse/by-the-numbers.html. 

24Centers for Disease Control and Prevention. 

Quarantine Activity Reporting System (version 

4.9.8.8.2.2A). Dog Importation data, 2010–2019. 

Accessed: 15 February 2021. 

25Centers 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; Vol. 84, No. 21. 31 January 2019. Available 

at: 2019–00506.pdf (govinfo.gov). 

26U.S. Department of Agriculture. Animal 

Welfare Regulations; Part 3, Subpart A: 

Transportation Standards. Sections 3.14–3.20. July 

2020. Available at: USDA Animal Care: Animal 

Welfare Act and Animal Welfare Regulations. 

from 45 days to 6 months based on their 

previous vaccination status.17

HHS/CDC estimates a range of costs 

for public health investigations and 

subsequent cost of care for people 

exposed to rabid dogs to cost between 

$215,386 and $508,879 per importation 

event as summarized in Section IV.18 19

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 or (2) ongoing 

transmission to other domestic and 

wildlife species in the United States. Reestablishment of CRVV into the United 

States, while unlikely, could result in 

costly efforts over several years to again 

eliminate the virus. 

A previous campaign to eliminate 

domestic dog-coyote rabies virus variant 

jointly with gray fox (Texas fox) rabies 

virus variant in Texas over the period 

from 1995 through 2003 cost $34 

million 20 21, or $52 million in 2019 U.S. 

dollars. Since January 2020, public 

health resources globally have been 

diverted to COVID–19 response 

activities which may have caused a 

lapse in canine rabies vaccination 

efforts in high-risk countries. The 

increased number of dogs with 

inadequate or falsified rabies 

vaccination certificates arriving in the 

United States 22 may increase the 

likelihood of a CRVV-importation event. 

An importation of a dog with CRVV 

would divert U.S. public health 

resources away from ongoing and time 

sensitive COVID–19 response activities. 

On January 21, 2020, CDC launched 

an agency-wide response to the COVID– 

19 pandemic, dedicating over 7,200 of 

the approximately 10,000 CDC 

personnel to support the outbreak 

response. CDC’s focus from the 

beginning has been to assist health 

departments, frontline healthcare 

workers, businesses, communities, and 

the public to protect themselves and 

save lives. As of March 15, 2021, over 

one thousand CDC personnel have 

conducted 3,150 deployments to 265 

cities across the United States and 

abroad, and over three thousand 

documents have been developed 

providing information and guidance for 

government agencies, business and the 

public.23 The unprecedented nature of 

this public health response has 

naturally drawn federal, state, and local 

public health resources away from other 

important public health efforts, 

including preventing the reimportation 

of CRVV into the United States. 

Historically, approximately 60–70% 

of CDC’s dog entry denials (or about 200 

cases annually) have been due to 

fraudulent paperwork.24 This number is 

less than 1 percent of dog importations. 

Between January and December 2020, 

(during the COVID–19 pandemic), CDC 

documented more than 450 instances of 

incomplete, inadequate, or fraudulent 

rabies vaccination certificates for dogs 

arriving from high-risk countries. These 

cases resulted in the dogs being denied 

entry into the United States and 

returned to their countries of origin. The 

increase in the number of dogs 

inadequately vaccinated against rabies 

that importers are attempting to import 

into the United States has created a 

public health risk of importing CRVV 

into the U.S. and public health 

management of these dogs is 

unsustainable during the current 

COVID–19 pandemic. 

To be considered complete and 

adequate, rabies vaccination certificates 

currently must include all the following 

information: 

• Name and address of owner 

• Breed, sex, date of birth (approximate 

age if date of birth unknown), color, 

markings, and other identifying 

information for the dog 

• Date of rabies vaccination and vaccine 

product information 

• Date the vaccination expires 

• Name, license number, address, and 

signature of veterinarian who 

administered the vaccination 

Upon the dog’s arrival, federal 

officials examine the rabies vaccination 

certificates and ensure the description 

of the dog listed on the paperwork 

matches the dog presented. For a rabies 

vaccine to be effective, the dog must be 

at least 12 weeks (84 days) of age at the 

time of administration. A dog’s initial 

vaccine must also be administered at 

least 4 weeks (28 days) before arrival in 

the United States. 

CDC has documented instances of 

fraudulent paperwork for dogs based on 

various factors. These include: Dogs that 

were younger than the age indicated on 

their rabies vaccination paperwork— 

based on dental examination by U.S. 

veterinarians; differences between the 

breed, sex, color, or microchip number 

listed on the rabies vaccine certificate 

and the dog presented for entry; 

suspicious veterinary stamps and 

inconsistent signatures between 

different veterinary paperwork; 

inconsistent dates of rabies vaccination 

between different veterinary documents; 

and vaccines administered after 

expiration date of the vaccine lot. 

Under CDC’s regulatory authority, 

dogs arriving from high-risk countries 

without appropriate rabies vaccination 

certificates are denied entry and 

returned to the country of origin on the 

next available flight.25 Airlines are 

required to house dogs awaiting return 

to their country of origin at a facility, 

preferably a live animal care facility, 

that has an active custodial bond and a 

Facilities Information and Resource 

Management System (FIRMS) code 

issued by U.S. Customs and Border 

Protection (CBP), which indicates the 

facility can provide accommodation that 

meets the US Department of 

Agriculture’s Animal Welfare Act 

standards. However, there are 

insufficient live animal care facilities 

with a CBP-issued FIRMS code available 

to house dogs that are denied entry. 

Currently only one facility exists 

nationwide (www.arkjfk.com). 

If a live animal facility with a CBPissued FIRMS code is not available, the 

airline must, at a minimum, provide 

accommodation that meets the U.S. 

Department of Agriculture’s Animal 

Welfare Act standards.26 Many airlines 

choose to leave dogs in cargo 

warehouses, which can create an unsafe 

environment for the dogs due to the 

prolonged periods of time between 

flights, inadequate cooling and heating, 

unacceptable cleaning and sanitization 

of crates, and inability to physically 


jbell on DSKJLSW7X2PROD with NOTICES
32044 Federal Register / Vol. 86, No. 114 / Wednesday, June 16, 2021 / Notices 

27https://www.cnbc.com/2020/04/02/ 

coronavirus-update-american-airlines-cutssummer-international-flights-by-60percent-asdemand-suffers.html. 

28https://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. 

29 Dog Dies At O’Hare Airport Warehouse, 17 

Others Saved After Being Left Without Food Or 

Water For 3 Days—CBS Chicago (cbslocal.com). 

30Centers for Disease Control and Prevention. 

Quarantine Activity Reporting System (version 

4.9.8.8.2.2A). Dog Importation data, 2018–2020. 

Accessed: 15 February 2021. 

31PCS Order definition https://www.gsa.gov/ 

policy-regulations/regulations/federal-travelregulation-ftr/i1186607#i1186607. 

separate the animals from areas of the 

warehouse where other equipment, 

machinery, and goods are used and 

stored. 

During 2020, due to the COVID–19 

pandemic, there were fewer 

international flights worldwide,27 28

resulting in delayed returns for dogs 

denied entry. In August 2020, while in 

the custody of an airline, a dog died at 

Chicago O’Hare International Airport 

after CDC denied entry based on 

falsified rabies vaccination certificates. 

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.29

While airlines are ultimately 

responsible for finding appropriate 

housing for dogs denied entry, the 

decreased number of flights combined 

with inadequate numbers of live animal 

care facilities with a CBP-issued FIRMS 

code for holding animals creates 

significant administrative and financial 

burden for federal, state, and local 

governments. The government may be 

required to find individualized 

solutions to ensure appropriate 

accommodations for prolonged periods 

of time for these animals. 

While costs associated with housing, 

caring for dogs, and returning dogs are 

the responsibility of the importer (or 

airline if the importer abandons the 

dog), some importers and airlines are 

reluctant to pay these costs, requiring 

the Federal government to find 

appropriate interim housing facilities 

and veterinary care. The cost for 

housing, care, and returning improperly 

vaccinated dogs ranges between $1,000– 

$4,000 per dog depending on the 

location and time required until the 

next available return flight. The Federal 

government bears these costs when 

airlines and importers do not. 

During 2020, CDC observed a 52% 

increase in dogs that were ineligible for 

entry compared to 2018 and 2019.30 The 

increasing demand to vaccinate and 

quarantine dogs that have been denied 

entry presents an increased burden to 

federal, state and local public health 

agencies already responding to the 

COVID pandemic. The increased 

inspections, medical care, and 

appropriate quarantine of dogs 

inadequately vaccinated against rabies 

has financially burdened federal and 

state public health agencies. 

Between 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 highrisk rabies countries during these eight 

months. The time spent represented a 

substantial increase from previous years 

because of (1) the 52% 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. These are resources and 

personnel-hours diverted from CDC’s 

current paramount objective in 

mitigating the COVID–19 pandemic and 

do not include time from other Federal, 

state, and local public health partners. 

Pursuant to the terms of this notice, 

HHS/CDC is temporarily suspending the 

importation of dogs from high-risk 

countries. This suspension includes 

dogs originating in low-risk or CRVVfree countries that have been in a highrisk country in the previous six months 

(not including animals transiting 

through high-risk countries). The 

suspension will reduce the risk of 

importation of CRVV and preserve 

public health resources needed for the 

COVID–19 response. The suspension 

will also allow CDC to work with 

Federal and state partners, airlines, and 

other stakeholders to consider options 

for a more streamlined and efficient dog 

importation process that will be safer for 

pets. Most importantly, it will ensure 

that U.S. public health remains 

protected. 

This notice creates a narrow set of 

exceptions for certain categories of dogs 

imported into the United States with 

advance written approval from CDC. 

The requirement for advanced written 

approval will help ensure that the 

limited number of dogs imported into 

the United State from high-risk 

countries have valid documentation of 

rabies vaccination upon entry. It will 

also mitigate the costs placed upon the 

U.S. government, airlines, and importers 

associated with reexporting dogs that do 

not meet CDC entry requirements. 

III. Advance Written Approval 

The suspension provisions of this 

notice do not apply if advance written 

approval from CDC has been obtained to 

import a dog from a high-risk country 

that has been fully immunized against 

rabies. This includes a dog that has been 

in a high-risk country in the previous 6 

months and is being imported from a 

low-risk or CRVV-free country. Such 

approvals will be granted on a limited 

and case-by-case basis and at CDC’s 

discretion. CDC’s decision will be 

considered final. 

The following categories of importers 

are eligible to request advance written 

approval to import a dog into the United 

States: 

• U.S. government personnel who are 

relocating back to the United States with 

Permanent Change of Station (PCS) 

orders or Temporary Duty (TDY) 

orders.31

• U.S. citizens and lawful residents 

relocating to the United States. The 

application should include written 

documentation from an employer or 

other official source stating the reason 

for the relocation, such as a letter by an 

employer or university stating that the 

U.S. citizen or lawful resident is 

relocating for reasons of employment or 

education. 

• Importers who wish to import dogs 

for purposes related to science, 

education, or exhibition, as these terms 

are defined in 42 CFR 71.50, or for a 

bona fide law enforcement purpose. 

• Owners of service animals, if the 

dog is individually trained to do work 

or perform tasks for the benefit of an 

individual with a disability, including a 

physical, sensory, psychiatric, 

intellectual, or other mental disability. 

In accordance with U.S. Department of 

Transportation regulations at 14 CFR 

part 382, emotional support animals, 

comfort animals, companionship 

animals, and service animals in training 

are not considered service animals for 

the purposes of this Notice. 

During this temporary suspension, 

importers who meet the eligibility 

criteria listed above may make a onetime request to import up to three dogs 

as part of a single importation. All dogs 

must be six months of age or older at the 

time of entry and, as further explained 

in this notice, must enter the United 

States at a port of entry with a live 

animal care facility with a CBP-issued 

FIRMS code. Importers of dogs for 

science, education, or exhibition, as 

these terms are defined in 42 CFR 71.50, 

or bona fide law-enforcement purposes 

may import more than three dogs. 

To request the advance written 

approval of the CDC, importers who 


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Federal Register / Vol. 86, No. 114 / Wednesday, June 16, 2021 / Notices 32045 

32The permit is currently under revision (Permit 

to Import a Dog Inadequately Immunized Against 

Rabies, (OMB Control Number 0920–0134 Foreign 

Quarantine Regulations (exp. 03/31/2022)). Despite 

the permit application’s current title, inadequately 

immunized dogs do not qualify for the exception. 

33Will provide link to CDC website with list of 

approved laboratories. 

34OIE Terrestrial Animal Health Code. Chapter 

5.11. Available at: Access online: OIE—World 

Organisation for Animal Health. 

35HHS/CDC. Guidance Regarding Agency 

Interpretation of ‘‘Rabies-Free’’ as It Relates to the 

Importation of Dogs Into the United States. (January 

31, 2019) 84 FR 724: 724–730. 

meet the eligibility criteria listed above 

must submit the Application for a 

Permit to Import a Dog Inadequately 

Immunized Against Rabies, (approved 

under OMB Control Number 0920–0134 

Foreign Quarantine Regulations (exp. 

03/31/2022), or as revised). To request 

an application for the permit, an 

importer must send an email to the 

Director, Division of Global Migration 

and Quarantine, at cdcanimalimports@

cdc.gov. 

Once an importer receives 

instructions and the permit application, 

the importer’s request with all 

supporting documentation must be 

submitted at least 30 business days 

before the date on which the dog will 

enter the United States. A request 

cannot be made at the port of entry 

upon the dogs’ arrival into the United 

States; dogs that arrive without advance 

written approval from the CDC will be 

returned to their country of origin on 

the next available flight. As required by 

the permit application, a request must 

present sufficient and reliable evidence 

conclusively demonstrating that the dog 

to be imported has been fully 

immunized against rabies.32 Such 

evidence includes: 

1. A valid rabies vaccination 

certificate that was issued in the United 

States by a U.S.-licensed veterinarian. 

The certificate must state that the 

vaccine was administered on or after the 

dog was 12 weeks (84 days) of age and 

at least 28 days prior to entry, if it was 

the dog’s initial vaccine. OR 

2. A valid rabies vaccination 

certificate from a non-U.S.-licensed 

veterinarian AND serologic evidence of 

rabies vaccination from an approved 

rabies serology laboratory 33 (serologic 

results >0.5IU/mL required)collected in 

accordance with the OIE Terrestrial 

Manual.34 The certificate must state that 

the vaccine was administered on or after 

the dog was 12 weeks (84 days) of age 

and at least 28 days prior to entry, if it 

was the dog’s initial vaccine. The 

certificate must be in English or 

accompanied by a certified English 

translation. 

Furthermore, based on the 

circumstances, an importer may also be 

required to submit the following: 

• Permanent Change of Station (PCS) 

orders, or Temporary Duty Orders (TDY) 

(U.S. Government personnel); 

• Documentation or evidence that the 

dog to be imported is a service dog (as 

defined in this Notice); 

• Employment letter or other 

evidence of relocating to the United 

States after living abroad; or 

• Other justification that meets the 

above-listed eligibility criteria along 

with supporting documentation. 

Dogs arriving from a high-risk country 

with a CDC permit must enter the 

United States at a port of entry with a 

live animal care facility with a CBPissued FIRMS code that can provide 

accommodation that meets the U.S 

Department of Agriculture’s Animal 

Welfare Act standards. Currently, John 

F. Kennedy International Airport in 

New York City is the only U.S. port of 

entry with a live animal care facility 

that meets these standards. However, if 

any additional ports of entry become 

capable of meeting these standards, CDC 

will publish the list of ports of entry in 

the Federal Register and on the CDC 

animal importation website. Animals 

imported for bona fide law-enforcement 

purposes are not required to enter the 

United States at a port of entry with a 

live animal care facility with a CBPissued FIRMS code. 

CDC additionally requires dogs 

arriving from a high-risk country with a 

CDC permit be microchipped on or 

before the date that they receive their 

rabies vaccination. The microchip 

number must be listed on the rabies 

vaccination certificate. Photographs of 

the dog’s teeth are required for age 

verification. CDC will respond to an 

importer’s request in writing and may 

impose additional conditions in 

granting the approval. An importer must 

present CDC’s written response and 

approval upon entry into the United 

States. If a request for advance approval 

is denied, CDC’s written denial will 

constitute final agency action. 

Any dog from a high-risk country will 

be excluded from entering the United 

States and returned to its country of 

origin on the next available flight, 

regardless of carrier or route, if it arrives 

without advance written approval from 

the CDC, arrives at a port of entry 

without a live animal care facility with 

a CBP-issued FIRMS code, or if the 

animal presented does not match the 

description of the animal listed on the 

permit. The importer (or airline carrier 

if the importer abandons the animal) 

will be financially responsible for all 

housing, care, and return costs. 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 reentry into the United States. 

IV. Economic Impact of This 

Temporary Suspension 

Executive Orders 12866: ‘‘Regulatory 

Planning and Review’’ and 13563: 

‘‘Improving Regulation and Regulatory 

Review’’ direct agencies to assess the 

costs and benefits of available regulatory 

alternatives and, if regulation is 

necessary, to select regulatory 

approaches that maximize net benefits 

(including potential economic, 

environmental, public health and safety 

effects, distributive impacts, and 

equity). Executive Order 13563 

emphasizes the importance of 

quantifying both costs and benefits, 

reducing costs, harmonizing rules, and 

promoting flexibility. 

Although the temporary suspension of 

dogs from countries at high-risk for 

CRVV is expected to reduce the number 

of dogs imported into the United States, 

importers of dogs from high-risk 

countries will be able to submit a 

request for advanced written permission 

at least 30 days prior to planned 

importation in the United States. Thus, 

some importers will be able to import 

up to three dogs from high-risk 

countries with CDC-issued permits. 

CDC has previously estimated that 

between 87,000 and 116,000 dogs are 

imported from high-risk countries each 

year.35 This estimate is significantly 

greater than the numbers recorded by 

CBP for formal entry under HTS code 

0106199120 and HTS Description: Other 

live animals, other, dogs, which 

averaged 16,390 and varied from 9,966 

to 24,031 over the 3-year period from 

2018 through 2020. 

The number of dogs reported under 

this HTS category do not include handcarried dogs traveling in airplane cabins 

or crossing at land borders without 

formal entry and, thus, are not inclusive 

of all dog imports. To account for the 

uncertainty in the number of dogs 

imported to the United States from highrisk countries without formal entry, 

CDC used the following assumptions in 

the analysis of this action: (1) Most 

likely estimate: 3 times the average 

number of dogs with formal entry from 

2018–2020 = 60,696 dogs per year, (2) 

Lower bound: 2 times the average 

number of dogs with formal entry from 

2018–2020 = 32,781, and (3) Upper 

bound: 5 times the number of dogs 

arriving in the highest year (2019) = 


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32046 Federal Register / Vol. 86, No. 114 / Wednesday, June 16, 2021 / Notices 

120,155. These baseline estimates are 

used throughout the analysis (Table 1). 

CDC assumed that the temporary 

suspension would reduce the number of 

dogs imported from high-risk countries 

by 75% and considered a range of 50%– 

90% to calculate lower and upper 

bound estimates. This would result in 

estimates of 15,124 (range: 3,203–60,040 

dogs) dogs imported with CDC-issued 

permits per year with the suspension in 

place. The temporary suspension would 

reduce the estimated numbers of dogs 

imported per year by 45,572 (range: 

29,758–60,115). CDC also estimated the 

numbers of dogs denied entry under the 

baseline and with the temporary 

suspension in effect. An estimated 500 

(range: 300–750) dogs would be denied 

entry under the baseline based on data 

from 2020 and previous years. The 

temporary suspension and CDC permit 

process are expected to reduce the 

number of dogs denied entry by 90% 

(range: 75%–95%) such that only 50 

(range: 15–188) dogs would be denied 

entry with the temporary suspension. 

TABLE 1—ESTIMATED NUMBERS OF DOGS FROM HIGH-RISK COUNTRIES IMPORTED OR DENIED ENTRY UNDER THE

BASELINE AND WITH THE TEMPORARY SUSPENSION

Most likely 

estimate Lower bound Upper bound 

Estimated number of dogs imported from high-risk countries at baseline ................................. 60,696 32,781 120,155 

Estimated % reduction in number of dogs imported from high-risk countries with temporary 

suspension ............................................................................................................................... 75% 90% 50% 

Estimated number of dogs imported from high-risk countries with temporary suspension ........ 15,174 3,278 60,078 

Change in number of dogs imported from high-risk countries .................................................... 45,522 29,503 60,078 

Estimated number of dogs denied entry from high risk countries at baseline ........................... 500 300 750 

Estimated % reduction in dogs denied entry with temporary suspension .................................. 90% 95% 75% 

Estimated number of dogs denied entry with temporary suspension ......................................... 50 15 188 

Change in numbers of dogs denied entry with temporary suspension ...................................... 450 285 563 

The estimated costs and benefits (in 

2019 U.S. dollars) associated with the 

temporary suspension of dogs from 

countries at high-risk for CRVV are 

summarized in Table 2. CDC estimates 

that importers, CDC, and DHS/CBP will 

incur about $11.8 million in costs 

(range: $2.2–$57.6 million) over the oneyear period anticipated for the 

suspension. The large difference 

between the lower and upper bound is 

due to both uncertainty in the number 

of dogs imported from high-risk 

countries under the baseline as well as 

uncertainty in many of the costs 

associated with the suspension. 

Most of the costs will be incurred by 

importers (most likely estimate of $10.8 

million, 91% of the total), who will 

have to (1) spend time requesting 

advance written permission, (2) pay for 

serologic testing unless the imported 

dog already has a valid U.S. rabies 

vaccination certificate issued by a U.S.- 

licensed veterinarian, (3) re-route travel 

to a port of entry with a live animal care 

facility with a CBP-issued FIRMS code, 

and (4) the potential economic costs of 

being unable to import a dog from a 

high-risk country (either the inability to 

travel with a pet from a high-risk 

country or the need to substitute the 

importation of a dog from CRVV-free or 

low-risk country instead of a dog from 

a high-risk country). 

The one-year benefits (averted costs) 

from the temporary suspension are 

estimated to be $2.3 million, range: 

$1.0–$5.1 million). Most of the benefits 

(most likely estimate of $1.5 million, 

64% of total) of the temporary 

suspension accrue to CBP due to the 

reduction in the number of dogs 

imported from high-risk countries 

(which require screening), the number 

of dogs denied entry, and an estimated 

decrease in the amount of time to 

review a CDC permit vs. the time 

required to review documentation under 

the baseline. Importers, CDC, and 

airlines also benefit from the averted 

costs associated with the reduction in 

the number of dogs denied entry with 

the suspension relative to baseline. The 

net cost of the temporary suspension is 

calculated from the annual 

costs¥annual benefits resulting in an 

estimate of $9.5 million (range: $1.2– 

$52.5 million). 

TABLE 2—SUMMARY TABLE OF COSTS AND BENEFITS IN 2019 DOLLARS, OVER A 1-YEAR TIME HORIZON

Category Most likely 

estimate Lower bound Upper bound 

Benefits: 

Annual monetized benefits to importers/owners of dogs from high risk countries .............. $579,260 $215,765 $1,508,443 

Annual monetized benefits to airlines .................................................................................. 54,000 11,400 168,750 

Annual monetized benefits to DHS/CBP .............................................................................. 1,491,418 678,417 3,055,534 

Annual monetized benefits to HHS/CDC ............................................................................. 198,369 92,153 398,948 

Total annualized monetized benefits ............................................................................ 2,175,209 920,521 4,836,488 

Quantified, but unmonetized, benefits .................................................................................. The estimated response costs associated with a 

dog imported while infected with canine rabies 

virus variant (CRVV) are $315,682, range: 

$215,386 to $508,879. The permit requirement 

for high risk countries should reduce the risk of 

importation of dogs infected with CRVV. 


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36Raybern, C et al. Rabies in a dog imported from 

Egypt-Kansas, 2019. Morb Mort Wkly 2020; 69 (38): 

1374–1377. 37CDC. Guidance Regarding Agency 

Interpretation of ‘‘Rabies-Free’’ as It Relates to the 

Importation of Dogs Into the United States. Fed 

Register 2019;84:724–730. https://

www.federalregister.gov/documents/2019/01/31/ 

2019-00506/guidance-regarding-agencyinterpretation-of-rabies-free-as-it-relates-to-theimportation-of-dogs. 

38HHS/ASPE, 2016. Office of the Assistant 

Secretary for Planning and Evaluation, U.S. 

Department of Health and Human Services. 

Guidelines for Regulatory Impact Analysis. https:// 

aspe.hhs.gov/system/files/pdf/242926/HHS_

RIAGuidance.pdf. Accessed April 20, 2020. 

39TJ Sidwa et al. (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. 

40R.T. Sterner et al. (2009) Tactics and Economics 

of Wildlife Oral Rabies Vaccination, Canada and the 

United States. Emerging Infectious Diseases; 15(8), 

1176–1184. 

TABLE 2—SUMMARY TABLE OF COSTS AND BENEFITS IN 2019 DOLLARS, OVER A 1-YEAR TIME HORIZON—Continued 

Category Most likely 

estimate Lower bound Upper bound 

Qualitative benefits ............................................................................................................... Any importation of a dog with CRVV will require 

the reallocation of limited public health resources to support a response to mitigate the 

risk of transmission of CRVV. This could reduce the effectiveness of COVID–19 response 

activities and vaccination programs. In addition, these competing priorities may increase 

the risk of unlikely, but very costly outcomes 

associated with an importation of a dog with 

CRVV such as (1) the potential risk of death in 

a person who may be unaware of his/her exposure to a dog with CRVV and (2) the risk of reintroduction of CRVV in the United States. 

Costs: 

Annualized monetized costs to Importers/owners of dogs from high risk countries ........... $10,752,595 $1,956,530 $54,191,420 

Annual monetized costs to airlines ...................................................................................... 0 0 0 

Annualized monetized costs to DHS/CBP ........................................................................... 192,498 0 461,994 

Annual monetized costs to HHS/CDC ................................................................................. 848,142 280,952 2,974,298 

Total annualized monetized costs ................................................................................. 11,793,199 2,237,473 57,627,615 

The primary public health benefit of 

the temporary suspension is the reduced 

risk that a dog with CRVV will be 

imported from a high-risk country. 

Based on experience with previous 

importations, CDC estimated the cost 

per imported dog with CRVV to be 

$315,682, range $215,386 to 

$508,879.36 37 This cost estimate 

includes health department staff time 

for the public health response, 

payments for post-exposure prophylaxis 

for exposed persons, and the costs 

associated with quarantining or 

euthanizing exposed animals. Any 

importation of a dog with CRVV would 

also likely divert public health 

resources away from COVID–19 

response activities. 

Using the most likely estimates of the 

net cost ($9.5 million) and the most 

likely estimate of the potential benefits 

of averting the importation of a dog with 

CRVV from a high-risk country 

($316,000), it is possible to calculate 

how many dogs with CRVV would need 

to be imported under the baseline for 

the benefits to equal costs. The net costs 

($9.5 million) divided by the cost per 

importation ($316,000) suggests that at 

least 30 dogs with CRVV would need to 

be imported under the baseline for 

benefits to exceed costs. This would 

require a huge increase in the number 

of dogs imported into the United States 

while infected with CRVV, which could 

only occur as a result of widespread 

failures of rabies control programs in 

multiple high-risk countries. 

The above estimate of the cost of an 

importation of a dog with CRVV does 

not account for the worst-case 

outcomes, which include (1) 

transmission of rabies to a person who 

dies from the disease or (2) ongoing 

transmission to other domestic and 

wildlife species in the United States. Reestablishment of CRVV into the United 

States, while unlikely, could result in 

costly efforts over several years to again 

eliminate the virus. 

The cost of re-introduction could be 

especially high if CRVV spreads to other 

species of U.S. wildlife. Both of these 

worst-case outcomes may be more likely 

to occur during the COVID–19 

pandemic because public health 

resources have been diverted to COVID– 

19 response activities and vaccination 

programs. 

Human deaths from rabies continue to 

occur in the United States after 

exposures to wild animals. However, no 

U.S. resident has died after exposure to 

an imported dog with CRVV in at least 

20 years. CDC uses the value of 

statistical life (VSL) to assign a value to 

interventions that can result in mortality 

risk reductions. For 2019, the estimated 

VSL is $10.6 million with a range of 

$5.0 to $16.2 million.38 However, CDC 

is unable to estimate the potential 

magnitude of the mortality risk 

reduction associated with the temporary 

suspension. 

Re-establishment of CRVV into the 

United States, while unlikely, would 

also result in costly efforts over a 

number of years to eliminate the virus. 

A previous campaign to eliminate 

domestic dog-coyote rabies virus variant 

jointly with gray fox (Texas fox) rabies 

virus variant in Texas over the period 

from 1995 through 2003 cost $34 

million,39 40 or $52 million in 2019 U.S. 

dollars. The costs to contain any 

reintroduction would depend on the 

time period before the reintroduction 

was realized, the wildlife species in 

which CRVV was transmitted, and the 

geographic area over which 

reintroduction occurs. The above 

estimate is limited to the cost of rabies 

vaccination programs for targeted 

wildlife and does not include the costs 

to administer post-exposure prophylaxis 

to any persons exposed after the 

reintroduction has been identified. 

Assumptions Used To Estimate Costs 

and Benefits 

CDC estimated costs and benefits to 

importers, CDC, CBP, and airlines under 

the baseline and with the temporary 


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32048 Federal Register / Vol. 86, No. 114 / Wednesday, June 16, 2021 / Notices 

41Bureau of Labor Statistics in the May 2019 

National Occupational Employment and Wage 

Estimates United States https://www.bls.gov/oes/ 

current/oes_nat.htm. 42U.S. Department of Transportation, Office of 

Transportation Policy. The Value of Travel Time 

Savings: Departmental Guidance for Conducting 

Economic Evaluations Revision 2 (2016 Update), 

‘‘Table 4 (Revision 2—2016 Update): Recommended 

Hourly Values of Travel Time Savings.’’ September 

27, 2016. https://www.transportation.gov/sites/ 

dot.gov/files/docs/2016%20Revised%

20Value%20of%20

Travel%20Time%20Guidance.pdf. Accessed June 

4, 2020. 

43United Kingdom Animal and Plant Health 

Agency Laboratory Price List TC702. https://

science.vla.gov.uk/Tests/SearchResults.aspx?Site

Name=CDT&PriceListCategoryId=33. Accessed 11/ 

1/2020. 44PetSide. How Much Does it Cost to Microchip 

a Dog. https://www.petside.com/dog-microchipcost/ Accessed 2/17/2021. 

45HHS/CDC. Guidance Regarding Agency 

Interpretation of ‘‘Rabies-Free’’ as It Relates to the 

Importation of Dogs Into the United States. (January 

31, 2019) 84 FR 724: 724–730. 

46HHS/CDC. Guidance Regarding Agency 

Interpretation of ‘‘Rabies-Free’’ as It Relates to the 

Importation of Dogs Into the United States. (January 

31, 2019) 84 FR 724: 724–730. 

47HHS/CDC. Guidance Regarding Agency 

Interpretation of ‘‘Rabies-Free’’ as It Relates to the 

Importation of Dogs Into the United States. (January 

31, 2019) 84 FR 724: 724–730. 

48HHS/CDC. Guidance Regarding Agency 

Interpretation of ‘‘Rabies-Free’’ as It Relates to the 

Importation of Dogs Into the United States. (January 

31, 2019) 84 FR 724: 724–730. 

suspension in place. All cost estimates 

were converted to 2019 U.S. dollars. 

The costs to importers with the 

temporary suspension were calculated 

using the following assumptions: 

• The opportunity costs for importer 

time were estimated at $36.41 (range: 

$25.72–$47.10) per hour based on the 

average U.S. wage rate and a 

Department of Transportation estimate 

specific to international travelers.41 42

• Importers seeking advance written 

permission for 15,124 (range: 3,263– 

59,890) dogs. 

Æ An assumption of 1 hour (range 

0.5—2 hours) to submit advance written 

approval and fulfill the informational 

and testing requirements for a permit. 

Æ Estimated costs of $50 (range: $20– 

$65) for a rabies titer test at an approved 

rabies serology laboratory.43

Æ Assumed cost of $100 (range: $80– 

$120) for a veterinarian to draw blood 

sample and ship it to an approved rabies 

serology laboratory. 

Æ Estimated cost of $40 (range: $25– 

$50) to implant a microchip.44

Æ An assumption that 40% of 

importers will already have a valid 

rabies vaccination certificate issued by a 

U.S.-licensed veterinarian and will not 

need testing from an approved rabies 

serology laboratory or microchip. 

Æ An assumption that 75% of 

importers of dogs from high-risk 

countries would need to re-route travel 

to a port of entry with a live animal care 

facility with a CBP-issued FIRMS code, 

which would incur an increased ticket 

cost of $200 and 4 additional hours of 

travel time. 

• Importers who are unable to import 

a dog from a high-risk country because 

of the temporary suspension (45,572, 

range: 29,518–60,265 dogs) would incur 

an assumed cost of $100 (range: $50– 

$400) per dog because of time spent 

away from pets or increased costs of 

substitution to import a dog from a 

CRVV-free or low-risk country. 

The costs for CDC were estimated 

based on: 

• An assumed staff time cost of 20 

minutes (range: 15–30 minutes) per 

permit issued by a GS–12, step 5 

reviewer. 

• Oversight of the permit process by 

two GS–13, step 5 veterinarians. 

• 30 minutes of staff time to revise 

training materials for CBP staff. 

• CDC staffing costs are estimated 

using the GS pay scale for the Atlanta 

area and multiplying by 2 to account for 

non-wage benefits and overhead. 

The costs for CBP included 5 minutes 

(range 0–10 minutes) for 25,052 (range: 

20,402–30,602) CBP officers (average 

level GS–12, step 5) to receive training 

on the temporary suspension. CBP 

staffing costs are estimated using the GS 

pay scale for the Washington, DC area 

and multiplying by 2 to account for nonwage benefits and overhead. 

CDC assumed that airlines would not 

incur new costs for this temporary 

suspension because the time required to 

review CDC-issued permits prior to 

boarding dogs from high-risk countries 

should be similar to the amount of time 

required to review vaccination 

certificates under the current baseline. 

There may be some reduction in cargo 

fees revenue associated with the 

reduction in dogs imported from 

countries at high risk for CRVV (range: 

29,518–60,265 dogs), but this lost 

revenue may be offset by revenues 

received to import dogs from CRVV-free 

or low-risk countries or revenue 

received for cargo other than dogs. CDC 

lacks sufficient data to estimate such 

costs but expects the net cost to airlines 

to be limited. 

The expected annual benefits (averted 

costs) were estimated for importers, 

CDC, CBP, and airlines based on the 

reduced numbers of dogs delayed entry 

and the reduced time spent by CBP 

officers to screen dogs from high-risk 

countries. 

The estimated benefits (averted costs) 

for importers were estimated based on: 

• An estimated reduction in time 

spent by CBP to review documentation 

for dogs from high-risk countries 

assuming an estimate of 17 minutes 

(range: 13.6–20.4 minutes) per dog to 

review documentation under the 

baseline 45 to 5 minutes (range: 3–8 

minutes) per dog to review permits 

during the suspension. 

• An estimated 2 hours per dog 

denied entry (estimated at 450 fewer 

dogs denied entry, range: 285–563) with 

the suspension relative to baseline. 

• CDC assumed that 80% of dogs 

denied entry would be re-imported to 

the United States at a round-trip cost of 

$1,200 per dog to the importer.46

• CDC assumed that 20% of dogs 

denied entry would be abandoned by 

importers at a cost of $100 per dog to 

the importer. 

The estimated benefits (averted costs) 

to CDC were estimated based on: 

• An estimated 4 hours of CDC staff 

time per dog denied entry at an average 

GS-level 13, step 5 at CDC Headquarters 

and an average of 30 minutes of CDC 

quarantine station staff time per dog 

denied entry at an average GS-level 11, 

step 5. The actual mix of staff at CDC 

Headquarters who need to support 

denials of entry would vary from GS–11 

through Senior Executive Staff and 

varies depending on time spent on 

appeals and finding shelter for 

abandoned dogs. 

The estimated benefits (averted costs) 

to CBP were estimated based on: 

• An estimated reduction in the 

number of dogs imported from high-risk 

countries due to the temporary 

suspension: 45,572 (range: 29,758– 

60,115) relative to baseline. 

• Under the baseline, CDC estimated 

that each dog imported from a high-risk 

country requires 17 minutes (range: 

13.6–20.4 minutes) of CBP officer time 

to review documents (GS–12, step 5).47

• With the temporary suspension in 

place, CDC estimates that the time 

required to review CDC-issued permits 

would decrease from the above to 5 

(range: 3–8) minutes per dog for the 

estimated 15,124 (range: 3,263–59,890) 

dogs arriving with permits. 

• An estimated reduction in the 

number of dogs denied entry because of 

the temporary suspension: (estimated at 

450 fewer dogs denied entry, range: 

285–563). 

• An estimate of 71 (range: 47–95) 

minutes of CBP staff time required per 

dog denied entry (GS–12, step 5).48

The estimated benefits (averted costs) 

for airlines were estimated based on: 

• The reduction in the estimated 

numbers of dogs denied entry and 

abandoned by importers (100 under the 

baseline vs. 10 with the suspension of 

entry). 


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Federal Register / Vol. 86, No. 114 / Wednesday, June 16, 2021 / Notices 32049 

49HHS/CDC. Guidance Regarding Agency 

Interpretation of ‘‘Rabies-Free’’ as It Relates to the 

Importation of Dogs Into the United States. (January 

31, 2019) 84 FR 724: 724–730. 

50HHS/CDC. Guidance Regarding Agency 

Interpretation of ‘‘Rabies-Free’’ as It Relates to the 

Importation of Dogs Into the United States. (January 

31, 2019) 84 FR 724: 724–730. 

51Bureau of Labor Statistics, May 2019 National 

Occupational Employment and Wage Estimates. 

https://www.bls.gov/oes/current/oes_nat.htm. 

52Bureau of Labor Statistics in the May 2019 

National Occupational Employment and Wage 

Estimates United States https://www.bls.gov/oes/ 

current/oes_nat.htm. 

53Rayburn et al. (2020) Rabies in a Dog Imported 

from Egypt—Kansas, 2019. MMWR; 69(38): 1374– 

1377. 

54HHS/CDC. Guidance Regarding Agency 

Interpretation of ‘‘Rabies-Free’’ as It Relates to the 

Importation of Dogs Into the United States. (January 

31, 2019) 84 FR 724: 724–730. 

55Rayburn et al. (2020) Rabies in a Dog Imported 

from Egypt—Kansas, 2019. MMWR; 69(38): 1374– 

1377. 

56HHS/CDC. Guidance Regarding Agency 

Interpretation of ‘‘Rabies-Free’’ as It Relates to the 

Importation of Dogs Into the United States. (January 

31, 2019) 84 FR 724: 724–730. 

• An assumed cost of $600 per dog 

for airlines to fly abandoned dogs back 

to their countries of origin.49

The costs associated with an 

importation of a dog with CRVV 

includes health department staff time 

for the public health response, 

payments for post-exposure prophylaxis 

treatment for exposed persons, and the 

costs associated with quarantining or 

euthanizing exposed animals. CDC 

estimated the response cost per 

imported dog with CRVV to be 

$315,682, range $215,386 to $508,879 

based on the following assumptions: 

• An estimate of 800 hours of health 

department staff time per importation.50

• The public health response time is 

split evenly among veterinarians (code 

29–1131, $50.39 per hour), 

epidemiologists (19–1041, $37.64 per 

hour), registered nurses (29–1141, 

$37.24 per hour), licensed practical 

nurses (29–2061, $23.32 per hour), and 

office and administrative assistants (43– 

0000, $19.73 per hour).51 52 These wage 

estimates are multiplied by 2 to account 

for non-wage benefits and overhead. 

• An average of 25 (range: 16–44) 

individuals will require post-exposure 

prophylaxis because of exposure to the 

dog with CRVV.53 54

• The average cost of post-exposure 

prophylaxis was estimated to be 

$9,290.55

• An estimated 29.6 animals would 

need to be quarantined or euthanized 

due to exposure to the dog with CRVV. 

• Each exposed animal would incur 

economic costs of $1,000 for quarantine 

or euthanasia.56

V. Terms of This Notice 

Therefore, pursuant to 42 CFR 

71.51(e) and 42 CFR 71.63, and subject 

to the terms of this notice, CDC hereby 

excludes the entry and suspends the 

importation of dogs from high-risk 

countries, including dogs from low-risk 

and CRVV-free countries if the dogs 

have been present in a high-risk country 

in the previous six months. 

Additionally, under 42 CFR 71.63, 

CDC finds that CRVV exists in countries 

designated as high-risk countries and 

that, if reintroduced into the United 

States, CRVV would threaten the public 

health of the United States. The 

continued entry of dogs from high-risk 

countries in the context of the current 

limited CDC resources and personnel 

diverted to respond to COVID–19 

further increases the risk that CRVV 

may be introduced, transmitted, or 

spread into the United States. CDC has 

coordinated in advance with other 

federal agencies as necessary to 

implement and enforce this notice. 

This notice is not a rule within the 

meaning of the Administrative 

Procedure Act (‘‘APA’’), but rather 

notice of an emergency action taken 

under the existing authority of 42 CFR 

71.51(e) and 42 CFR 71.63. In the event 

that this notice qualifies as a rule under 

the APA, notice and comment and a 

delay in effective date are not required 

because there is good cause to dispense 

with prior public notice and the 

opportunity to comment on this notice. 

Considering the public health 

emergency caused by the virus 

associated with COVID–19, the ongoing 

diversion of public health resources and 

personnel to respond to the pandemic, 

and the risk of reintroduction of CRVV 

from dogs being imported from high-risk 

countries, it would be impractical and 

contrary to the public’s health, and by 

extension the public’s interest, to delay 

the issuance and effective date of this 

notice. 

Effective July 14, 2021: Pursuant to 

the exception, dogs from high riskcountries must be 6 months of age to be 

imported and fully vaccinated against 

rabies, and eligible importers may only 

import up to 3 dogs upon receipt of 

advanced written approval from the 

CDC. Importers wishing to import dogs 

from high-risk countries should: 

1. Submit a request for advanced 

written permission (i.e., Application for 

a Permit to Import a Dog Inadequately 

Immunized Against Rabies, (approved 

under OMB Control Number 0920–0134 

Foreign Quarantine Regulations (exp. 

03/31/2022), or as revised)) at least 30 

days prior to planned importation in the 

United States. 

2. Submit all documentation listed 

above in Section III Advanced Written 

Approval. 

The request for advance written 

permission must include proof of the 

dog’s identity including pictures of the 

dogs’ teeth, other descriptive details, 

proof of rabies vaccination, and 

microchip information. Dogs arriving 

from high-risk countries must enter the 

United States at a port of entry with a 

live animal care facility with a CBPissued FIRMS code that can provide 

accommodation that meets the U.S 

Department of Agriculture’s Animal 

Welfare Act standards. 

This temporary suspension will 

remain in place until the earliest of (1) 

the expiration of the Secretary of Health 

and Human Services’ declaration that 

COVID–19 constitutes a public health 

emergency; (2) the CDC Director 

rescinds or modifies this suspension 

based on specific public health or other 

considerations; or (3) 360 days from 

publication in the Federal Register. 

Dated: June 9, 2021. 

Sandra Cashman, 

Executive Secretary, Centers for Disease 

Control and Prevention. 

[FR Doc. 2021–12418 Filed 6–14–21; 4:15 pm] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10494 and CMS– 

10773] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, Health and Human 

Services (HHS). 

ACTION: Notice. 

SUMMARY: The Centers for Medicare & 

Medicaid Services (CMS) is announcing 

an opportunity for the public to 

comment on CMS’ intention to collect 

information from the public. Under the 

Paperwork Reduction Act of 1995 (the 

PRA), federal agencies are required to 

publish notice in the Federal Register 

concerning each proposed collection of 

information (including each proposed 

extension or reinstatement of an existing 

collection of information) and to allow 

60 days for public comment on the 

proposed action. Interested persons are 

invited to send comments regarding our 

burden estimates or any other aspect of 

this collection of information, including 

the necessity and utility of the proposed 


jbell on DSKJLSW7X2PROD with NOTICES