Logan Reed
As of August 2025, the US Centers for Disease Control and Prevention (CDC) recommends COVID-19 vaccines for children aged 6 months to 2 years. However, the CDC does not specify whether vaccination is mandatory for children entering the US. Instead, vaccination requirements for immigrants are determined by the CDC's Technical Instructions for Civil Surgeons, which are based on recommendations from the Advisory Committee on Immunization Practices (ACIP). These instructions outline the necessary vaccinations for entry into the US, which may vary depending on age and specific criteria set by the CDC. Children travelling to the US may also need additional documentation, such as a passport or visa, and should contact their airline for specific requirements.
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What You'll Learn
- Children under 2 don't need a negative COVID-19 test to enter the US
- Children entering the US alone need their own travel documents
- Children travelling with one parent may need a letter of consent
- The CDC decides which vaccines are required for immigration purposes
- The ACIP advises the Department of Health and Human Services on immunisations
Children under 2 don't need a negative COVID-19 test to enter the US
As of December 2021, all visitors to the US must provide a negative COVID-19 test result. This rule applies to everyone travelling to the US on international flights, including US citizens. However, there are exceptions for children under the age of two. Children under two years old do not need to present a negative COVID-19 test result.
The US requires visitors to take a COVID-19 test no more than 24 hours before their flight departs. The test can be either a PCR test or a supervised antigen test. Visitors must also be fully vaccinated to enter the US. Children under the age of 18 are exempt from the vaccination requirement, but they are expected to take an extra test within 3-5 days of arrival.
It's important to note that local vaccine mandates in the US vary by state, county, and city. Generally, more liberal states and regions are more likely to require proof of vaccination for entering restaurants, bars, and other public spaces. For example, Los Angeles has a vaccine mandate that requires anyone aged 12 and up to be vaccinated to enter public spaces. Therefore, while children under 12 may be exempt from COVID-19 testing requirements when entering the US, they may still face restrictions when accessing public spaces within the country.
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Children entering the US alone need their own travel documents
For any child entering the US, there are specific requirements that must be met. Children, including infants, must have their own travel documents, such as a passport or visa, to enter the US. If the child is travelling alone, with only one custodial parent, or with a guardian, certain additional documents are required. These include documents that the child's country of origin requires for minors travelling outside their home country without both parents. Each country has its own rules for the specific documents it requires for a child to be allowed to leave without both parents or with a guardian. Therefore, it is important to check the specific requirements of the country of origin.
Furthermore, children travelling to the US alone may need a letter of consent from the other custodial parent. This letter, preferably in English and notarized, should indicate that the child has permission to travel with the accompanying adult. The letter should be signed by both parents if the child is travelling with a guardian or alone. It is also recommended to contact the airline in advance to learn about any specific age requirements for their unaccompanied minor service. For instance, US citizen children travelling by air to Canada or Mexico must have a US passport or Trusted Traveler Program card.
In terms of vaccination requirements, there are general guidelines set by the US Centers for Disease Control and Prevention (CDC). The CDC assesses whether new vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) for the general US population should be mandatory for immigration. This determination is made based on specific criteria, including age-appropriateness and protection against diseases eliminated or being eliminated in the US. While vaccination requirements primarily focus on immigrants and non-US citizens, there are certain instances where US citizens may also need to meet specific vaccination criteria when returning to the country.
As of November 8, 2021, all US citizens, nationals, lawful permanent residents, and immigrants entering the US by air are required to show proof of vaccination. Additionally, a negative COVID-19 test result taken no more than three days before boarding is mandated. Children under two years old are exempt from testing. The CDC and US Embassy websites provide further details and guidance on these requirements. It is worth noting that the American Academy of Pediatrics (AAP) has issued differing recommendations from the CDC regarding COVID-19 vaccinations for children. The AAP strongly recommends COVID-19 shots for children aged six months to two years.
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Children travelling with one parent may need a letter of consent
While there are no specific vaccination requirements for children entering the US, standard travel documentation is required. All children, including infants, must have their own travel documents. Children travelling with one parent may need a letter of consent from the other parent. This is not a legal requirement, but it may be requested by immigration authorities, and failure to produce this letter could result in delays or refusal of entry. The letter should be in English and notarized, and should include the sentence: "I acknowledge that my child is travelling outside the country with [the name of the adult] with my permission." If the other parent is deceased, a copy of their death certificate should be brought.
The US government recommends that children travelling alone, with only one parent, or with a guardian, should have a letter of consent at the border. This letter should be signed by the other parent, or by both parents if the child is travelling with a guardian or alone. The letter should be in English and notarized, and should include the sentence: "I acknowledge that my child is travelling outside the country with [the name of the adult] with my permission."
If a child is travelling to the US from Canada, a consent letter is not a legal requirement, but it may be requested by immigration authorities. The person accompanying the child should bring the original signed letter, as officials may be less likely to question the authenticity of an original document. If the accompanying adult has sole custody of the child, it is still advisable to obtain a consent letter signed by the non-accompanying parent.
It is important to note that the definition of a 'child' varies from country to country, but generally, any child under 19 should carry a consent letter. This letter may not be considered sufficient by a country's immigration authorities, and there is no guarantee that they will recognize it. The child may be subject to the same entry and exit requirements as other citizens of that country. It is recommended that you check the entry and exit requirements for your destination country, and contact the nearest embassy or consulate before travelling.
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The CDC decides which vaccines are required for immigration purposes
The Advisory Committee on Immunization Practices (ACIP) is an advisory committee to the Department of Health and Human Services (HHS)/Centers for Disease Control and Prevention (CDC). The ACIP provides recommendations on immunizations for the general US population, including how vaccines should be given, the age groups to which they should be given, and the number of doses required for each vaccine. The ACIP's guidance is based on the best available science, and it is used by the CDC to decide which vaccines are required for immigration purposes.
Since December 14, 2009, when the ACIP recommends new vaccines for the general US population, the CDC assesses whether these vaccines should be required for immigration purposes on a regular and as-needed basis according to specific criteria set by the CDC. The CDC publishes the Technical Instructions for Civil Surgeons, which include the vaccination requirements and immigration medical examination instructions, including a detailed table listing all required vaccines.
The CDC's criteria for determining which vaccines are required for immigration purposes include:
- The vaccine must be age-appropriate as recommended by the ACIP for the general US population.
- The vaccine must protect against a disease that has been eliminated in the United States or is in the process of being eliminated.
- The vaccine must protect against a disease with the potential to cause an outbreak.
The ACIP recommendations are used to decide which vaccines are age-appropriate for the general immigrant population. These criteria are applied to ACIP-recommended vaccines that are not specifically named in immigration law. If an overseas immigrant applicant has not received a vaccine that meets these criteria, they will be required to receive it during their immigrant medical exam, unless they can provide proof of having already received it or if the vaccine is not medically advised.
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The ACIP advises the Department of Health and Human Services on immunisations
As of November 8, 2021, all U.S. citizens, U.S. nationals, U.S. lawful permanent residents, and U.S. immigrants seeking to enter the United States by air are required to show proof of COVID-19 vaccination. Children under 2 years old are exempt from this rule. However, there is no general requirement for children to be vaccinated to enter the US. Instead, specific vaccination requirements are in place for immigrants.
The Advisory Committee on Immunization Practices (ACIP) advises the Department of Health and Human Services (HHS) on immunisations. ACIP is a committee within the United States Centers for Disease Control and Prevention (CDC) that provides advice and guidance on controlling vaccine-preventable diseases in the US civilian population. The committee is made up of medical and public health experts who develop recommendations on the use of vaccines. ACIP meetings are held three times a year and are open to the public. The committee's statements are official federal recommendations for using vaccines and immune globulins in the US and are published by the CDC.
The CDC decides which vaccines are required for immigration purposes. In addition to those specifically listed in INA section 212(a)(1)(A)(ii), the statute also requires that individuals receive any other vaccinations recommended by the ACIP. The CDC assesses whether new vaccines recommended by the ACIP for the general US population should be required for immigration. The CDC publishes the Technical Instructions for Civil Surgeons, which set the requirements for the immigration medical examination, including vaccination requirements. Civil surgeons are required to follow these instructions and record the results of the examination.
In June 2025, Secretary of Health and Human Services Robert F. Kennedy Jr. removed all 17 members of the ACIP, citing a need to restore public trust in vaccines. Kennedy stated that the new committee members would prioritise "unbiased science" and be free from "conflicts of interest". However, this decision was criticised by experts, who characterised it as continuing a pattern of degrading public health protections based on personal and political biases.
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Frequently asked questions
Children under 2 years old do not need to present a negative COVID-19 test result when entering the US. However, children over 2 years of age must follow the same vaccination requirements as adults when entering the US.
Beginning November 8, 2021, all individuals seeking to enter the United States by air are required to provide proof of vaccination and a negative COVID-19 test result taken no more than 3 days before departure.
All children, including infants, must have their own travel documents such as a passport or visa to enter the US. If the child is travelling alone, with only one custodial parent, or with a guardian, they may need a letter of consent from the other custodial parent.
Yes, there are accommodations for people who have documented recovery from COVID-19 in the past 90 days. Please refer to the CDC and U.S. Embassy websites for further details and guidance.
Contact your airline before your child's trip to find out about any age requirements for their unaccompanied minor service.
