Children will be exempt from a new vaccine requirement for international travelers, but most will still be required to test negative for COVID-19 before getting on a plane to the United States, U.S. officials said Monday.

Most foreign nationals seeking to visit the United States will be required beginning Nov. 8 to provide proof to airlines that they are fully vaccinated against COVID-19 and tested negative for the virus within three days of their departures.

But there will be exemptions to those rules for children under age 18, and individuals from about 50 countries where vaccine access is extremely limited, senior administration officials told reporters. Individuals who have certain medical conditions or are participating in a COVID-19 vaccine trial will also be allowed to enter the United States without providing proof of vaccination.

“We fully are aware that the global distribution and availability of vaccines varies widely,” a senior administration official said. “There will be exemptions specifically for countries that have insufficient vaccines to have persons fully vaccinated.”

Covid tests will still be required for all international travelers, except very young children. Individuals from countries on the exemption list will be required to test negative one day before they board a U.S.-bound aircraft. Children ages 2 to 17 traveling with a fully vaccinated adult must test negative within three days prior to their flight to the United States. Children under age 2 will not be required to test.

Unaccompanied children and children traveling with unvaccinated adults will be required under the new rules to test negative within one day of their flight, the new guidance says.

The United States will also ease pandemic-related restrictions on its land borders on Nov. 8. The new rules for traveling to visit family and friends will be similar to those that will guide air travel.

Individuals who drive into the United States for non-essential purposes, including tourists, will have to attest that they have been vaccinated against the coronavirus and may be asked to provide documentation. They will not need to provide evidence of a negative test, a U.S. official previously said.

Truck drivers and other individuals who are coming across the land border for essential reasons will have to be vaccinated beginning in January, the Biden administration announced earlier this month.

Since the beginning of the pandemic, the United States has barred most non- U.S. citizens from certain countries from flying in. Countries on that list include China, India, the UK, France, Spain, Italy and Germany. All foreign nationals who meet a new set of criteria for international travel will be allowed in next month.

The Centers for Disease Control and Prevention has determined that individuals who have received a vaccine approved for use by the World Health Organization will be allowed in. That list includes some vaccines not approved for use in the United States such as AstraZeneca.

The CDC has announced that it would count as fully vaccinated individuals who have received doses of different vaccines on the approved list. For instance, an individual who received one dose of the AstraZeneca vaccine and one Moderna shot would be allowed to enter the country.

Foreign nationals flying from countries where the vaccination rate is 10% or less can apply for a travel exemption, U.S. officials said Monday. Foreign nationals seeking an exemption for humanitarian reasons must have a compelling reason for coming to the United States and tourist visas will not qualify, one official said.

“This will represent a very, very small number of actual travelers to the U.S.,” the official said.

All international plane passengers will be required to provide proof of a negative test under the new rules to enter the United States, including American citizens. Vaccinated Americans can test up to three days before their flight, while unvaccinated Americans will have to show proof of a negative test a day before their flights.

Rapid tests for COVID-19 are allowed under the U.S. rules. But rapid tests that are conducted at home require the supervision of a telehealth professional. United Airlines advises travelers coming to the United States to purchase a package of Abbott BinaxNOW home tests that come with telehealth services from eMed.

The system for providing proof of vaccination and a negative test could vary by airline. The Biden administration has opted not to create a vaccine passport similar to those that have been implemented in European countries.

Individual airlines have adopted their own systems for customers to show they meet international travel requirements.

For instance, Delta Air Lines offers passengers the opportunity to submit their negative test results before they arrive at the airport through the FlyReady application.

A senior administration official said that digital vaccination certificates would be accepted by airlines, and passengers who do not participate in such a program could show their paper vaccination card at the airport.

Paper vaccination cards could be rechecked at the time of boarding, one official said.

Airlines will also be required, beginning next month, to collect basic contact information from passengers, U.S. officials have said, to meet a new contact tracing requirement.

Updates with quotes from senior administration officials.

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