Vice President Kamala Harris’s doctor said in a letter Saturday that she is in “excellent health” as she released her first medical report in an effort to draw a sharp contrast with her 78-year-old opponent, Republican Donald Trump.

The letter, from Joshua R. Simmons, Harris’s physician for the past 3½ years, concludes that the 59-year-old Harris “possesses the physical and mental resiliency required to successfully execute the duties of the presidency.”

Harris had a physical in April that was “unremarkable,” according to the letter, and she has only minor medical conditions. She has seasonal allergies and urticaria, a common skin condition that can cause itchy, raised bumps or welts on the skin. Her allergies have been managed with over-the-counter and prescription medications, according to the letter, and Harris has been on allergy immunotherapy for the past three years, which her physician said has greatly improved both her allergy and urticaria symptoms to the point that she no longer needs regular medication.

Harris released the letter as her campaign seeks to draw more attention to Trump’s health and age and paint them as liabilities to his capacityto serve as commander in chief, according to a senior Harris aide, who spoke on the condition of anonymity to freely discuss a sensitive issue. The letter, which provides information including Harris’s blood pressure, heart rate and blood oxygen level, stops short of a full medical report.

Trump has refused to release his medical reports since entering the presidential race, which Harris’s advisers see as an opportunity to draw attention to questions about his age and mental acuity. In recent weeks, several Harris aides and surrogates have sought to draw more focus to Trump’s rambling speeches and confusing answers, especially during unscripted moments. He frequently mixes up names, dates, cities and countries when recalling events.

Harris is releasing the letter from her doctor as polls show she and Trump have been in a deadlocked race for several weeks and her campaign says they expect a race that will come down to razor-thin margins.

Democrats were careful not to draw attention to the issue of age when President Joe Biden, 81, was the party’s nominee, and the White House was extraordinarily defensive of questions about the president’s mental acuity and ability to serve for another four years — especially after a halting debate performance in June that ultimately led Biden to drop out of the race.

Since Harris’s ascent to the top of the ticket, however, Democrats and the Harris campaign have aimed to make Trump’s age a liability. In the final, critical three weeks before Election Day, on Nov. 5, Harris’s campaign is hoping to raise concerns among voters about why Trump has not released more medical information, contrast her age and “vitality” with his, and highlight Trump’s refusal to agree to another debate or mainstream media interviews.

Trump, who is the oldest person to become a presidential nominee after Biden dropped out of the race this summer, has long guarded even basic health information. Since entering the race last year, Trump has released only a vague, three-paragraph letter from his primary care physician, Bruce A. Aronwald.

In that letter in November, Aronwald wrote that the former president was in excellent physical and mental health He later said in a statement released by campaign officials to The Washington Post that “there is no need for President Trump to release another medical report in addition to the one he recently made public.”

After a gunman grazed Trump’s ear in an assassination attempt in July, Trump released a letter from his former White House physician, Rep. Ronny Jackson (R-Tex.), who described treating a two-centimeter-wide wound to Trump’s right ear. The letter stated that Trump had a CT scan of his head and other tests, but the campaign did not release the results.

Trump’s most detailed health update came in 2018, while he was serving as president. Jackson, who was then his physician, appeared at the White House press room podium and provided details that included a CT scan showing Trump’s coronary calcium score was 133, up from 34 in 2009. At the time, CNN’s chief medical correspondent, Sanjay Gupta, and other experts said the score indicated that Trump had heart disease.

That letter also said Trump weighed 239 pounds, making him borderline obese. In the following two years, Trump’s doctors revealed that his weight had increased to 243 and then 244 pounds, making him obese according to government standards.

But during other points of Trump’s presidency, he and his physicians were misleading about his health, including when he had covid-19 in October 2020, before vaccines were available and the virus was killing thousands of Americans every day. Trump’s infection was far more serious than his advisers acknowledged at the time.

Simmons’s letter noted that Harris’s family has a history of colon cancer, which led to her mother’s death. He said Harris has no personal history of diabetes, high blood pressure, high cholesterol, cardiac disease, pulmonary disease, neurological disorders, cancer or osteoporosis. Harris’s only surgical history is the removal of her appendix when she was 3 years old, Simmons wrote.

Simmons, who holds the rank of colonel in the Army, also wrote that Harris maintains “a healthy, active lifestyle despite her busy schedule, including vigorous daily aerobic exercise and core strength training,” noting that the vice president also “eats a very healthy diet.”