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Effective October 1, 2021, applicants subject to Form I-693 immigration medical examination must be fully vaccinated against COVID-19 before the civil surgeon can complete an immigration medical examination and sign Form I-693, Report of Medical Examination and Vaccination Record.

Applicants subject to the immigration medical examination must complete the COVID-19 vaccine series (one or two doses, depending on the vaccine) and provide documentation of vaccination to the civil surgeon before completion of the immigration medical examination. This requirement is effective Oct. 1, 2021, and applies prospectively to all Forms I-693 signed by the civil surgeons on or after that date.

In general, individuals applying to become a lawful permanent resident, and other applicants as deemed necessary, must undergo an immigration medical examination to show they are free from any conditions that would render them inadmissible under the health-related grounds. USCIS designates eligible physicians as civil surgeons to perform this immigration medical examination for applicants within the United States and to document the results of the immigration medical examination on the Form I-693.

Blanket Waivers Applicable to COVID-19 vaccinations:

    • Not age-appropriate
      For COVID-19 vaccines, the age for which a particular vaccine can be administered differs by formulation. If the applicant is younger than the lowest age limit for the formulations in use (less than 12 years of age at the time of posting), this blanket waiver should be documented.
    • Contraindication
      If an applicant has a contraindication or precaution to the COVID-19 vaccine formulation available, the “Contraindicated” reason should be documented, and the vaccine should not be administered. If the applicant has had a severe reaction to the first dose that is considered a contraindication to receiving a second dose, the first dose should be documented in addition to the blanket waiver.
    • Not routinely available
      If no COVID-19 vaccine is routinely available in the state where the Civil Surgeon practices, the “Not routinely available” reason should be documented.  If vaccine is available to the applicant but due to limited supply, it would cause significant delay for the applicant to receive their vaccination, then this situation would also be considered “Not routinely available.”

Other reasons why an applicant does not complete a COVID-19 vaccine series:

  • Applicant may request a waiver based on religious or moral convictions.
    If an applicant objects to vaccination based on religious or moral convictions, it must be documented that the applicant is requesting an individual waiver based on religious or moral convictions. This is not a blanket waiver, and the applicant will have to submit a waiver request to US Citizenship and Immigration Services (USCIS). USCIS will determine if this type of waiver is granted, not the civil surgeon or CDC.
  • Applicant refuses a COVID-19 vaccine series in part or entirety
    If an applicant refuses one or more doses of a COVID-19 vaccine series that is medically appropriate for the applicant, it should be documented that the vaccine requirements are not complete and that the applicant refuses vaccination. This applicant is Class A and is inadmissible to the United States.

Vaccination Requirements for Immigrants

The Immigration and Nationality Act (INA)2 specifies the following vaccinations:

  • Mumps, measles, rubella;
  • Polio;
  • Tetanus and diphtheria toxoids;3
  • Pertussis;
  • Haemophilius influenza type B; and
  • Hepatitis B.

CDC requires the following additional vaccines for immigration purposes:

  • Varicella;
  • Influenza;
  • Pneumococcal pneumonia;
  • Rotavirus;
  • Hepatitis A;
  • Meningococcal; and
  • COVID-19.

USCIS considers a completed Form I-693 as valid if the civil surgeon’s signature is dated no more than 60 days submission to USCIS and no more than four years have passed since the date of the civil surgeon’s signature.

For more information on #COVIDvaccine Required for I-693 Immigration Medical & Green Card,

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