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Effective on Nov. 1, 2018, applicants must submit Form I-693 that is signed by a civil surgeon no more than 60 days before filing the underlying application for an immigration benefit. The Form I-693 would remain valid for a two-year period following the date the civil surgeon signed it.

Also, starting October 1,  2018,  the tuberculin skin test (TST) will no longer be accepted for US Citizenship and Immigration Services (USCIS) I-693 Form Report of Medical Examination and Vaccination Record.

All applicants ages 2 and up will now be required to obtain a TB blood test (interferon-gamma release assay or IGRA) as the initial TB screening method.

This new TB blood test will bear the following consequences:

  • Children will be subjected to venipuncture (blood work)
  • There will be an increase in the price of the medical exam
  • The sealed envelope will be ready in 4-5 business days instead of 2 days as previously promised.

Questions regarding Form I-693 Report of Medical Examination and Vaccination Record:

Q1. Can a civil surgeon accept identification issued in an applicant’s maiden name if she also provides a marriage certificate? How does the civil surgeon notate this if the Form I-693 is completed in her married name but the identity document is in her maiden name?

A1. Yes. A civil surgeon can accept government-issued identification that was issued in an applicant’s maiden name if she also provides a marriage certificate. If a married applicant completes Part 1 of Form I-693 with a different name from the name on her government-issued identification, then the civil surgeon may note on the applicant’s Form I-693 that the name in Part 1 is different from the ID presented because it is the applicant’s married or maiden name. USCIS will gather and review the applicant’s aliases as part of the adjudication of the adjustment of status application.

Q2. Why is HIV testing no longer a required part of the medical exam?

A2. As of Jan. 4, 2010, HIV infection is no longer defined as a communicable disease of public health significance. By regulation, HIV infection was removed from the list of inadmissible conditions for immigration purposes and from the scope of the immigration medical examination. Therefore, HIV testing is no longer required as part of the immigration medical exam.

Q3. Please confirm that the civil surgeon is responsible for providing at least one dose of each required vaccine as part of the immigration medical exam.

A3. According to the CDC’s Vaccination Technical Instructions, all adjustment of status applicants must be assessed for vaccination requirements. The required vaccines are based on the applicant’s age at the time of the medical evaluation. An applicant only needs to receive a single dose of the age appropriate vaccine(s) that are not medically contraindicated and that have no valid documentation of previous immunization.. If a single dose of a vaccine is required and given, and the vaccine is one in which a series of doses is required to complete the series and the single dose given does not complete the series, then the ‘insufficient interval’ box should also be checked by the civil surgeon on Form I-693.

Therefore, the vaccines required for applicants do not include all the vaccines recommended by the ACIP and CDC for routine US domestic use, and are limited to vaccination for the following diseases:

  • Diphtheria
  • Tetanus
  • Pertussis
  • Polio
  • Measles
  • Mumps
  • Rubella
  • Rotavirus
  • Haemophilus influenzae type b (Hib)
  • Hepatitis A
  • Hepatitis B
  • Meningococcal disease
  • Varicella
  • Pneumococcal disease
  • Influenza

For more information on immigration medical,

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