U.S. Citizenship and Immigration Services today announced that, effective Oct. 1, 2021, applicants subject to the 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.

We are updating our policy guidance in accordance with the Centers for Disease Control and Prevention’s Aug. 17, 2021 update to the Technical Instructions for Civil Surgeons. That update requires applicants subject to the immigration medical examination to 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. We are working on updating Form I-693 and the form instructions to incorporate this new requirement.

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.

USCIS may grant blanket waivers if the COVID-19 vaccine is:

  • Not age-appropriate;
  • Contraindicated due to a medical condition;
  • Not routinely available where the civil surgeon practices; or
  • Limited in supply and would cause significant delay for the applicant to receive the vaccination.

Individuals may also apply for individual waivers based on religious beliefs or moral convictions by submitting Form I-601, Application for Waiver of Grounds of Inadmissibility.


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