Starting on October 1, 2021, any applicant for lawful permanent residence and other categories that require the immigration medical examination must be fully vaccinated against COVID-19. USCIS will implement this requirement by mandating proof of fully vaccinated status before a USCIS-approved civil surgeon can complete an immigration medical examination and sign Form I-693, Report of Medical Examination and Vaccination Record on behalf of an applicant.

U.S. Citizenship and Immigration Services (USCIS) announced that it is updating its policy guidance to incorporate the CDC’s August 17, 2021 instructions to civil surgeons. That update requires applicants subject to the immigration medical examination to be “fully” vaccinated against COVID-19. Currently, this means having received two doses of the Pfizer or Moderna vaccines or one dose of the Johnson & Johnson vaccine. Applicants will be required to provide documentation of vaccination to the civil surgeon before completion of the immigration medical examination.

The immigration medical examination is most commonly required of lawful permanent residence (“green card”) applicants to show they are free from any conditions that would render them inadmissible under 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. Failure to have completed the vaccination could result in a denial of the lawful permanent residence application by USCIS. This change adds COVID-19 to the list of diseases against which lawful permanent residence applicants must be vaccinated.

USCIS may grant a blanket waiver of the COVID-19 vaccine requirement for applicants based on one of the following conditions:

• The applicant is below a certain age and should not receive the vaccine;

• The applicant cannot be vaccinated due to a medical condition; or

• Vaccines are not routinely available or are in limited supply where the civil surgeon practices.

In addition to the blanket waivers that may be implemented by USCIS, applicants may also apply for an individual waiver based on religious beliefs or moral convictions by submitting Form I-601, Application for Waiver of Grounds of Inadmissibility.