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USCIS Policy Alert (COVID-19 Vaccination Requirement) September 14, 2021

September 14, 2021

SUBJECT: COVID-19 Vaccination Requirement for Immigration Medical Examination



U.S. Citizenship and Immigration Services (USCIS) is updating guidance in the USCIS Policy Manual regarding health-related grounds of inadmissibility in accordance with recently updated requirements issued by the Centers for Disease Control and Prevention (CDC). The updated guidance, which is effective October 1, 2021, requires applicants subject to the immigration medical examination to submit COVID-19 vaccination records before completion of immigration medical examinations conducted in the United States and overseas.



In general, those applying to become a lawful permanent resident, and other applicants as required, must undergo an immigration medical examination to show they are free from any conditions that would render them inadmissible under health-related grounds.1 USCIS designates eligible physicians as civil surgeons to perform this immigration medical examination for those applying within the United States using the Report of Medical Examination and Vaccination Record (Form I-693).


On August 17, 2021, the CDC released an update to the Vaccination Technical Instructions for Civil Surgeons, requiring applicants subject to the immigration medical examination to complete the COVID-19 vaccine series (currently one or two doses, depending on formulation) and provide documentation of vaccination to the civil surgeon before completion of the immigration medical examination.


This update, contained in Volumes 8 and 9 of the Policy Manual, is effective October 1, 2021, and applies prospectively to all Forms I-693 signed by a civil surgeon on or after that date. The guidance contained in the Policy Manual is controlling and supersedes any related prior guidance.

Policy Highlights

  • Explains that, beginning October 1, 2021, applicants who are required to undergo the immigration medical examination must complete the COVID-19 vaccine series before the civil surgeon can complete the immigration medical examination and sign Form I-693.

  • Explains that the civil surgeon may indicate that a blanket waiver could apply in cases where the COVID-19 vaccine is not age appropriate, where it is contraindicated, or where it is not routinely available in the state where the civil surgeon practices or where it is limited in supply and would cause significant delay for the applicant to receive the vaccination



Volume 8: Admissibility, Part B, Health-Related Grounds of Inadmissibility, Chapter 9, Vaccination Requirement [8 USCIS-PM B.9]; and Volume 9: Waivers and Other Forms of Relief, Part D, Health-Related Grounds of Inadmissibility, Chapter 3, Waiver of Immigrant Vaccination Requirement [9 USCIS-PM D.3].





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