Foreign nationals seeking to become lawful U.S. permanent residents have long been required to submit to an immigration medical examination conducted by a designated U.S. civil surgeon in order to prove they do not have any health conditions that would make them inadmissible to the U.S. for health-related grounds. When applying for a U.S. immigrant visa at a U.S. embassy or consulate abroad, or for adjustment to U.S. permanent resident status in the U.S., it is a long-standing requirement that foreign nationals receive vaccinations to prevent mumps, measles, rubella, polio, tetanus and diphtheria, pertussis, haemophilus influenza type B, hepatitis B, and any other vaccine-preventable diseases recommended by the Advisory Committee for Immunization Practices (“ACIP”). The ACIP is the advisory committee to the U.S. Department of Health and Human Services/Centers for Disease Control and Prevention (“CDC”) that recommends immunizations for the general U.S. population. As of December 14, 2009, when the ACIP recommends a new vaccine for the general U.S. population, the CDC uses specific criteria to determine whether this vaccine should also be required to attain admissibility for U.S. immigration purposes.
On August 17, 2021, the CDC issued updated the Vaccine Technical Instructions for Civil Surgeons by requiring foreign nationals undergoing an immigration medical examination to complete a COVID-19 vaccination series (one or two doses depending on the vaccine formulation) and provide documentation of vaccination to the U.S. civil surgeon prior to completion of the immigration medical examination. Following suit, U.S. Citizenship and Immigration Services (“USCIS”) has updated the USCIS Policy Manual to require applicants for a U.S. immigration visa abroad, as well as applicants in the U.S. for adjustment to permanent resident status, to submit COVID-19 their vaccination records to the U.S. civil surgeon prior to completion of the immigration medical examination. Notably, a U.S. civil surgeon may issue a waiver of this COVID-19 vaccination requirement when it is not age-appropriate; is contraindicated by the applicant’s health condition; where the vaccine is not routinely available in the state or country where the civil surgeon practices; or is available in limited supply and would cause significant delay of applicant’s completion of the vaccination series. Generally, however, as of October 1, 2021, without proof of a prior completion of a COVID-19 vaccination series, a U.S. civil surgeon cannot complete and sign the required Form I-693 for the immigration medical examination, effectively preventing the applicant from receiving a U.S. immigrant visa abroad or adjusting to U.S. permanent resident status in the U.S.