Beginning October 1, 2021, United States Citizenship and Immigration Services (“USCIS”) will require COVID-19 vaccinations for all applicants applying for lawful permanent residence (i.e. green card) with some exceptions. Specifically, all green card applicants who receive their medical examination from a designated civil surgeon/panel physician (“Physician”) on or after October 1, 2021 must complete the COVID-19 vaccine series and provide documentation of vaccination. This change will impact applicants who have their Physician complete Form I-693, Report of Medical Examination and Vaccination Record, on or after October 1, 2021. Green card applicants attending their medical examination on or after October 1, 2021 without proof of a completed COVID-19 vaccine series will most likely experience delays in the green card process. If Form I-693 is completed before October 1, 2021 and remains valid for filing (which must occur within 60 days of the Physician’s signature on the form), the COVID-19 vaccine should not be required.
USCIS has a long history of mandating certain vaccines for green card applicants. On or after October 1, 2021, before the routine medical examination can be completed, applicants must have received the entire COVID-19 vaccine series (1 or 2 doses depending on the formulation) and provide appropriate documentation to the Physician. Acceptable vaccination documentation includes an official vaccination record or a copy of a medical chart with entries made by a physician or other appropriate medical personnel. Self-reported vaccine doses without written documentation are not acceptable. Although an applicant may have received a laboratory test to confirm COVID-19 immunity, this may not be used for the medical examination and the applicant must receive the COVID-19 vaccine regardless of immunity. If applicants have not received all doses of the COVID-19 vaccine and the COVID-19 vaccine is available to the Physician, the Physician may vaccinate applicants and document the doses.
There are a few exceptions to the new CDC guidance, which includes blanket waivers.
Not age appropriate: If an applicant is not age-appropriate to receive the COVID-19 vaccine, a blanket waiver should be documented. Currently, the lowest age limit to receive a formulation is 12 years of age.
Contraindication: If an applicant is unable to receive a COVID-19 vaccine due to having a contraindication or precaution to any formulation available, they may qualify for a vaccine waiver. In the event this occurs, the “Contraindicated” reason should be documented. If an applicant has received the first dose of a COVID-19 vaccine series and has a severe reaction, the first dose should be documented in addition to the blanket waiver.
Not routinely available: If there is no COVID-19 vaccine available in the state where the Physician practices, or if there is a vaccine available but it would cause a significant delay for the applicant to receive the vaccine due to a limited supply, it should be documented as “Not routinely available.”
If an applicant objects to the COVID-19 vaccine based on religious or moral grounds, they must submit a waiver request to USCIS who will approve or deny the waiver. This type of waiver is not a blanket waiver, and neither the Physician nor CDC are authorized to grant this waiver.
If an applicant refuses to receive one or more doses of a COVID-19 vaccine series and one of the waivers above does not apply, it will be documented that the applicant refuses vaccination and will be inadmissible to the United States (Class A).
I-693 Medical Examination Update
Due to the COVID-19 pandemic, USCIS announced that effective August 12, 2021, the Form I-693 validity period would be temporarily extended from two (2) to four (4) years to help with delays in completing the medical examination. This temporary extension is effective only through September 30, 2021. If an applicant has received a Request for Evidence (“RFE”) from USCIS due to a medical examination expiration, and the medical exam is valid under the temporary extension, they should respond to USCIS by citing the updated guidance.