COVID-19 Vaccinations Required for Green Card and Immigrant Visa Medical Exams Starting October 1, 2021

Beginning October 1, 2021, COVID-19 vaccinations will be required for all immigrant visa applicants in the United States and abroad who receive their medical examination from a Civil Surgeon (U.S.) or a Panel Physician (abroad) on or after October 1, 2021.

This new requirement is according to recent instructions issued by the Centers for Disease Control and Prevention (CDC). The requirement affects those applying for permanent residence in the U.S. and immigrant visas abroad at U.S. consular posts. COVID-19 infections have been classified as a Class A medical condition of inadmissibility because they meet the definition of a severe acute respiratory syndrome.

Green card applicants have long been required to receive a medical exam by an approved civil surgeon when applying from within the U.S.  After the medical exam, the civil surgeon completes a Form I-693, Report of Medical Examination and Vaccination Record, which is submitted with the green card/permanent residence application. Abroad, U.S. embassies and consulates empanel local physicians, referred to as “panel physicians,” to conduct the required medical exams.

During the exam, applicants are required to show proof that they have received certain vaccines, soon to include the COVID-19 vaccination.   The COVID-19 vaccination requirement will differ from previous requirements in that the entire vaccine series (1 or 2 doses depending on formulation) must be completed in addition to the other routinely required vaccines. Only records with dates of receipt (month, day, and year) will be acceptable, and the manufacturer and lot number should be included as well. Self-reported vaccinations without written documentation will not be accepted.  Below is an example of the timetable for COVID-19 vaccinations provided by the CDC:


If an applicant does not have proof of having received the COVID-19 vaccine(s), the civil surgeon or panel physician may vaccinate the applicant at the time of the medical exam.  However, applicants will still need to complete the entire vaccine series (1 or 2 doses depending on formulation), which could delay completion of the exam.  Although the COVID-19 vaccine schedules cannot be shortened, the other parts of the medical examination can be scheduled at the discretion of the applicant and the civil surgeon. The civil surgeon is required to confirm documentation in person that the applicant received all doses of the COVID-19 vaccine.  If applicants wish to complete the remaining exam components after they are fully vaccinated against COVID-19, civil surgeons are encouraged to accommodate their requests.

COVID-19 Vaccination Waivers

In certain situations, a blanket waiver of the COVID-19 vaccination may apply, meaning applicants in the following scenarios are not required to prove they received the COVID-19 vaccine(s):

  • Not age-appropriate. Applicants who are younger than the lowest age limit (less than 12 years of age at present) for the specific formulations in use in their jurisdiction;
  • Applicants with a documented contraindication or precaution to the administration of the COVID-19 vaccine formulation available; and
  • Not routinely available. If no COVID-19 vaccine is routinely available in the state where the civil surgeon practices, or if the vaccine is available, but due to limited supply, it would cause significant delay to receive the vaccination.

The CDC instructions also address certain scenarios when an applicant does not complete a COVID-19 vaccine:

  • Religious or moral convictions. Applicants may request a vaccination waiver based on religious or moral convictions by submitting a waiver request to U.S. Citizenship and Immigration Services (USCIS). USCIS will determine if this type of waiver is granted, not the civil surgeon or CDC.
  • If an applicant refuses to receive the COVID-19 vaccination, the examining physician will document that the vaccine requirements are not complete and that the applicant refuses vaccination. Such applicants are inadmissible to the U.S., and therefore will not be eligible for a green card/immigrant visa.

Proof of immunity from COVID-19 cannot be used for the medical exam. Applicants are required to receive the vaccine series regardless of evidence of immunity or prior COVID-19 infection, as the duration of immunity due to natural infection is still being investigated and might not protect the applicant throughout the immigration process.

Applicants who arrive for their medical exams abroad with clinical signs and symptoms of COVID-19 should be tested for infection, and applicants with symptoms of COVID-19 must complete the required isolation period before returning for the exam even with a negative COVID-19 test result. In addition to symptom screening, panel physicians may choose to require lab testing of all applicants two years of age and older.  Close contacts of persons with laboratory-confirmed or probable COVID-19 must complete 14 days of quarantine.

In light of this new vaccine requirement, green card and immigrant visa applicants should prepare well in advance of their medical exams to receive the entire vaccine series to avoid delays.  Finally, applicants who qualify for one of the blanket waivers should have their documents prepared in advance to help expedite the process. It is unclear how long the COVID-19 vaccine(s) will be required, but for now, early preparation is key.


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About The Author

Matthew Martinez is a Member in Dickinson Wright’s Phoenix office, representing employers in all matters of business immigration. He can be reached at 602-285-5056 or His biography can be viewed here.