Immigration, Public Health, and COVID-19 Vaccinations (Form I-693)

Public health concerns sit at the foundation of immigration law and policy. In 1647, the Massachusetts Bay Colony enacted a quarantine to restrict ships from Barbados, for fear of the transmission of the plague. The newly constituted United States government took an interest in the inspection of foreign vessels in 1789 and passed a federal Quarantine law in 1796. Over the years, yellow fever, bubonic plague, smallpox, malaria and other diseases have been responsible for quarantines, vaccinations, and other immigration restrictions.

Today, health care concerns sit at the top of the list of reasons for inadmissibility in the Immigration and Nationality Act. The Center for Disease Control issues guidance and restrictions related to health restrictions. COVID-19 is the latest concern, as we all know.

Effective October 1st, COVID-19 vaccines will be required for lawful permanent residence applicants, subject to limited exceptions. The particulars are explained in a recently related USCIS release, which is pasted and linked below.

COVID vaccinations are currently not required for temporary travelers to the United States, but they may soon be. Canada and other countries have adopted vaccination travel requirements. The vaccination requirements are clearly a growing trend.

Vaccine waivers for immigration are available when (1) a person is vaccinated but lacks documentation; the vaccine is not medically appropriate, as professionally determined; there is a sincere conflict with religious or moral convictions; and with certain vaccine shortage situations. For a religious or moral conviction waiver, the applicant must show that they are a.) opposed to vaccinations in any form; b.) their objection is based on religious belief or moral conviction; and c.) their belief or conviction is sincere.

Unfortunately, we are living through a time where public health concerns have once again taken center stage. COVID-19 vaccinations and COVID-19 testing requirements are sure to continue to factor into immigration procedures in the coming year.  Updates on the latest policy changes will be available at the USCIS and Department of State websites. We are available to discuss, with particularity.

Wishing all who read this the best in these difficult times, and especially good health.

COVID-19 Vaccination Required for Immigration Medical Examinations

Release Date 


U.S. Citizenship and Immigration Services today announced that, effective Oct. 1, 2021, applicants subject to the immigration medical examination must be fully vaccinated against COVID-19 before the civil surgeon can complete an immigration medical examination and sign Form I-693, Report of Medical Examination and Vaccination Record.

We are updating our policy guidance in accordance with the Centers for Disease Control and Prevention’s Aug. 17, 2021 update to the Technical Instructions for Civil Surgeons. That update requires applicants subject to the immigration medical examination to complete the COVID-19 vaccine series (one or two doses, depending on the vaccine) and provide documentation of vaccination to the civil surgeon before completion of the immigration medical examination. This requirement is effective Oct. 1, 2021, and applies prospectively to all Forms I-693 signed by the civil surgeons on or after that date. We are working on updating Form I-693 and the form instructions to incorporate this new requirement.

In general, individuals applying to become a lawful permanent resident, and other applicants as deemed necessary, must undergo an immigration medical examination to show they are free from any conditions that would render them inadmissible under the 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 of the immigration medical examination on the Form I-693.

USCIS may grant blanket waivers if the COVID-19 vaccine is:

  • Not age-appropriate;
  • Contraindicated due to a medical condition;
  • Not routinely available where the civil surgeon practices; or
  • Limited in supply and would cause significant delay for the applicant to receive the vaccination.

Individuals may also apply for individual waivers based on religious beliefs or moral convictions by submitting Form I-601, Application for Waiver of Grounds of Inadmissibility.

For more information, see the policy alert (PDF, 969.45 KB).

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