The medical examination is considered an essential step of the immigration procedure required for all seeking immigration. According to Immigration and Nationality Act (INA), section 212(a)(1)(A)(ii), it is compulsory to ensure that the green card seeker has no health issue to make them ‘inadmissible for the green card. A healthcare professional may conduct blood tests during the medical examination to check for specific diseases, immunization status, and the required vaccine.
Steps of Immigration Medical Exam:
The medical exam must be conducted by a government-authorized doctor, consists of the following steps;
- A review of medical history
- Immunization record of an individual
- Screening of drug and alcohol
- Tests for various diseases
Most applicants feel nervous about the medical exam that can delay their immigration process. But applicants should consider it normal and prepare themselves to make the entire exam less stressful. The applicant must receive vaccination listed in the Immigration and Nationality Act (INA) and recommended by the ACIP. CDC’s Division of Global Migration and Quarantine (DGMQ) has the legal authority to set health screening standards for immigrants and refugees. Immigrants are screened
- Before coming to the United States, when seeking permanent residence, OR
- In the United States, when changing their visa status to become permanent residents.
The Advisory Committee on Immunization Practices (ACIP) is a group of vaccine experts who provide written guidance for the vaccination of children and adults in the United States. As per the recommendations of the Advisory Committee on Immunization Practices (ACIP), Centers for Disease Control and Prevention (CDC) uses the following criteria to determine the requirement of specific vaccines for immigration purposes:
- The vaccine must be age-appropriate and for one of the following:
- The vaccine for a contagious disease or pandemic; or
- The vaccine for a disease that is eliminated entirely or in the process of being eliminated in the United States.
Authorized person to conduct medical examination:
CDC issues the technical Instructions for the immigration medical examination in the United States. As per technical instruction of the CDC, the civil surgeon is authorized to conduct the vaccination assessment. The civil surgeon will review the vaccination record against vaccine-preventable diseases during a medical examination.
In case of a lack of vaccination records as per age categorization, the civil surgeon will administer the vaccines as needed. As an alternative, a green card applicant can choose a private healthcare provider to request immigration vaccination.
The civil surgeon records the medical examination results on USCIS Form I-693 and issues medical examination and vaccination records reports. In case of vaccination from private healthcare, the immigration applicant must submit complete documentary evidence to the civil surgeon.
Moreover, if someone doesn’t wish to receive the required vaccines, they must tell the civil surgeon about the reason to avoid vaccination. In this case, they may get a waiver under the following circumstances:
- As opposed to a specific type of vaccination
- Objection based on religious beliefs or moral convictions
- The religious or moral beliefs must be sincere.
Requirement of Vaccination for specific diseases:
From December 14, 2009, the human papillomavirus (HPV) and zoster vaccines are not required for immigrants. According to new vaccination criteria, proof of vaccination is needed against the following diseases;
- Tetanus and diphtheria
- Meningococcal disease
- Pneumococcal disease
- Haemophilus influenza type B
- Varicella (chickenpox)
- Hepatitis A
- Hepatitis B
Application of New Vaccination Criteria:
New vaccination criteria are applied on all types of recommended vaccines by CDC and to all applicants applying for a green card and or who seek legal permanent residence in the United States at regular periods. It includes all those examined overseas and those already in the United States who want to adjust their visa status to become legal permanent residents.
Vaccination requirement according to age:
These are the age-appropriate vaccines as stated by the CDC and the USCIS:
|Vaccine type according to the disease||Requirement according to the age group|
|Tetanus and diphtheria
|2-11 months (DTP/DTaP/DT)
7-10 years- sometimes (Td/Tdap)
11-65 years (Td/Tdap)
|Measles, Mumps, and Rubella||12 months to 64 years (if born in 1957 or later)|
|Rotavirus||Six weeks to 8 months old|
|Hib||2 months to 59 months|
|Hepatitis A||12 months to 23 months|
|Hepatitis B||From birth to 18 years old|
|Meningococcal||11 years to 18 years|
|Varicella||Over 1 year|
|Pneumococcal||2 months to 59 months (PVC)
Over 65 (PVS or PPSV)
|Influenza||Over 6 months|
In the following cases, an individual may get be an exemption from the required vaccinations:
- Exemption for Medical Reasons.
- Not age-appropriate
- Medical risk
- Not the right time to receive vaccinations
- Influenza vaccine is not available
- Exemption for Non-Medical Reasons.
- Religious exemptions
- Exemption for Certain Adopted Children.
- If someone adopted the child from outside of the US, complete all vaccination. While vaccination waiver can only be availed for a child under ten years of age if the adoptive parent signs an affirmation to ensure the child completes the vaccinations after they enter the US.
On October 1, 2021, CDC issued the technical instructions for panel physicians to ensure the full COVID-19 vaccination series for all immigrant visa applicants during their medical exam prior to being issued a visa. Additionally, the CDC requires the COVID-19 vaccine must be approved through either the World Health Organization (WHO) or the U.S. Food and Drug Administration (FDA).
Blanket waivers for the COVID vaccination will be applied to those countries where the vaccine is not routinely available or when the vaccine is not age-appropriate. Overall, The Department of State encourages all immigrant visa applicants to get vaccinated against COVID-19 as soon as possible to avoid delays in their visa processing.
- https://www.boundless.com/immigration-resources/preparing for the medical exam/ retrieved on December 23, 2021.
- https://www.uscis.gov/tools/designated-civil-surgeons/vaccination-requirements retrieved on December 23, 2021.
- https://www.cdc.gov/immigrantrefugeehealth/laws-regs/vaccination-immigration/revised-vaccination-immigration-faq.html retrieved on December 23, 2021.
- https://www.cdc.gov/immigrantrefugeehealth/pdf/revised-fact-sheet-fed-reg-notice-vaccination-immigration.pdf retrieved on December 23, 2021.
- https://visaguide.world/us-visa/green-card/vaccination-requirements/ retrieved on December 23, 2021.