Beginning October 1, USCIS along with the United States Department of State (DHS) will be requiring green card applicants, seeking either refugee or lawful permanent status to be fully vaccinated for COVID-19 and show proof of it at their medical exam. This new I-693 Medical Exam vaccine requirement will apply to any permanent resident applicant (with exceptions permissible) who has a medical exam (by the Civil Surgeon or Panel Physician) scheduled on or past October 1st, 2021. Green card applicants are already required to be vaccinated for other diseases that would deem them inadmissible to the United States such as Mumps, Measles, Rubella, Polio, et c.

Based on the Center for Disease Control and Prevention’s (CDC) guidelines, “the applicant must complete the COVID-19 vaccine series and provide documentation of vaccination to the civil surgeon in person before completion of the medical examination.  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. COVID-19 vaccinations can now be given at any time, without regard to the timing of other vaccinations.”

The timelines for the Pfizer-BioNTech, Moderna, and Janssen (Johnson & Johnson) COVID-19 vaccines are outlined below. If you have only received the first dose of the COVID-19 vaccine at the time of your medical exam then you will be allowed to return to complete your medical exam after receiving the second dose.


covid vaccine immigration

What serves as proof of vaccination?

The following forms of documentation serve as proof of COVID-19 vaccination:

  • Medical vaccination record
  • Copies of your medical chart with dates of receiving the vaccine

Tests showing natural immunity from a past infection will not serve as proof for immigration purposes because the “duration of immunity due to natural infection is still being investigated and might not protect the applicant throughout the immigration process,” according to the CDC.

Extension to I-693 Validity Due to COVID

If you completed your I-693 Medical Exam prior to October 1, 2021 and it is still valid then you are exempt from this COVID-19 vaccine requirement. Remember, the medical exam is not required to be submitted to USCIS with the initial I-485 application filing. It will not be rejected if you do not include the medical exam information in the initial filing and as long as you submit it within the validity window (from the date the civil surgeon signs it) you should be okay.

Effective August 12, 2021, USCIS is temporarily extending the validity period of an otherwise valid Form I-693 in cases where:

  • The civil surgeon’s signature on Form I-693 is dated no more than 60 days before the applicant files Form I-485;
  • No more than 4 years have passed since the date of the civil surgeon’s signature; and
  • The decision on Form I-485 is issued on or before September 30, 2021.

If you are an I-485 applicant and have a priority date that will most likely be current soon (up to four years with the COVID extension), then it could be a good choice to have the medical exam ready to go in a sealed I-693 medical exam envelope. Check out this Complete Medical Exam Guide including details on the best time to prepare and submit the I-693 medical exam to USCIS.

Who is exempt from the vaccine requirement?

There are some reasons you can be exempt from the vaccine requirement including age, existing medical conditions, inability to acquire a vaccine due to limited supply, moral or religious reasons. Individuals who are under 12 years old are currently too young to receive the Moderna, Pfizer-BioNTech, and Johson & Johnson vaccines. The Pfizer-BioNTech vaccine is currently approved for children 12 years old or older and the Moderna and Johson & Johnson vaccine is approved for those 18 years and older. To qualify for the religious exemption you must submit a waiver request to USCIS and await their approval.