United States: Starting October 1, CDC Requires COVID-19 Vaccination for Most Green Card Applicants

When the new requirement takes effect, green card applicants attending their medical examination will be required to show proof of full COVID-19 vaccination with a vaccine authorized for use in the United States or listed for emergency use by the World Health Organization. Self-reports of vaccination will not be accepted without written documentation.  

If an applicant is not yet fully vaccinated and the COVID-19 vaccine is available to the U.S. civil surgeon or panel physician performing the medical exam, the doctor is permitted to vaccinate the applicant.  However, the applicant must receive the full COVID-19 vaccine series before the medical exam can be completed, so case processing may be delayed if the applicant attends an exam unvaccinated.

The new CDC policy includes guidance regarding waivers and testing for adjustment of status and immigrant visa applicants as follows:

• Blanket waivers: Blanket waivers of the COVID-19 vaccine requirement will apply to applicants who are younger than the lowest age limit for available vaccines in their jurisdiction, as well as for those who can document a medical contraindication. Also, in certain circumstances, if the COVID-19 vaccine is not routinely available in the jurisdiction of the U.S. civil surgeon or panel physician performing the medical exam, the applicant may be permitted a blanket waiver.

• Waiver based on religious or moral convictions: If an applicant objects to COVID-19 vaccination on religious or moral grounds, the applicant must submit a waiver request to U.S. Citizenship and Immigration Services (USCIS). USCIS will determine if the waiver is granted. Neither the examining physician nor the CDC can make this determination.

• Tests for immunity: The CDC advises that lab tests for COVID-19 immunity are not to be conducted as part of the green card medical exam. Applicants must receive the vaccine regardless of evidence of immunity or prior COVID-19 infection. The CDC notes that this is because the duration of immunity due to natural infection is still being investigated and may not protect the applicant throughout the immigration process.

The CDC will also implement some additional protocols for foreign nationals applying for immigrant visas abroad (IV) at U.S. embassies and consulates. 

• Testing for COVID-19 infection: IV applicants must be tested for infection if they report symptoms of COVID-19 at the time of scheduling or attending their medical exam. The exam will be postponed until they have met the recovery criteria to end isolation. Further, testing of asymptomatic applicants ages two years and older may be required at the discretion of the panel physician, in order to support the public health safety of their clinics.

• Close contacts of persons with COVID-19 infection: Immigrant visa applicants in close contact with someone with COVID-19 will be unable to clear their medical exam until they complete 14 days of quarantine.

Starting October 1, green card applicants who attend their medical examination without proof of full COVID-19 vaccination will likely experience delays in their case processing, unless clearly exempt under one of the blanket waiver categories.

As a reminder, for international airline passengers ages two years and older, the Centers for Disease Control and Prevention requires a negative COVID test or evidence of recent COVID recovery in order to travel to the United States.