USCIS Removes COVID-19 Vaccine Requirement from Green Card Medical Exam

As of January 22, 2025, USCIS officially stopped requiring proof of COVID-19 vaccination from permanent residence applicants in the United States. The change was formalized through a policy alert that removed the requirement from Form I-693, the immigration medical examination report. In 2026, the rule remains in effect, aligning the immigration process with the American public health stance adopted after the end of the federal public health emergency declared by the federal government in May 2023.

The measure affects all applicants for adjustment of status within the United States, all consular processing abroad, and any pending case that had not yet been decided. For many immigrants, this means one fewer item on the medical exam checklist, with no impact on the public health requirements that remain in effect.

How the Previous Requirement Worked

The COVID-19 vaccine mandate was added to the immigration medical examination in October 2021, at the height of the pandemic, following technical guidance from the Centers for Disease Control and Prevention (CDC) to USCIS-accredited civil surgeons. At the time, permanent residence applicants had to present complete proof of their vaccination schedule — two doses of mRNA vaccines or the single-dose Janssen regimen — before the authorized physician signed Form I-693.

Those who could not prove vaccination faced three options: get vaccinated before the medical appointment, formally request an exemption on religious or moral conscience grounds through Form I-601, or face a Request for Evidence (RFE) and potential denial of their petition. This situation caused significant delays in adjustment of status cases between 2021 and 2024.

What Changed Under the New Policy

Removing the requirement has concrete and immediate effects:

• USCIS-authorized civil surgeons no longer need to verify COVID-19 vaccination status when completing Form I-693.
• USCIS stopped issuing Requests for Evidence (RFE) or Notices of Intent to Deny (NOID) for lack of COVID-19 vaccination.
• Pending cases that had not yet been decided were automatically processed under the new rule, with no action required from the applicant.
• Approved petitions that referenced the vaccine requirement were not retroactively affected.

Important to clarify: the change does not mean USCIS stopped evaluating public health. CDC-listed vaccines remain mandatory and the medical examination continues to be a non-negotiable requirement for permanent residence.

Vaccines That Remain Required for the Green Card

The Vaccination Technical Instructions for Civil Surgeons, updated by the CDC in 2025, maintains a substantial list of required immunizations. Mandatory vaccines include:

• Measles, mumps, and rubella (MMR)
• Polio
• Varicella (chickenpox)
• Diphtheria, tetanus, and pertussis (Tdap or DTP)
• Hepatitis A
• Hepatitis B
• Haemophilus influenzae type B (Hib), age-dependent
• Pneumococcal conjugate vaccine, age-dependent
• Rotavirus, age-dependent
• Meningococcal, age-dependent
• Seasonal influenza, during flu season

Those who have already completed these vaccination schedules in their home country should present their official vaccination record to the civil surgeon during the exam. In the absence of proof, doses will need to be administered before the finalized I-693 is issued.

Practical Impact for Those Adjusting Status in the U.S.

Adjustment of status, formalized through Form I-485, is the path used by immigrants already residing in the United States on a valid visa — including H-1B, L-1, F-1, O-1, E-2, J-1 holders, and spouses on derivative visas — to convert their status to permanent residence without leaving the country.

Under the new rule:

• The medical exam can be submitted alongside the I-485 without any COVID-19-related documentation.
• Cases with a pending I-485 since 2022, 2023, or 2024 that still carried unresolved issues related to the vaccine requirement were administratively unlocked.
• Form I-693 is valid for two years from the civil surgeon’s signature, so those who completed their exam before 2025 with the vaccine on record do not need to repeat the procedure due to the regulatory change.

What Changes in Consular Processing

Consular processing is the path used by applicants who apply for an immigrant visa at a U.S. embassy or consulate abroad. In this process, the medical examination is conducted by credentialed panel physicians within the consular network, not by USCIS-accredited civil surgeons.

Following the January 2025 change, the Department of State also aligned its instructions to panel physicians, removing the COVID-19 vaccine requirement from pre-immigration exams conducted abroad. Consular cases processed in 2026 should no longer include this requirement, but it is prudent to verify with the embassy or consulate handling your case, as protocols may vary locally in specific situations.

Long-Term Stability of the Rule

U.S. immigration policy is volatile. Changes in administration, health outbreaks, or executive orders could reintroduce similar requirements. The COVID-19 vaccine specifically was removed because the federal public health emergency ended and the CDC reclassified the disease as manageable within the regular immunization system. For the mandate to return, a new declared health emergency or revised CDC technical guidance would be required.

Every applicant is advised to monitor the official USCIS website, especially the Form I-693 page, and the CDC portal for civil surgeons, before scheduling their medical exam.

Practical Recommendations for the Immigration Medical Exam

Form I-693 remains one of the most sensitive documents in the Green Card process. A few practices reduce the risk of rework:

• Locate a USCIS-accredited civil surgeon using the official Find a Civil Surgeon tool before scheduling your appointment — exams performed by non-accredited physicians are not accepted.
• Bring your complete vaccination record from your home country; the more documented your history, the lower the chance of needing additional doses.
• In cases of a past positive tuberculosis test, bring treatment records — this is currently one of the most common grounds for an RFE.
• Remember that Form I-693 can only be used within two years of the civil surgeon’s signature. Sync your exam date with the expected USCIS decision timeline.
• In consular processing, schedule the exam with the panel physician designated by the consulate — other clinics are not accepted.

The removal of the COVID-19 vaccine from Form I-693 is a genuine simplification, but the medical examination continues to be the primary public health gateway in the American immigration system. Keeping a complete vaccination record, choosing the correct accredited professional, and respecting administrative deadlines are practices that continue to make the difference between a smooth application and months of pending issues.

Victoria Harper

Editor-in-Chief

Meet the author

Leading journalism and editorial content at Visto n’ Visa, Victoria helps make immigration topics clear, trustworthy, and easy to understand. Her focus is on delivering useful, human, and relevant content for people exploring new paths abroad.