Under the immigration laws of the United States, an individual who applies for an immigrant visa abroad, or who seeks permanent residency while in the United States, must undergo a medical examination to establish that they are free from any conditions that would render them inadmissible on health-related grounds.

Effective October 1, 2021, in addition to the current list of mandatory inoculations, the Centers for Disease Control (CDC) mandates that applicants must also demonstrate completion of a COVID-19 vaccination series (one or two doses, depending on the vaccine) to the panel physician or civil surgeon performing the medical evaluation. According to the CDC, the following constitute acceptable proof of vaccination: (1) an official vaccination record, or (2) a copy of a medical chart with entries made by a physician or other appropriate medical personnel. Absent this documentation, the panel physician or civil surgeon may agree to administer the vaccine to the applicant to meet this requirement.

Alternatively, under CDC guidelines, waivers from this requirement are available under certain circumstances. Blanket waivers may be granted to those deemed age-inappropriate for the vaccine, those for whom vaccination is contraindicated due to other medical concerns, and those in locations with limited supply. In addition, an applicant may seek an exemption from the vaccination requirement by establishing with evidence that:

  • The applicant is opposed to vaccinations in any form (not an objection to just one type of vaccination);
  • The objection is based on religious beliefs or moral convictions; and
  • The belief or conviction is sincere.

In response to the CDC announcement, U.S. Citizenship and Immigration Services will update the medical evaluation form and instructions to reflect the new COVID-19 vaccination requirement.

The new requirement reflects the White House's national strategy to combat COVID-19 and substantially increase the number of people covered by vaccination requirements. According to the CDC, the United States recently surpassed 40 million COVID-19 cases since the start of the pandemic, with more than 4 million of these cases reported in the past few weeks. The CDC also reports that approximately 63% of the U.S. population has received at least one dose of vaccine, and about 53% of the U.S. population has been fully vaccinated.

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