Immigrants in US need to be aware of a new rule introduced by the U.S. Citizenship and Immigration Services (USCIS). The new USCIS rule will apply to all foreigners submitting ‘Application to Register Permanent Residence or Adjust Status’ while in the US.

The USCIS Policy Manual has been updated to clarify that a Form I-693, Report of Immigration Medical Examination and Vaccination Record, signed by a civil surgeon on or after November 1, 2023, is only valid while the application the Form I-693 was submitted with is pending.

If the application a Form I-693 was submitted with is withdrawn or denied, that Form I-693 is no longer valid. This guidance is effective immediately and applies to applications pending or filed on or after June 11, 2025.

Under this updated policy, if a foreigner submitted Form I-693 with their Form I-485, Application to Register Permanent Residence or Adjust Status, and then they withdrew their Form I-485 or USCIS denied it, then if they submit a future Form I-485, they must submit a newly completed Form I-693 signed by a civil surgeon.

Form I-485, Application to Register Permanent Residence or Adjust Status, is used to apply for lawful permanent resident status if you are in the United States.

Adjustment of status is the process that you can use to apply for lawful permanent resident status (also known as applying for a Green Card) when you are present in the United States. This means that you may get a Green Card without having to return to your home country to complete visa processing.

Most foreigners subject to health-related grounds of inadmissibility must have an immigration medical examination to demonstrate they are not inadmissible. In general, a foreigner applying to adjust status must submit Form I-693 to show they are free from any conditions that would render them inadmissible under the health-related grounds of inadmissibility.

On April 4, 2024, the USCIS Policy Manual was updated to provide that a Form I-693 properly completed and signed by a civil surgeon on or after November 1, 2023, was valid indefinitely. This allowed a foreigner to use that Form I-693 as evidence that they were not inadmissible on health-related grounds for any future immigration benefit application.

On December 2, 2024, USCIS published a requirement that aliens submit Form I-693 when they file Form I-485.

USCIS has since determined that the April 4, 2024, policy is overly broad and could potentially threaten public health in the United States. By limiting the validity period to only the current immigration benefit application or request, USCIS ensures that foreigners get timely and proper medical examinations and treatment, which safeguards public health.

On January 22, 2025, USCIS announced that, as of January 20, 2025, officers would no longer issue any Requests for Evidence (RFEs) or Notices of Intent to Deny (NOIDs) related to the COVID-19 vaccination.

On March 11, 2025, the Centers for Disease Control and Prevention (CDC) updated their Technical Instructions for Civil Surgeons to remove the COVID-19 vaccination from the list of required vaccinations for foreigners seeking admission as immigrants.

Therefore, documentation of having completed the COVID-19 vaccination is not required for any immigration medical examinations associated with adjustment applications pending on or after January 20, 2025.

Until USCIS updates Form I-693, Report of Immigration Medical Examination and Vaccination Record, civil surgeons can either cross out the COVID-19 section or write “N/A,” and if the foreigner meets all the vaccination requirements, mark “Applicant completed vaccination requirements.”