Person with blue medical gloves holding syringe and vial.

Effective October 1, 2021, and in compliance with new instructions from the U.S. Centers for Disease Control and Prevention (CDC), COVID-19 vaccinations will be required for applicants for lawful permanent residence (i.e., green card status). On August 17, 2021, the CDC announced in guidance for civil surgeons that the new requirement will apply to persons who are seeking to adjust their immigration status within the United States as well as those applying for an immigrant visa at U.S. consulates abroad.

The CDC is responsible for ensuring that noncitizens entering the United States do not have health conditions that would pose a threat to the public health of this country. As such, a medical examination is required by CDC regulations as a means of evaluating the health of persons applying for adjustment of status as permanent residents in the United States. According to the CDC, “COVID-19 meets the definition of a quarantinable communicable disease,” and “[s]pecifically … meets the definition of severe acute respiratory syndromes …, thus making it a Class A Inadmissible Condition.” The U.S. Citizenship and Immigration Services (USCIS) policy manual defines Class A conditions as “medical conditions that render a person inadmissible and ineligible for a visa or adjustment of status.”

At the time of the medical examination, the CDC guidance states that green card applicants must present evidence of completing the entire vaccine series (one or two doses depending on the vaccine formulation). To demonstrate they have completed the vaccination series, applicants may present their official vaccination record or a copy of their medical chart showing they have been vaccinated against COVID-19. The United States will not accept “self-reported vaccine doses without written documentation” from a doctor or medical professional. The acceptable versions of the vaccine include those manufactured by Pfizer-BioNTech, Moderna, and Janssen (Johnson & Johnson).

The CDC further noted that “there are specific blanket waivers that cover reasons why an applicant did not receive the required vaccination.” These blanket waivers include those granted for individuals who are not yet at the age recommended for the current formulations (i.e., children under 12 years of age). Additionally, a waiver may apply “[i]f an applicant has a contraindication or precaution to the COVID-19 vaccine formulation available,” such as an allergy. Another waiver may be provided if the vaccine is not available where the civil surgeon is practicing. The CDC stated that civil surgeons should document the applicant’s reason for not receiving the vaccination as “not routinely available” and no additional waiver request to USCIS is needed.

If an applicant declines a COVID-19 vaccination for other reasons, such as on the basis of moral or religious grounds, the applicant must submit an individual waiver request to USCIS. At its sole discretion, USCIS will determine whether the waiver will be granted. If the applicant refuses the vaccination, whether in part or the entire series, the applicant may be found inadmissible for lawful permanent resident status.

The COVID-19 vaccine is the latest to join the list of required vaccinations. USCIS requires all green card applicants to receive vaccinations for eight specified diseases, and “[a]ny other vaccine-preventable diseases recommended by the Advisory Committee for Immunization Practices.” The U.S. Department of State also lists 14 required vaccinations for immigrant visa applicants seeking entry to the United States.

Ogletree Deakins’ Immigration Practice Group will continue to monitor developments with respect to these and other policy changes and will post updates on the Immigration blog and in the firm’s Coronavirus (COVID-19) Resource Center as additional information becomes available. Important information for employers is also available via the firm’s webinar and podcast programs.


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Ogletree Deakins has one of the largest business immigration practices in the United States and provides a wide range of legal services for employers seeking temporary business visas and permanent residence on behalf of foreign national employees.

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