If you started researching your green card medical exam a couple of years ago and are only now scheduling it, one thing has changed: the COVID-19 vaccine is no longer on the required list. That single removal has left a lot of applicants unsure whether they misread an old blog post, whether their particular case is an exception, or whether the shot could come back before their appointment. It didn’t come back, and it isn’t case-by-case — but the change is narrower than many applicants assume, and it’s worth understanding exactly what did and didn’t move.
The COVID-19 Requirement Was Formally Removed in Early 2025
USCIS officially removed the COVID-19 vaccination requirement from the immigration medical exam on January 22, 2025. The change was tied to the Centers for Disease Control and Prevention updating its general public health guidance once the COVID-19 public health emergency phase had ended, and USCIS revised its own vaccination criteria for Form I-693 to match. Practically, that means a civil surgeon completing your exam today does not check a box for COVID-19 vaccination status, does not ask for a COVID-19 vaccine card, and cannot issue a waiver request for it — there is nothing to waive, because there is nothing to require.
If your civil surgeon’s office is still asking about COVID-19 vaccination as part of your intake paperwork, that’s likely an outdated form that hasn’t been refreshed since the change, not a sign that the requirement is somehow still active for your case. It’s a reasonable thing to ask about directly when you book: a clinic that’s current on the January 2025 change won’t blink at the question, and a quick confirmation can save you from showing up with a vaccine card you didn’t need.
What’s Still Mandatory on Form I-693
The COVID-19 removal did not touch the rest of the vaccination requirement. A licensed civil surgeon still verifies your immunization history against the CDC’s Technical Instructions for the applicant’s age group, and the core list of vaccine-preventable diseases covered on Form I-693 remains in place, including:
- Measles, mumps, and rubella (MMR)
- Polio
- Tetanus and diphtheria, with pertussis (Tdap)
- Hepatitis A
- Hepatitis B
- Varicella (chickenpox)
Applicants who can’t locate old immunization records, or who received their childhood vaccines outside the U.S. in a format the civil surgeon can’t verify, may still be asked to get a titer test or a catch-up dose — that process hasn’t changed either. What changed is narrower than the whole vaccine list: it’s specifically the COVID-19 line item that disappeared.
It also doesn’t mean any of the remaining vaccines are treated as optional or "nice to have." A civil surgeon working through Form I-693 is filling out a federal document under a specific set of criteria, and a gap in any one of the still-required vaccines gets flagged the same way it always did — either you get a dose that day, or your case moves forward with a formal waiver request attached. The only line item that quietly went away is COVID-19; everything else on the checklist behaves exactly as it did before the change.
The One Seasonal Wrinkle: Influenza
There’s a detail that trips people up because it looks similar to the COVID-19 situation but works differently: the seasonal flu vaccine is mandatory, but only for exams conducted during flu season, generally October 1 through March 31. Outside that window, it isn’t assessed. If your appointment lands in April and your civil surgeon doesn’t ask about a flu shot, that’s expected, not an oversight. If it lands in November, expect the question — and expect that a missing flu vaccine during flu season can trigger the same kind of waiver conversation that any other missing required vaccine would.
| Vaccine | Current Status | Notes |
|---|---|---|
| COVID-19 | Not required | Removed by USCIS, effective January 22, 2025 |
| MMR | Required | Age-based per CDC Technical Instructions |
| Polio | Required | Age-based per CDC Technical Instructions |
| Tdap | Required | Age-based per CDC Technical Instructions |
| Hepatitis A & B | Required | Age-based per CDC Technical Instructions |
| Varicella | Required | Age-based per CDC Technical Instructions |
| Influenza | Required seasonally | Assessed only for exams October 1 – March 31 |
What This Means If You Already Got the COVID-19 Vaccine
Nothing negative. Being vaccinated against COVID-19 doesn’t cause any problem on Form I-693 — it’s simply no longer a data point the civil surgeon needs to record. You don’t need to disclose it, hide it, or bring documentation for it. If you were previously denied, delayed, or issued an RFE specifically over a missing COVID-19 vaccine before the January 2025 change, that basis no longer applies, and a fresh exam under current criteria should not raise it again.
What applicants sometimes get wrong is assuming that because one vaccine requirement was dropped, the whole vaccination section became optional or discretionary. It didn’t. The civil surgeon is still working from an age-based checklist for the vaccines listed above, and gaps there still lead to the same waiver-request or catch-up-dose conversation they always have.
This is also a reasonable moment to double-check your file if your green card case has been pending for a long time. A Form I-693 completed before January 2025 may have COVID-19 vaccination status noted on it somewhere, but that notation doesn’t invalidate the form or require a resubmission on its own — it simply reflects the criteria in effect on the day of your exam. If you have a separate reason your I-693 needs to be redone, such as its own validity window running out, the new exam will be evaluated under current requirements, COVID-19 excluded.
Bottom Line for Your Appointment
Before you schedule your green card medical exam, assume the current requirement list, not the one from two or three years ago. The COVID-19 vaccine question is gone; the rest of the standard immunization panel is not, and if your appointment falls in flu season, bring your flu vaccination status along with everything else. When in doubt about which category a specific vaccine falls into for your age group, ask your civil surgeon directly before the appointment rather than guessing from outdated information online — requirement lists on Form I-693 have changed before, and they can change again.