Emergency Memo

U.S. Citizenship and Immigration Services
Office of Policy and Strategy
Camp Springs, MD 20588

Decision Memorandum
TO:

Sharon Block
Acting Administrator
Office of Information and Regulatory Affairs
Office of Management and Budget

THROUGH: Eric Hysen
Chief Information Officer
Department of Homeland Security
FROM:

signed by ERIC N HYSEN
ERIC N HYSEN Digitally
Date: 2021.09.07 17:38:58 -04'00'

Samantha Deshommes
Chief, Regulatory Coordination Division SAMANTHA L
DESHOMMES
USCIS Office of Policy and Strategy

Digitally signed by SAMANTHA L
DESHOMMES
Date: 2021.09.01 12:30:42 -04'00'

SUBJECT: Request for Office of Management and Budget Emergency Clearance of an
Information Collection Request – Form I-693, Report of Medical Examination and
Vaccination Record – 1615-0033
Purpose: U.S. Citizenship and Immigration Services (USCIS) is seeking emergency processing
under 5 CFR 1320.13 of changes to Form I-693, Report of Medical Examination and
Vaccination Record, that will require civil surgeons conducting immigration medical
examinations to document whether a noncitizen applying for certain immigration benefits has
completed the COVID-19 vaccine series, as applicable.
Background: USCIS is modifying Form I-693 and its Instructions in response to updates to the
Centers for Disease Control and Prevention (CDC) Technical Instructions for Civil Surgeons
(Technical Instructions). The Technical Instructions update requires civil surgeons to document
whether an immigrant for whom they conduct an immigration medical examination has
completed the COVID-19 vaccine series. The updated Technical Instructions are effective
October 1, 2021.

Subject: Request for Emergency Office of Management and Budget Paperwork Reduction
Act Clearance – Form I-693, Report of Medical Examination and Vaccination
Record – 1615-0033
Page 2
Discussion: U.S. immigration law has reflected a concern for public health since the
Immigration Act of 1882. 1 Noncitizens seeking to come to the United States may be considered
inadmissible on health-related grounds, including having communicable diseases, physical or
mental disorders with associated harmful behavior, or drug abuse or addiction problems. 2 Since
1996, Congress has required all immigrant visa and adjustment of status applicants to establish
that they have been vaccinated against certain vaccine-preventable diseases. 3
Congress authorizes the U.S. Department of Homeland Security (DHS) to determine a
noncitizen’s admissibility to the United States, which includes determinations of inadmissibility
on health-related grounds. 4 Congress also authorized DHS to designate qualified physicians as
civil surgeons who conduct immigration medical examinations of noncitizens physically present
in the United States. 5 Civil surgeons document the immigration medical examination and
vaccination record of an applicant for adjustment of status on USCIS Form I-693.
The current pandemic of COVID-19 has been determined by the World Health Organization
(WHO) to be a public health emergency of international concern (PHEIC) under the
International Health Regulations, and it creates unique challenges for the immigration-related
medical evaluation. COVID-19 meets the definition of a quarantinable communicable disease
under 42 USC 264 and Executive Order 13295, as amended by Executive Orders 13375 and
13674. Specifically, COVID-19 meets the definition of severe acute respiratory syndromes as
specified by Presidential Executive Order 13674 (issued July 31, 2014), thus making it a Class A
Inadmissible Condition.
The Advisory Committee on Immunization Practices (ACIP) has recommended the COVID-19
vaccine for the age appropriate, general U.S. population. 6 Therefore, the COVID-19 vaccine
now meets the criteria for required vaccinations and is a requirement for most adjustment of
status applicants eligible for the vaccine. An adjustment of status applicant who is required to get
the COVID-19 vaccine but fails to do so (and has not obtained a waiver) would be inadmissible.
Accordingly, the CDC has updated the Technical Instructions for Civil Surgeons to require
documentation of whether an applicant has received a COVID-19 vaccine. In general, applicants
must complete the COVID-19 vaccine series and provide documentation to the civil surgeon in
person before completion of the immigration medical examination.
In order to allow civil surgeons to document an adjustment of status applicant’s COVID-19
vaccination status, as required by the updated Technical Instructions, USCIS is modifying Form
See the Immigration Act of 1882, 22 Stat. 214 (August 3, 1882).
See the Immigration Act of 1990 (IMMACT 90), Pub. L. 101-649 (PDF) (November 29, 1990).
3
See the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA), Division C of Pub. L.
104-208 (PDF) (September 30, 1996). See INA 212(a)(1)(A)(ii).
4
See INA 212(a).
5
See INA 232.
6
See INA 212(a)(1)(A)(ii).
1
2

www.uscis.gov

Subject: Request for Emergency Office of Management and Budget Paperwork Reduction
Act Clearance – Form I-693, Report of Medical Examination and Vaccination
Record – 1615-0033
Page 3
I-693, specifically, the table provided in Part 10. Vaccination Record. The Form I-693
Instructions are being modified to include references to COVID-19 and the COVID-19 vaccine
where appropriate. These changes are essential to USCIS’ mission to efficiently and fairly
adjudicate requests for immigration benefits. The October 1, 2021 effective date of the updated
Technical Instructions does not provide sufficient time for USCIS to complete the Paperwork
Reduction Act (PRA) form revision process before civil surgeons will be required to document
COVID-19 vaccination status as part of the immigration medical examination process.
Pursuant to 44 U.S.C. 3507(j)(1)(B) and 5 CFR 1320.13, USCIS seeks emergency processing of
the Form I-693, and requests that the Administrator approve modifications to the instruments
under the impacted information collection. USCIS certifies that the requirements of 5 CFR
1320.13(a) are met and that:
•
•
•

The subject collection of information is needed immediately and is essential to the
mission of the agency;
The agency cannot reasonably comply with the normal collection procedures because
public harm is reasonably likely to result if normal clearance procedures are followed;
and
The use of normal clearance procedures is reasonably likely to prevent or disrupt the
collection of information as unanticipated events have occurred.

USCIS greatly appreciates the timely consideration of this request.

www.uscis.gov