Adoption Notice: Updates to Medical Exam Requirements, Including the COVID-19 Vaccination, for All Immigrant Visa Applicants

Last Updated: October 26, 2021

Effective October 1, 2021, the Centers for Disease Control and Prevention (CDC) Technical Instructions for panel physicians requires all immigrant visa applicants to receive a full COVID-19 vaccine series as part of their medical exam prior to being issued a visa. Please understand this is not a Department of State requirement. This is a CDC requirement that applies to all immigrant visa applicants, including adoptees.

The Department of State encourages all immigrant visa applicants to get vaccinated against COVID-19 as soon as possible to avoid unnecessary delays in their visa processing. If the medical exam is completed prior to October 1 and is valid, the vaccine will not be required. If the medical exam is completed on or after October 1, 2021, or expires before the applicant travels, the immigrant visa applicant will be required to receive the COVID-19 vaccine. The CDC requires the COVID-19 vaccine to be approved through either the World Health Organization (WHO) or the U.S. Food and Drug Administration (FDA).  

The lower age limit for the COVID-19 vaccine will depend on the formulation available to applicants in their country. For any of the vaccines authorized or licensed for use by the US FDA, applicants should use the US FDA age limits. This means the current lower age limit for these vaccines are 12 years and older for the Pfizer vaccine, and 18 years and older for the Moderna and Johnson and Johnson vaccines. If the age limit is lowered by the US FDA for any of these vaccines, then please act accordingly if allowed to do so in the country of origin. 

If the vaccines available in country are the vaccines approved for Emergency Use Listing (EUL) by the WHO, such as Sinopharm, Sinovac, etc., please use the WHO recommended lower age limit, which is currently 18 years of age and older for all of these formulations. Even though these vaccines are approved in many countries for younger children, at this time CDC will defer to the WHO guidance for the lower age limits. If the approved age limits are lowered by the WHO for any of these vaccines, please act accordingly. 

In summary, if applicants have access to the Pfizer vaccine at this time, then everyone 12 years of age and older will be required to receive a COVID-19 primary vaccine series. If the Pfizer vaccine is not available, and one of the other approved vaccines are available, then everyone 18 years of age and older will be required to be vaccinated.

Blanket waivers for the COVID vaccination will be applied in countries where the vaccine is not routinely available or when the vaccine is not age appropriate. This blanket waiver is already used with other routine vaccinations in places where vaccines may be in short supply.  If someone cannot be vaccinated due to this limitation, or a requirement in the country prohibits certain age groups from receiving the COVID-19 vaccine, then the “Not age appropriate” blanket waiver applies

Panel physicians may grant blanket waivers if the COVID-19 vaccine is:

  • Not age-appropriate;
  • Contraindicated due to a medical condition;
  • Not routinely available where the panel physician practices; or
  • Limited in supply and would cause significant delay for the applicant to receive the vaccination.

Applicants may also apply for individual waivers based on religious beliefs or moral convictions by submitting Form I-601, Application for Waiver of Grounds of Inadmissibility. It is the responsibility of the panel physician to know whether there is an approved vaccine for all applicants, including children, within a country. The panel physician determines whether the vaccination is contraindicated for each applicant using the guidelines linked to in the technical instructions. Applicants should refer to Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States, the WHO approved vaccines, or similar guidance for other vaccine formulations for information about contraindications and precautions. If the panel physicians have specific questions related to availability of the vaccine in their country and whether a blanket waiver should apply, it is recommended that they reach out to CDC.

CDC’s announcement can be found at the following link:

Information regarding these changes were published on the Department of State website and U.S. Citizenship and Immigration Services (USCIS) website as well.

For more information on vaccines, including vaccines approved specifically for children in other countries, please visit the following website:

World Health Organization – COVID-19 Vaccines

WHO Coronavirus disease Q&A (COVID-19): Vaccines