Everyone applying to visit or reside in U.S., whether on a temporary visa or a permanent green card, must prove that they do not present a health risk to the general public. These requirements are known as health-related grounds of inadmissibility. (See 42 C.F.R. § 34.2(e).)
You might not be allowed to enter or remain in the United States if you have what's known as a "Class A" condition, which means you:
Even if you have never been diagnosed with an alcohol- or drug-related health issue, a record of alcohol- or drug-related arrests (a DUI, for instance) or criminal offenses can result in your being found inadmissible on health grounds.
The medical exam will also look for "Class B conditions," meaning serious in degree or permanent diseases or disabilities. Although they likely won't make you inadmissible, they can be considered significant enough to interfere with your ability to care for yourself, attend school, or work; or they might require extensive future medical treatment or institutionalization. This raises a separate inadmissibility concern: That you will be found to be a likely "public charge," or someone who will not be financially self-sufficient but instead rely on government assistance.
There are waivers available for all health-related grounds of inadmissibility except drug abuse and addiction. See, for example, Waivers of Health-Based Inadmissibility for U.S. Green Card Applicants.
Health-related inadmissibility issues are typically discovered when immigration officials review either:
You will need to answer questions regarding your health on almost any application you might submit, whether it's for a temporary (nonimmigrant) or an immigrant visa. The questions you see on the forms asking about your history of communicable disease, substance abuse, and physical and mental disorders all pertain to your potential inadmissibility on health-grounds.
In an immigration medical examination, the physician will most likely review your medical record, vaccination records, chest X-rays, and laboratory results, and perform a physical examination. If you lack certain vaccinations but have had the disease, the doctor can use a U.S.-government-approved test kit to check whether you have antibodies for it; and if so, you won't be required to get the vaccination. (You are said to have "laboratory-confirmed immunity.") This only works for the following diseases, however:
If you are applying for an immigrant visa from outside the U.S. (so called "consular processing," allowing you to enter and reside permanently), you must undergo a medical examination by a physician certified by the Department of State. If you are already residing in the United States and applying for permanent residency (via the procedure known as "adjustment of status"), you will need to attend a medical examination by a physician certified by U.S. Citizenship and Immigration Services (USCIS).
The physician will administer needed vaccinations (which includes for COVID-19) and prepare a report summarizing the medical findings for the immigration authorities.
The list of communicable diseases that bar people from entering the United States, which is kept by the U.S. Centers for Disease Control (CDC), continues to grow.
The list includes a number of quarantinable diseases (such as cholera, plague, smallpox, and yellow fever), as well as leprosy, tuberculosis, and any novel or pandemic flu. It also includes any illnesses recognized as a public health emergency of international concern by the World Health Organization (WHO). Coronavirus or COVID-19 definitely falls within the above criteria. HIV was on the inadmissibility list once, but was later removed.
The physician conducting an immigration medical examination will ask about certain diseases depending on what countries you've lived in or traveled to. The physician will also examine your medical history, blood test, and chest X-rays for traces of communicable diseases.
Having a physical or mental disorder that creates behavior harmful to property, safety, or public welfare can make you inadmissible to the United States. Harmful behavior is defined as psychological or physical injury to the applicant or another person (which covers a wide variety of concerns, from suicide attempts to pedophilia), a threat to health or safety (such as driving while intoxicated or threatening to kill someone), or damage to major property. Mental illness alone without any harmful behavior will not make you inadmissible.
Even if you no longer have a harmful disorder, you might still be inadmissible if the disorder is likely to reoccur. And even if you have no prior diagnosis or record of any disorders, a history of crimes such as assaults and domestic violence involving alcohol and drugs could result in a referral for a mental examination and ultimately a finding of inadmissibility.
A record of alcohol-related offenses, or any other evidence of alcohol abuse, like driving while under the influence, could lead to a referral to a physician to determine whether you have and alcohol-related mental or physical disorder causes harmful behavior. Anything more than a single drunk driving arrest or conviction may result in a referral to a physician.
A history of drug abuse or addiction will bar you from entering the U.S. on health grounds. Drug abuse is broadly defined to mean anything beyond mere experimenting. In general, experimenting is considered just one use. Anything beyond one non-medical use of a controlled substance will be considered drug abuse. Normally, the physician giving the medical examination will administer a drug test only upon deciding that it is necessary in the individual person's case.
If you have any drug- or alcohol-related arrests or convictions on your record, consult with an immigration attorney before applying for a U.S. visa or residency. These items on your record may also make you inadmissible on criminal or controlled substance trafficking grounds.
Applicants for green cards or immigrant visas (but not temporary visas) are required to have vaccinations against a number of diseases, including influenza, measles, mumps, and rubella. The coronavirus or COVID-19 vaccination is the most recent one on the list, required for immigrant visa and some nonimmigrant visa applicants. If you're a K fiancé(e) visa applicant, this and other vaccines might not be required for U.S. entry, but will be if and when you decide to adjust status in the United States following your marriage.
(See the USCIS web page on Vaccination Requirements for the full list.)
The influenza vaccine will be required only if you are entering the United State during flu season, generally between October and March of each year.
Bring your vaccination records to your immigration medical examination: If you show the physician proof of your past vaccinations, you can avoid getting them again, and paying for them! The physician will determine which vaccines are appropriate for your age.
Internationally adopted children under the age of 10 are not required to have vaccinations before they enter the United States. However, they will be required to have their vaccinations completed within 30 days of arrival. Vaccinations that are against your religious beliefs will not be required.
Though it's not an outright ground of inadmissibility, pregnancy can result in denial of a woman's application for a B-2 visitor visa. This is due to a 2020 U.S. State Department (DOS) amendment to its regulations, with the goal of preventing "birth tourism," or the practice of coming to the U.S. to deliver one's child so that the child can automatically obtain U.S. citizenship. Under the new rule, a noncitizen who will give birth during the period of time her tourist visa is valid will be presumed to be visiting the U.S. for the purpose of obtaining U.S. citizenship for the child.
If you are pregnant and hope to successfully apply for a tourist visa, you will need to convincingly show that you have another valid reason for visiting the U.S. or that you do not intend to give birth there as a means of gaining citizenship for your child.