Medical exclusion of immigrants

Applicants for immigration into the United States must meet certain medical standards, as assessed by the I-693, Report of Medical Examination and Vaccination Record. The purpose of the medical exam is to ensure that an applicant is “not inadmissible to the United States on public health grounds." Inadmissibility is defined in Act 212 of the Immigration and Nationality Act (INA). Accordingly, an alien is inadmissible if he or she has a communicable disease of public health significance, lacks the required vaccines, is a drug abuser or addict, or has a physical or mental disorder with a behavior, or history of a behavior, that is a threat to “the property, safety, or welfare of the alien or others”.

The current communicable diseases of public health significance include the following: Tuberculosis, Syphilis, Chancroid, Gonorrhea, Granuloma Inguinale, Lymphogranuloma Venereum, Hansen's Disease (Leprosy) and “quarantinable diseases designated by any Presidential Executive Order”. International public health emergencies, as determined by the International Health Regulations (IHR) are also included. An applicant with one of these diseases can still be admitted if it is under the “national interest” or if they are the “spouse, unmarried son, unmarried daughter, minor unmarried lawfully adopted child, father, or mother of a U.S. citizen, alien lawfully admitted for permanent residence, or an alien issued an immigrant visa, or is a VAWA self-petitioner”. In 2009, 482 of the 993 potential LPRS that were originally denied for communicable disease were accepted.

The vaccination requirement includes the following vaccinations: Mumps, Measles, Rubella, Tetanus, diphtheria, Meningococcal disease, Pneumococcal disease, Haemophilus influenzae type B, Rotavirus, Varicella, Influenza, Hepatitis A and B, Pertussis, and Polio. These requirements are established by the Advisory Committee on Immunization Practices (ACIP).

The examination “consists of a physical examination, an evaluation (skin test/chest x-ray examination) for tuberculosis, and blood test for syphilis”. All immigrants are required to have this examination conducted by a panel physician overseas before they come to America. Foreign nationals pay for their own exam but the cost is covered by the US government for refugees. I-693, the Report of Medical Examination and Vaccination Record, is used to report the medical examination to officials. There is no filing fee for the I-693 form.

Medical inspections fall under the authority of Customs and Border Protection (CBP) division the Department of Homeland Security (DHS), as it is responsible for the inspection of all people who enter the country. The medical exam guidelines are created by the Center for Disease Control’s Division of Global Migration and Quarantine. The Department of Health and Human Services is responsible for “promulgating” the regulations.

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Wikipedia