IMMIGRATION CHANGES TUBERCULOSIS AND VACCINATION REQUIREMENTS FOR APPLICANTS TO ADJUST STATUS TO LEGAL PERMANENT RESIDENCE    Suzanne St. Luce, P.A. All applicants to adjust status to legal permanent residents (green card seekers) must complete an Immigration physical. The physical tests for communicable diseases from childhood diseases such as mumps, rubella, diphtheria, to sexually transmitted diseases such as Rapid Plasma Reagin (RPR) for syphilis and Human Immunodeficiency Virus (HIV). The Immigration physical can only be completed on Form I-693, Report of Medical Examination and Vaccination Record, by a designated civil surgeon. Designated civil surgeons are doctors who are authorized by U.S. Citizenship and Immigration Services (USCIS) to complete Immigration medicals. These medicals submitted to USCIS must be sealed, or their results are void and a new sealed medical must be submitted. On July 24, 2008, USCIS issued a press release of the revised requirements for tuberculosis (TB) testing and treatment and the list of vaccinations required for applicants seeking to adjust their status to that of legal permanent residents. All applicants who are two years or older must have a TB skin test (TST). Children under two years of age are required to have a TST if there is evidence that the child came into contact with someone known to have TB. Many of the new requirements relate to additional tests and treatments that are required if an applicant tests positive to TB through the TST. Any applicant who requires a chest X-ray must include a full and formal radiologist chest X-ray report. The report must be a copy or an original signed by the radiologist and must be on official hospital or medical office letterhead. No handwritten reports will be accepted by USCIS. Any medical examinations for Immigration performed on or after June 1, 2008, must comply with the new TB requirements. A 1996 Immigration law states that any vaccinations recommended by the Center for Disease Control (CDC) become mandatory for applicants seeking to adjust status to legal permanent residence. The new mandatory vaccinations are for the following diseases: Rotavirus, Hepatitis A, Meningococcal (meningitis), Zoster, and Human papillomavirus (HPV). Rotavirus is the leading cause of severe acute gastroenteritis (vomiting and diarrhea) among children worldwide. According to the CDC, the rotavirus vaccine currently licensed in the United States will prevent 74 percent of all rotavirus cases. Hepatitis A is a serious liver disease caused by the hepatitis A virus (HAV). Some of the symptoms include fever, fatigue, loss of appetite, nausea, vomiting, jaundice, and abdominal pain. Meningococcal (meningitis) also called spinal meningitis is an infection of spinal cord fluid and the fluid that surrounds the brain. Meningitis is usually caused by a viral or bacterial infection. There are two vaccines for meningitis approved for use in the United States and both vaccines can prevent four types of meningococcal disease. Zoster or shingles is a painful skin rash or blisters caused by the same virus that causes chickenpox. A shingles vaccine was recently recommended by the Advisory Committee on Immunization Practices (ACIP) of the CDC to reduce the risk of shingles for people sixty (60) years of age or older. Due to this recommendation, USCIS now requires all applicants who are sixty years old or older to have the shingles vaccination. Human papillomavirus (HPV) are viruses passed generally genital contact that cause most cases of cervical cancer and genital warts. Currently, Gardasil is the only vaccine that is approved for use in the United States for HPV. Gardasil does not protect for all forms of HPV, but for most of those viruses that cause cervical cancer. The vaccine is not for boys or men. It is only for girls and young women. It is given in three shots over a six month period and is routinely recommended for young girls between eleven (11) and twelve (12) years old; and for thirteen (13) to twenty-six (26) year old females who have not yet been vaccinated or who have not completed the full course of vaccinations. Since the recommendation of Gardasil by the ACIP last year, Gardasil became a mandatory requirement for USCIS. However, some members of the ACIP were unaware of the requirement that any recommendations for the United States public, would become mandatory for applicants seeking their green cards and never intended Gardasil to become mandatory. Since the approval of Gardasil, there have been reports in the national press that some recipients of the vaccine have had reactions as mild as a rash to as severe to a seizure or even death. The CDC reports that the cost for each dose should be approximately $125, or $375 for the full course. The vaccinations are still mandatory for USCIS. Any Immigration physicals completed on the wrong edition of the form or not meeting the new requirements will cause the physical to be rejected by USCIS and will delay the issuance of an Employment Authorization Document (work permit). A new Report of Medical Examination and Vaccination Record must be completed and submitted to USCIS. For consultation, contact the Law Offices of Suzanne St. Luce, PA at (305) 249-5534 or (954) 318- 0930, or send an e-mail to info@stlucelawoffice.com. Our offices are located at 160 NW 176 Street, Suite 300, Miami Gardens, FL 33169; and 3810 Inverrary Blvd., Suite 102-M, Lauderhill, FL 33319.