U.S. Citizenship and Immigration Services (USCIS) has revised the Form
I-693, Report of Medical Examination and Vaccination Record (Revision
Date 10/14/09/Expiration Date 10/30/11) to include new updates regarding
testing for Tuberculosis. USCIS took this action based on the Department of
Health and Human Services (HHS), Centers for Disease Control and Prevention
(CDC)'s Update to the Tuberculosis (TB) Component of the Technical Instructions
for the Medical Examination of Aliens in the United States (TB Component of
the Technical Instructions), which took effect on Nov. 1, 2009.
With the update to the TB component of the Technical Instructions, and under
the revised version of the Form I-693, a civil surgeon may now administer an
interferon gamma release assay (IGRA) in place of a Tuberculin Skin Test (TST).
Under the June 5, 2008 version of the Form I-693, a civil surgeon was directed
to use the TST as an initial testing method to determine whether the applicant
had cell-mediated immune reactivity to Mycobacterium tuberculosis.
Current acceptable IGRAs for the change
of status examination are: QuantiFERON® TB Gold, QuantiFERON® TB
Gold In Tube, and the T-Spot® TB test.
Civil surgeons may continue to use the June 5, 2008 edition of Form I-693
until Jan. 1, 2010, but only if the civil surgeon uses the TST test as an initial
screening method for TB. If an IGRA is used as a means to initially screen
for TB infection, the civil surgeon must submit the results of the medical examination
on Form I-693 (Edition Oct. 14, 2009). The civil surgeon may not provide the
results of the IGRA on Form I-693 (Edition June 5, 2008). Beginning on Jan.
1, 2010, the civil surgeon must use the Oct. 14, 2009 edition of Form I-693
to record the results of the medical exam, irrespective of the TB screening