If you are applying for a Green Card by filing a form I-485, as adjustment of status.
Effective Dec. 2, 2024, if you are required to submit Form I-693, Medical Exam, or a partial Form I-693 (such as the Vaccination Record), you must submit it with your Form I-485. Otherwise, USCIS may reject your Form I-485 if submitted without a required medical exam.
Read the alert here https://www.uscis.gov/i-485
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