Chloe Ramirez
Vaccinations are typically required for immigration applications, and the specific requirements vary depending on the country of immigration and the applicant's age. In the United States, for example, applicants must undergo a medical examination and provide proof of vaccination or immunity for certain vaccine-preventable diseases, such as measles, mumps, rubella, and varicella (chickenpox). Refugees and those with specific medical conditions may be exempt from certain vaccination requirements. It is important for applicants to review the specific requirements for their intended country of immigration and to provide complete and valid documentation to ensure a smooth application process.
| Characteristics | Values |
|---|---|
| Who needs to be vaccinated? | All immigrant applicants, including children, must get a medical exam and show proof of required vaccines. |
| What vaccines are required? | MMR, Polio, Influenza, COVID-19, Shingles, Hepatitis A, Meningitis, Haemophilus influenzae type b (Hib), Pneumonia, Rotavirus, DTaP (Tetanus, Diphtheria, and Pertussis). |
| Are there any exemptions? | Refugees who had a medical exam in another country may not need to repeat it. Adopted children aged 10 or younger are exempt. |
| What forms are required? | Form I-693, Report of Medical Examination and Vaccination Record, is the primary document. Refugees should file Form I-602, and other applicants may need to file Form I-601. |
| Who can administer the vaccines and exams? | Civil surgeons designated by USCIS or panel physicians can perform immigration medical exams and vaccinations. |
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What You'll Learn
Waivers for the COVID-19 vaccination
The United States Citizenship and Immigration Services (USCIS) grants two types of waivers for the COVID-19 vaccination: blanket waivers and individual waivers. Blanket waivers are granted if a health professional indicates that you have received the required vaccinations or are unable to receive them for medical reasons. On the other hand, individual waivers are granted based on religious or moral objections and must be filed on Form I-601, accompanied by the appropriate fee.
To qualify for a waiver based on religious or moral objections, you must demonstrate that you oppose all vaccinations, not just specific ones, and that your objection is sincere. Your objection cannot be based on scientific beliefs such as side effects, vaccine efficacy, or disliking particular vaccines. If you are seeking a waiver under health-related grounds, you must demonstrate that you are inadmissible under the Immigration and Nationality Act and seek a waiver of such inadmissibility.
Additionally, if you are outside the United States and wish to immigrate with a Green Card or pursue a work visa/investor visa, or if you are already in the United States and wish to update your status to a permanent resident with a Green Card, you may be eligible for a waiver of the COVID-19 vaccination requirement. If the COVID-19 vaccine is not routinely available in the country where you undertake your medical examination, you may be exempt from the requirement. Similarly, if the supply of the vaccine is severely limited and would cause a significant delay in receiving it, it may also be considered "not routinely available".
It is important to note that the waiver process can be complex, and seeking the guidance of an immigration attorney is recommended to increase your chances of success and ensure a proper form submission. They can assist you in coordinating your waiver application with other immigration applications and prepare your application to be accepted the first time without any mistakes.
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Vaccination requirements for a Green Card
Vaccination requirements are part of the medical exam for those applying for a Green Card, whether adjusting their status in the US or applying from overseas. The medical exam will be valid for 2 years once received.
The CDC publishes the Technical Instructions for Civil Surgeons, including the vaccination requirements. These instructions include the seasonal flu vaccine, and the polio vaccine, which changed on May 1, 2024, to include anyone over 2 months old. The influenza vaccine is required when available in the country the panel physician is practising. The CDC also states that the vaccination requirements do not apply to adopted children aged 10 or younger, provided the adoptive parent signs an affidavit concerning exemption from immigrant vaccination requirements.
For all other applicants, the CDC outlines six "Not Medically Appropriate" reasons for a Blanket Waiver, which must be documented on the DS-3025 Form by the panel physician. If an applicant's vaccine history is incomplete and they refuse a dose of any required vaccine that is medically appropriate, they are inadmissible to the United States.
USCIS outlines that some applicants who have previously completed an immigration medical examination abroad are not required to repeat the entire process when they apply for adjustment. However, they should refer to the instructions for Form I-693 to determine if they must repeat the vaccination assessment.
To obtain a Green Card, applicants must comply with vaccination mandates for diseases, including: mumps, measles, rubella, polio, tetanus, hepatitis B, pertussis, and COVID-19. If an applicant refuses to obtain the vaccination requirements, their Green Card application may be denied. However, it is possible to request a waiver in limited circumstances. The applicant must be opposed to all vaccinations, with objections based on religious beliefs or moral convictions, and these beliefs must be sincere.
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Blanket Waivers
For immigration purposes, certain vaccines are required by statute, while others are mandated by the CDC. These vaccination requirements are designed to protect the health of the U.S. population. Failure to meet these requirements could result in an applicant being deemed inadmissible to the United States and denied a visa.
However, there are instances where waivers can be granted for these vaccine requirements. There are two types of waivers: blanket waivers and religious/moral waivers. Blanket waivers are medical waivers for vaccines required for immigration. When a blanket waiver is granted, the applicant does not have to file a form or pay a fee. In contrast, applicants must file a form and pay a fee when applying for a religious or moral waiver.
There are six acceptable reasons for granting a blanket waiver:
- The required vaccine is not licensed or routinely available in the country where the panel physician practices.
- The required vaccine is not medically appropriate for the applicant due to their age.
- The required vaccine is contraindicated based on pregnancy or a condition other than pregnancy.
- The required vaccine is contraindicated due to an immunocompromised condition, such as HIV/AIDS or a weakened immune system from certain medications.
- A vaccination shortage, if the CDC recommends that USCIS grant waivers based on a nationwide shortage.
- It is not flu season, or a specific flu vaccine is not available in the location where the applicant is receiving the medical exam.
It is important to note that even if an applicant qualifies for a blanket waiver, they may still be required to complete an immigration medical examination, and there is no guarantee that USCIS will grant the waiver. Additionally, for religious or moral waivers, the applicant must be opposed to all vaccinations, not just certain ones, and this opposition must be based solely on religious or moral convictions.
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Vaccination requirements for children
The vaccination requirements for children seeking to immigrate to the United States are outlined by the Centers for Disease Control and Prevention (CDC) and the U.S. Citizenship and Immigration Services (USCIS). These requirements are subject to change and are assessed regularly by the CDC and the Advisory Committee on Immunization Practices (ACIP). The ACIP is a group of 15 vaccination experts that provide written guidance on the vaccination of children and adults in the United States.
As of December 14, 2009, the CDC and ACIP implemented new vaccination criteria for all applicants seeking legal permanent residence in the United States, including children. These criteria outline that all immigrant applicants, regardless of age, must receive all vaccines required for U.S. immigration based on their age. The only exceptions are if a vaccine is not medically advised or if the applicant can show proof of prior vaccination.
The specific vaccines required for immigration are determined by the CDC and listed in the Technical Instructions for Civil Surgeons. Some vaccines are expressly required by statute, such as those listed in INA section 212(a)(1)(A)(ii), while others are required because the CDC has determined they are in the interest of public health. For example, the Immigration and Nationality Act (INA) requires applicants to submit documentation of having received the Hepatitis B and Meningococcal vaccines.
In addition to the vaccines listed in the Technical Instructions for Civil Surgeons, the CDC may also require immigrant applicants to receive additional vaccines that are recommended by the ACIP and fit specific criteria. These criteria include the vaccine being age-appropriate for the general U.S. population and protecting against a disease that has been or is in the process of being eliminated in the United States.
It is important to note that the vaccination requirements do not apply to adopted children 10 years of age or younger. In these cases, the adoptive parent must sign an affidavit concerning the exemption from immigrant vaccination requirements for a foreign-adopted child. Additionally, if a required vaccine is not available or medically appropriate for a child applicant, a waiver may be granted by USCIS.
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Medical examinations
Medical Examination Process:
The medical examination for immigration purposes typically involves a designated civil surgeon or panel physician, depending on the applicant's location and visa type. The process aims to evaluate the applicant's physical health and identify any potential health risks or concerns. It includes the following components:
- Medical History Review: This involves discussing the applicant's personal and family medical history, including any previous or current health conditions, hospitalizations, surgeries, medications, allergies, and immunizations.
- Physical Examination: The civil surgeon or panel physician will conduct a thorough physical examination, including but not limited to evaluating the applicant's eyes, ears, nose, throat, extremities, heart, lungs, abdomen, lymph nodes, and skin.
- Chest X-ray: A chest X-ray is typically required as part of the medical examination. This is especially important for applicants who have a history of tuberculosis or abnormal chest X-rays. Pregnant women may also need a chest X-ray but will require additional protective measures to ensure the safety of both the mother and the unborn child.
- Blood Tests: Blood tests are conducted to screen for infectious diseases such as syphilis. Applicants with a history of syphilis must provide documentation of adequate treatment.
- Vaccination Assessment: The examining physician will review the applicant's vaccination history and determine which vaccinations are required or recommended for immigration. This process may involve completing specific forms, such as Form I-693 or DS-3025, to ensure the applicant meets the vaccination requirements.
- Mental Health Evaluation: In certain cases, applicants with a history of harmful or violent behavior may be required to provide information to the panel physician to determine if the behavior was related to psychiatric issues, substance abuse, or other relevant factors.
Waivers and Exemptions:
It is important to note that there are instances where applicants may be granted waivers or exemptions from certain vaccination requirements. For example, refugees and asylees seeking adjustment of status may need to file specific forms, such as Form I-602, for a waiver of grounds of excludability. Additionally, adopted children 10 years of age or younger are typically exempt from vaccination requirements if the adoptive parent signs an affidavit concerning exemption. Waivers may also be granted in cases where a specific vaccine is not available or medically appropriate for the applicant.
Form I-693:
Form I-693, Report of Immigration Medical Examination and Vaccination Record, is a crucial document in the immigration medical examination process. It is used to record the results of the medical examination and vaccination status. Applicants must ensure that this form is completed and submitted properly, as it is a requirement for adjusting immigration status or obtaining a Green Card. The form must be submitted in a sealed envelope, and specific instructions must be followed to avoid rejection.
In summary, the medical examination process for immigration involves a comprehensive assessment of an applicant's physical and, in some cases, mental health. It is designed to ensure that individuals meet the health requirements for immigration and to identify any potential health risks. Applicants should carefully follow the instructions provided by the relevant immigration authorities and consult designated civil surgeons or panel physicians to ensure they fulfill all medical and vaccination requirements.
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Frequently asked questions
One requirement of the medical exam is showing that you have had all required vaccinations, whether you're applying for the Green Card from within the US or overseas.
If you are an applicant who is found inadmissible for not being vaccinated, you would be eligible for a waiver. You can also delay the completion of your immigration medical examination until you receive the required vaccine(s).
The CDC publishes the Technical Instructions for Civil Surgeons, including the vaccination requirements. For more information about the civil surgeon program, visit uscis.gov, or call the USCIS Contact Center at 800-375-5283 (TTY 800-767-1833).
