Live Vaccines Are Contraindicated During Pregnancy

Live attenuated vaccines are contraindicated during pregnancy due to the theoretical risk of transmission of the vaccine virus to the fetus. The live vaccines required for immigration include MMR (measles, mumps, rubella) and varicella (chickenpox). These vaccines should not be administered during pregnancy. The civil surgeon will document these contraindications on Form I-693 and complete a medical waiver for each affected vaccine.

Vaccines That Are Safe During Pregnancy

Several required immigration vaccines are safe and recommended during pregnancy:

• Tdap (tetanus, diphtheria, pertussis) — recommended during each pregnancy, ideally between 27 and 36 weeks
• Influenza (inactivated flu shot) — recommended during any trimester
• Hepatitis B — safe during pregnancy if you are not already immune
• COVID-19 (mRNA vaccines) — recommended during pregnancy

The Waiver Process for Contraindicated Vaccines

For vaccines that are contraindicated during pregnancy, the civil surgeon will document the contraindication on Form I-693 as a medical waiver. This is a standard, well-established process. USCIS accepts pregnancy as a valid medical contraindication for live vaccines. The waiver does not negatively affect your immigration application.

Timing After Delivery

After delivery, you can receive the live vaccines that were deferred during pregnancy. MMR and varicella can typically be given at your postpartum visit. If you are breastfeeding, MMR and varicella are generally safe to receive. If you complete your immigration medical exam while pregnant and receive waivers for live vaccines, you may need to return for a follow-up appointment after delivery to complete your vaccination record.