Allergy as a Medical Contraindication

A documented allergy to a required vaccine or one of its components can constitute a medical contraindication to that vaccine. Common vaccine components that can cause allergic reactions include gelatin (found in MMR and varicella vaccines), neomycin, and yeast (found in hepatitis B vaccines). A history of anaphylaxis to a vaccine or vaccine component is a recognized contraindication.

The Medical Waiver Process

If a required vaccine is medically contraindicated due to a documented allergy, the civil surgeon can document this on Form I-693 as a medical contraindication and complete a medical waiver for that vaccine. This is a standard, well-established process.

USCIS accepts documented medical contraindications as a valid reason for not receiving a required vaccine. The waiver does not negatively affect your immigration application. The civil surgeon will note the specific allergy and the contraindicated vaccine on Form I-693.

Documentation Needed

To support a vaccine allergy contraindication, bring the following to your appointment:

• A letter from your allergist or treating physician documenting the specific allergy and the vaccine or vaccine component involved
• Any records of prior allergic reactions to vaccines, including the type of reaction (e.g., anaphylaxis, hives, swelling)
• Documentation of any allergy testing that has been performed

The Civil Surgeon's Role

The civil surgeon is responsible for evaluating whether a claimed allergy constitutes a valid medical contraindication under USCIS guidelines. Not all adverse reactions to vaccines qualify as contraindications — for example, a mild local reaction at the injection site is not a contraindication. The civil surgeon will review your documentation and make a clinical determination. If the contraindication is documented, the civil surgeon will complete the appropriate section of Form I-693.

Alternatives and Precautions

In some cases, an allergist can perform allergy testing or a graded challenge to determine whether a vaccine can be safely administered. If you have a mild or uncertain allergy, your allergist may be able to administer the vaccine under observation in a controlled setting. Discuss this option with your allergist before your immigration medical exam.