How Do I Get a Medical Exemption From a Required Vaccine for Immigration?
Quick Answer
A medical exemption from a required vaccine requires documentation of a valid contraindication or precaution recognized by ACIP. The civil surgeon documents this on Form I-693. USCIS reviews the documentation as part of the adjudication process. Religious exemptions are separate and have a different process.
Contraindications vs. Precautions
A contraindication is a condition that makes it inadvisable to administer a particular vaccine because the risk of a serious adverse reaction outweighs the benefit. A precaution is a condition that might increase the risk of an adverse reaction or compromise the ability of the vaccine to produce immunity, but where the vaccine may still be given in some circumstances. For immigration purposes, both contraindications and precautions can support a medical exemption, but the documentation requirements and USCIS review process may differ.
Common Medical Contraindications
Common contraindications to vaccines that may be relevant for immigration include: pregnancy (for live vaccines such as MMR and varicella), severe immunocompromise (for live vaccines), severe allergic reaction (anaphylaxis) to a prior dose of the vaccine or a vaccine component, and age-based non-applicability (e.g., rotavirus vaccine for infants over 15 weeks). These are recognized ACIP contraindications and are documented on Form I-693 by the civil surgeon.
Documentation Required
To support a medical exemption, you should bring the following to your appointment: documentation of your medical condition from your treating physician (a letter on letterhead is ideal), relevant medical records (e.g., allergy testing results, immunology records, pregnancy documentation), and a list of current medications. The civil surgeon will review this documentation and determine whether a recognized contraindication or precaution exists.
The Civil Surgeon's Role
The civil surgeon is responsible for documenting vaccine contraindications on Form I-693. The civil surgeon does not have the authority to grant a "waiver" in the traditional sense — rather, they document the medical basis for why a vaccine cannot be given. USCIS then reviews this documentation as part of the adjudication process. A properly documented contraindication should not negatively affect your immigration case.
USCIS Review Process
USCIS reviews vaccine contraindications documented on Form I-693 as part of the adjudication of your immigration application. In most cases, a properly documented medical contraindication is accepted without issue. However, USCIS may issue a Request for Evidence (RFE) if the documentation is insufficient or if the contraindication is not clearly supported. If you receive an RFE related to vaccine documentation, consult with your immigration attorney.
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