What Happens With Vaccines If I Am Immunocompromised?
Quick Answer
If you are immunocompromised, live vaccines such as MMR and varicella are contraindicated and will be deferred or waived. Inactivated vaccines are generally safe and will still be required. The civil surgeon will document your condition and any contraindications on Form I-693.
Immunocompromised Status and Vaccine Safety
Immunocompromised individuals — including those with HIV/AIDS, organ transplant recipients on immunosuppressive therapy, patients receiving chemotherapy, those with primary immunodeficiency disorders, and others with significantly impaired immune function — face special considerations with vaccines. The primary concern is with live attenuated vaccines, which contain weakened but live pathogens that could potentially cause disease in someone with a severely impaired immune system.
Live Vaccines Contraindicated for Immunocompromised Patients
The live vaccines required for immigration include MMR (measles, mumps, rubella) and varicella. These vaccines are contraindicated for severely immunocompromised individuals. The degree of immunosuppression matters — for example, HIV-positive individuals with adequate CD4 counts may be able to receive MMR and varicella vaccines, while those with severely depleted CD4 counts cannot. The civil surgeon will assess your specific level of immunosuppression and determine which live vaccines, if any, can be safely administered.
Inactivated Vaccines Are Generally Safe
Inactivated vaccines do not contain live pathogens and are generally safe for immunocompromised individuals. Required inactivated vaccines include influenza (inactivated), hepatitis A, hepatitis B, Tdap, pneumococcal, meningococcal, polio (IPV), and COVID-19 (mRNA). These vaccines will still be required for immunocompromised applicants. In fact, immunocompromised individuals may need additional doses of some vaccines because their immune response may be weaker.
Medical Waiver Process for Contraindicated Vaccines
When a required vaccine is contraindicated due to immunocompromised status, the civil surgeon will document this on Form I-693 as a medical contraindication. You will need to provide documentation of your medical condition from your treating physician. The civil surgeon will note the specific contraindication and the medical basis for it. USCIS reviews these contraindications as part of the Form I-693 adjudication process.
Documentation Needed
To support a vaccine contraindication based on immunocompromised status, bring the following to your appointment: documentation of your diagnosis (e.g., HIV diagnosis, transplant records, cancer treatment records), current medication list (especially immunosuppressive medications), recent laboratory results (e.g., CD4 count for HIV patients), and a letter from your treating physician explaining your immunocompromised status and any vaccine contraindications.
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