Why Vaccination Deadlines Matter

USCIS requires applicants to demonstrate proof of all USCIS-required vaccinations as a condition of adjustment of status. Failure to show proof of required vaccinations is a Class A ground of inadmissibility under INA § 212(a)(1)(A)(ii). This means that an incomplete vaccination record — not just a missing vaccine, but a missed follow-up dose in a multi-dose series — can result in a finding that bars the applicant from receiving a green card.

Vaccination deadlines arise in two main scenarios: (1) the applicant received the first dose of a multi-dose vaccine series at the medical exam but missed the follow-up doses, and (2) a vaccine was deferred at the exam (due to pregnancy, contraindication, or age) and the follow-up was never completed.

Option 1: Complete the Missing Vaccination Before the Interview

The simplest and most effective strategy is to identify the missing vaccination and complete it before the USCIS interview. The civil surgeon can administer the missing dose and update Form I-693 to reflect the completed vaccination.

For multi-dose series (such as hepatitis B, which requires three doses), the civil surgeon will review the timing of prior doses and administer the next dose in the series. If the series was interrupted for an extended period, the civil surgeon may need to restart the series depending on the specific vaccine and the elapsed time.

Attorneys should review the client's vaccination record well in advance of the interview — ideally at least 60 to 90 days before — to identify any incomplete series and allow time for completion.

Option 2: Document a Medical Contraindication

If the client cannot receive a required vaccine due to a medical contraindication, the civil surgeon can document the contraindication on Form I-693. A documented medical contraindication is not a Class A finding — it is an accepted reason for not receiving a vaccine.

Common medical contraindications include severe allergic reactions to vaccine components, immunocompromising conditions, and certain medical treatments that preclude vaccination. The civil surgeon must document the specific contraindication and the clinical basis for the determination.

Attorneys should gather documentation of the contraindication from the client's treating physician before the exam. A letter from the treating physician explaining the contraindication and why the vaccine cannot be safely administered will support the civil surgeon's documentation.

Option 3: Apply for a Religious or Moral Objection Waiver

If the client objects to a required vaccine on religious or moral grounds, a vaccine waiver can be requested. The waiver is filed with USCIS and requires the applicant to demonstrate a sincere religious or moral belief that is opposed to vaccination.

Vaccine waivers are discretionary — USCIS is not required to grant them. The waiver application should include a detailed personal statement explaining the religious or moral basis for the objection, supporting documentation (such as a letter from a religious leader), and any other evidence that supports the sincerity of the belief.

Attorneys should advise clients that a vaccine waiver is not guaranteed and that the waiver process adds time to the case. If the client's objection is based on a specific religious doctrine, documentation from the religious institution is particularly important.

When a Class A Vaccine Finding Has Already Been Made

If the civil surgeon has already documented a Class A finding for failure to show proof of required vaccinations, the most direct path to resolution is to receive the missing vaccine(s) and return to the civil surgeon for a follow-up evaluation. The civil surgeon will update Form I-693 to reflect the completed vaccination and remove the Class A designation.

If the Class A finding was made and the interview is approaching, contact our clinic immediately for a priority appointment. We can administer the missing vaccine(s) and update Form I-693 on an expedited basis.