The Key Distinction: Live vs. Inactivated Vaccines

The safety of a vaccine during pregnancy depends primarily on whether it is a live attenuated vaccine or an inactivated (killed) vaccine. Live vaccines contain weakened but living viral or bacterial organisms and carry a theoretical risk of causing infection in the fetus. Inactivated vaccines contain killed organisms or protein subunits and do not carry this risk.

USCIS civil surgeon instructions follow standard medical guidelines: inactivated vaccines are administered during pregnancy; live vaccines are deferred until after delivery.

Vaccines Safe to Give During Pregnancy

The following immigration-required vaccines are safe during pregnancy and are administered on the standard schedule:

• Td (tetanus, diphtheria) or Tdap (tetanus, diphtheria, pertussis) — inactivated; Tdap is actually recommended during each pregnancy
• Hepatitis B — inactivated; safe and recommended during pregnancy
• Hepatitis A — inactivated; safe during pregnancy
• Inactivated influenza (injection form) — safe and recommended during pregnancy
• Meningococcal (MenACWY, MenB) — inactivated; safe during pregnancy
• Pneumococcal (PCV15, PCV20, PPSV23) — inactivated; safe during pregnancy
• COVID-19 vaccines (mRNA and protein subunit types) — recommended during pregnancy

Vaccines Deferred During Pregnancy

The following immigration-required vaccines are live attenuated and are deferred during pregnancy:

• MMR (measles, mumps, rubella) — live; deferred until after delivery
• Varicella (chickenpox) — live; deferred until after delivery
• Live attenuated influenza vaccine (LAIV, nasal spray form) — live; deferred; inactivated injection is used instead

What Happens to Deferred Vaccines?

When a live vaccine is deferred due to pregnancy, the civil surgeon documents the deferral on Form I-693 with pregnancy listed as the contraindication. This is a recognized and accepted reason for deferral under USCIS guidelines.

After delivery, you must return to the civil surgeon to receive the deferred vaccines. The civil surgeon will update Form I-693 to reflect the completed vaccinations. Most live vaccines can be administered 4–6 weeks after delivery, but your civil surgeon will advise you on the appropriate timing based on your specific situation.

Does Having Deferred Vaccines Affect My Green Card Application?

Having deferred vaccines documented on Form I-693 does not automatically delay or jeopardize your green card application. USCIS understands that pregnancy-related deferrals are standard medical practice. However, the deferred vaccines must be completed and documented before USCIS will consider the vaccination requirement fully satisfied. Discuss the timing with your immigration attorney to coordinate the completion of deferred vaccines with your overall immigration timeline.