The Consequences of Refusing Required Vaccines

Immigration vaccination requirements are established by federal law under the Immigration and Nationality Act. If you refuse to receive a required vaccine without a valid medical contraindication or approved exemption, the civil surgeon is required to document this refusal on Form I-693. USCIS will then make a finding of inadmissibility based on the vaccination requirement, which can result in the denial of your green card application.

Medical Contraindication Waivers

A medical contraindication exists when receiving a particular vaccine poses a genuine medical risk to you. Common contraindications include severe allergic reactions (anaphylaxis) to a vaccine component, a compromised immune system that makes live vaccines dangerous, or certain pregnancy-related considerations.

If you have a documented medical contraindication, the civil surgeon will note this on Form I-693. USCIS will then evaluate whether to grant a medical waiver. Supporting documentation from your treating physician is typically required. The civil surgeon cannot grant the waiver — that decision belongs to USCIS.

Religious and Moral Objection Waivers

The Immigration and Nationality Act provides for waivers based on religious beliefs or moral convictions that are opposed to vaccinations. However, these waivers are not automatic and are evaluated by USCIS, not by the civil surgeon. The civil surgeon documents your objection on Form I-693, and you must then file a formal waiver application with USCIS. These waivers are granted on a case-by-case basis and are not guaranteed.

What the Civil Surgeon Can and Cannot Do

The civil surgeon's role is to document your vaccination history, administer missing vaccines, and accurately complete Form I-693. The civil surgeon cannot grant waivers, override USCIS requirements, or certify you as admissible if you refuse required vaccines without a valid basis. If you have concerns about a specific vaccine, discuss them with the civil surgeon before your appointment so that appropriate documentation can be prepared.

Practical Guidance for Applicants With Concerns

If you have concerns about a specific vaccine — whether medical, religious, or otherwise — contact our office before your immigration medical exam. We can review your situation, advise you on the available options, and help you prepare the appropriate documentation. Addressing these issues proactively is far better than arriving at your appointment unprepared.