Vaccination Requirements (and Exceptions) for Green Card Applicants

If you are applying for U.S. lawful permanent residence (a green card), you will need to show that you have had all the recommended vaccinations for preventable diseases. Failure to get these vaccinations makes you "inadmissible" to the United States under § 212(a)(1)(A)(ii) of the Immigration and Nationality Act (I.N.A.), or 8 U.S.C. § 1182.

Some of the vaccinations are named in the statute. Others are recommended by the U.S. Advisory Committee for Immunization Practices (ACIP).

Which Vaccinations Are Required for a U.S. Green Card

There are several vaccinations that are (as of 2023) required for consideration of lawful permanent residence. They are as follows:

• Diphtheria
• Tetanus
• Pertussis
• Polio
• Measles
• Mumps
• Rubella
• Rotavirus
• Haemophilus influenzae type b (Hib)
• Hepatitis A
• Hepatitis B
• Meningococcal disease
• Varicella
• Pneumococcal disease
• Influenza
• COVID-19 (coronavirus)
• Any additional vaccinations that are recommended by the ACIP.

Note that this list may change as new vaccines are developed. For example, HPV and zoster vaccines were once required, but no longer. Check the Centers for Disease Control and Prevention website for the latest, by looking at its Overview of Vaccination Technical Instructions.

Getting the Immigration Vaccinations Done

Part of the green card application process involves undergoing a medical exam. You will meet with a designated physician (not your own). If you're applying for your green card by adjusting status within the U.S., you will choose from a list of local "civil surgeons," and yours will fill out Form I-693. If you're applying from overseas (consular processing), you'll choose from a a list of "panel physicians."

In preparation for your medical exam, you should gather your vaccination records and any tests by your doctor that determined that you are already immune to a particular disease. During the exam, the physician will review the record and decide which additional vaccinations you need, given your age and vaccination history.

The doctor will give you any needed vaccinations at that time and will be responsible for paying for the vaccinations. The exception is the COVID-19 vaccine: Because it's normally administered in a two-jab series, it's best to get this done before your immigration medical exam.

You might also want to read, What to Expect at the Green Card Medical Exam.

Exceptions to the Vaccination Requirements

There are a few exceptions to the green card vaccination requirements, as follows:

• Adopted children age ten years or younger who are applying for immediate relative visas need not have the vaccinations before arriving in the United States if their U.S. parents submit an affidavit stating that they will ensure that, within 30 days of the child's admission or at the earliest time that is medically appropriate, the child will receive the needed vaccinations.
• If you are pregnant, you should advise the physician, who will evaluate the vaccines you can safely receive. If the doctor cannot safely administer a required vaccine, he or she will not do so, and will annotate the medical report by marking the vaccine as contraindicated (not recommended).
• If you are opposed to vaccinations in any form, you can file a waiver request showing that your objection is based on religious beliefs or moral convictions, and that these beliefs are sincere. You'll need to fill out a waiver form, most likely using either Form I-601, or if you're a refugee or asylee, Form I-602. Along with the form, you'll need to attach documents in support of your claim (for example, proving membership in a particular religious group) and pay a fee. Keep in mind that you can't pick and choose vaccines to object to; this must be an across-the-board waiver request.

Your request for an exception or waiver to the vaccination requirements stands the greatest chance of success if you hire a lawyer to help you with it.