All applicants for lawful permanent residency in the United States are required to submit to a medical examination to ensure that they are not carrying any communicable diseases of public health significance, and that they have received all medically appropriate vaccinations to the following diseases:

• Mumps
• Measles
• Rubella
• Polio
• Tetanus and Diphtheria Toxoids
• Pertussis
• Haemophilus influenzae type B
• Hepatitis B
• COVID-19
• Any other vaccine-preventable diseases recommended by the Advisory Committee for Immunization Practices

As we previously reported, the COVID-19 vaccine was added to the list on October 1, 2021.

If the civil surgeon or panel physician conducting the medical exam deems a specific vaccine medically inappropriate for an individual, one or more of the vaccine requirements may be waived on that basis. This could occur because the vaccine is not age-appropriate; the vaccine is contraindicated; there is insufficient time to complete a vaccination series; lack of availability; or other similar reasons.

There is also an immigrant waiver available for individuals who have a religious belief or moral conviction against all vaccinations. The waiver is only available if the individual is opposed to all vaccinations (not just certain ones) and if the opposition is based solely on religious or moral convictions. There is no waiver available based on scientific arguments or political beliefs.

Specifically, in order to qualify for a vaccine waiver, an individual must meet the following three requirements, as outlined in Chapter 3 of the USCIS Policy Manual:

1. The applicant must be opposed to all vaccinations in any form.

The applicant has to demonstrate that he or she opposes vaccinations in all forms; the applicant cannot “pick and choose” between the vaccinations. The fact that the applicant has received certain vaccinations but not others is not automatic grounds for the denial of a waiver. Instead, the officer should consider the reasons provided for having received those vaccines. …

2. The objection must be based on religious beliefs or moral convictions.

This second requirement should be handled with sensitivity. On one hand, the applicant's religious beliefs must be balanced against the benefit to society as a whole. On the other hand, the officer should be mindful that vaccinations offend certain persons' religious beliefs.

3. The religious belief or moral conviction must be sincere.

To protect only those beliefs that are held as a matter of conscience, the applicant must demonstrate that he or she holds the belief sincerely, and in subjective good faith of an adherent. Even if these beliefs accurately reflect the applicant's ultimate conclusions about vaccinations, they must stem from religious or moral convictions, and must not have been framed in terms of a particular belief so as to gain the legal remedy desired, such as this waiver. …

The applicant does not need to be a member of a recognized religion or attend a specific house of worship. …

The waiver application is filed on Form I-601, with fee, together with a sworn statement from the applicant articulating the exact nature of his or her sincere religious belief or moral conviction against vaccines, and how those beliefs would be violated or compromised by complying with the vaccine requirement.

If the beliefs do originate from specific religious doctrine, it is helpful to include any literature published by the relevant religious organization regarding its stance on vaccines, or affidavits from fellow adherents to the religious organization.

Vaccine waivers, like other immigration waivers, involve a discretionary determination by a USCIS officer. However, they are usually granted if the individual meets the requirements outlined above.