Vaccination Requirement for Immigrant Visas and Adjustment of Status



An alien seeking lawful permanent resident status, either through consular processing or adjustment of status, must not be inadmissible for not having received required vaccine immunizations under section 212(a)(1)(A)(ii) of the Immigration and Nationality Act (INA). In limited circumstances, an applicant for lawful permanent resident status may be eligible for a waiver of part or all of the vaccination requirement. In this article, we will examine the vaccination requirement for applicants for lawful permanent resident status through consular processing or adjustment of status.

Please note that although we will discuss waivers of vaccine-related inadmissibility in this article, we cover the issue in more detail in our companion article [see article] in our Waivers section [see category].

Please see our related article to learn about the medical examination requirement for adjustment of status [see article].

Vaccine-Related Inadmissibility

Statutes: Vaccine-Related Inadmissibility, Exceptions, and Waivers

The provisions for vaccine related inadmissibility, exceptions, and waivers are found in section 212 of the INA. In the following subsections, we will provide the statutory background for the issue.

Vaccine-Related Inadmissibility

The provision for vaccine-related inadmissibility is found in section 212(a)(1)(A)(Ii) of the INA. With a limited exception, an alien seeking an immigrant visa through consular processing or adjustment of status must present documentation that he or she has received certain vaccinations. Please see the relevant section of our article for the list of vaccinations [see section].

Limited Exception for Certain Adopted Children

Section 212(a)(1)(C) contains a limited exception from the vaccination-related inadmissibility ground. Under this provision, the vaccination requirement does not apply to an adopted child who is 10 years of age or under and who is seeking an immigrant visa as an immediate relative under section 201(b) of the INA. The adopted child must either be an orphan as described by section 101(b)(1)(F) or a Hague Convention adoptee under section 101(b)(1)(G). This exception is, however, limited. Section 212(a)(1)(C)(iii) requires that the adoptive parent or prospective adoptive parent sponsor of the child's petition have executed an affidavit stating that the parent is aware of the vaccination requirement in section 212(a)(1)(A)(Ii) and will ensure that either within 30 days of the child's admission, or at the earliest time that is medically appropriate, the child will receive his or her required vaccinations.


Section 212(g)(2) of the INA sets forth three separate provisions for waiver of the vaccination requirement. Unlike the exception found in section 212(a)(1)(C), the visa or adjustment applicant must apply for a waiver.

Section 212(g)(2)(A) provides a waiver for an alien who was found inadmissible under section 212(a)(1)(A)(ii), but who them receives the missing vaccination(s).

Under section 212(g)(2)(B), an alien may qualify for section 212(a)(1)(A)(ii) waiver of inadmissibility if a civil surgeon, medical officer, or panel physician certifies, in accordance with Department of Health and Human Services (HHS) regulations, that one or more of the required vaccinations would not be medically appropriate for the applicant.

Finally, an alien may seek a waiver under section 212(g)(2)(C) based on the assertion that the vaccination requirement is contrary to his or her religious believes.

Please see our companion article on waivers of the vaccination requirement to learn about these issues in more detail [see article].

List of Required Vaccinations

Section 212(a)(1)(A)(ii) requires that immigrant visa applicants and adjustment of status applicants have received the following vaccinations:

  • Mumps
  • Measles
  • Rubella
  • Polio
  • Tetanus
  • Diphtheria toxoids
  • Pertussis
  • Influenza type B
  • Hepatitis B

In addition to the vaccines explicitly listed in section 212(a)(1)(A)(ii), applicants for immigrant visas or adjustment of status are also required to receive any other vaccinations against vaccine-preventable diseases recommended by the Advisory Committee for Immunization Practices. Accordingly, the recommended vaccines, listed in the United States Citizenship and Immigration Services (USCIS) Policy Manual (PM) at 8 USCIS-PM B.9, are as follows (note: as of the date of this article):

  • Varicella
  • Influenza
  • Pneumococcal pneumonia
  • Rotavirus
  • Hepatitis A
  • Meningococcal

The Center for Disease Control (CDC) has established guidelines for when vaccinations are age-appropriate and medically-appropriate. If the civil surgeon examining the applicant determines that a required vaccination is not, or required vaccinations are not, medically appropriate, the applicant may be granted a section 212(g)(2)(B) waiver. We discuss this issue in more detail in our article on vaccine-related inadmissibility waivers [see section]. Our companion article will also discuss the limited religious belief waiver of the vaccine-related inadmissibility provision [see section].

8 USCIS-PM B.9(E) lists special considerations for USCIS officers in considering whether an individual is inadmissible on vaccine-related grounds.

First, from August 1, 2008, through December 13, 2009, female applicants between the ages of 11 and 26 were required to receive the human papillomavirus (HPV) vaccination. This HPV vaccination requirement was eliminated on December 14, 2009. Accordingly, USCIS officers are instructed to disregard any annotation of the HPV vaccination, or lack of such annotation, when determining whether the individual has received all of her required vaccines.

Second, also from August 1, 2008, through December 13, 2009, applicants aged 60 years or older who had not received the varicella vaccine were required to receive the zoster vaccination. However, the USCIS-PM explained that the zoster vaccination was not available in the United States when it was required. Accordingly, the USCIS approved the Form I-693, Report of Medical Examination and Vaccination Record, in cases where the civil surgeon indicated that the zoster vaccination was unavailable. On December 14, 2009, the zoster vaccination was stricken from the requirements. Accordingly, USCIS officers are instructed to disregard any annotation of the zoster vaccination, or lack of such annotation, when determining whether the individual has received all of his or her required vaccines.

Finally, the influenza vaccine is only available during flu season. For purpose of the Form I-693, flu season begins on October 1 and runs through March 31. As of November 16, 2010, all applicants 6 months of age or older are required to receive the vaccine during flu season. If an applicant was required to receive a flu vaccine at the time of his or her medical examination and did not do so, the USCIS will issue a request for evidence (RFE) if (1)it is still the same flu season; and (2) it is reasonable to expect that the applicant will be able to obtain the flu vaccine within the time frame of the RFE. USCIS officers are instructed to not issue an RFE if it is no longer the same flu season or if it is no longer flu season at all.

Prior to August 1, 2008, the Hepatitis A, meningococcal, and rotavirus vaccinations were not required.

Completing the Vaccination Requirement

Applicants seeking immigrant visas through consular processing must have a panel physician abroad complete the Form DS-3025, Vaccination Documentation Worksheet. If the applicant is an adopted child who qualifies for an exemption, the parent will fill out the Form DS-1981, Affidavit Concerning Exemption from Immigrant Vaccination Requirements for a Foreign Adopted Child.

Applicants in the United States must have the Form I-693 completed by a civil surgeon.

It is important to note that the panel physician or civil surgeon will assess the applicant's existing vaccination records, health history, and age to determine which vaccinations are needed based on the requirements. The requisite forms are filled out by the panel physician or civil surgeon and not by the applicant.


The vaccination requirement is part of the general medical examination requirement for immigrant visa applicants and adjustment of status applicants. An applicant may consult the USCIS and Department of State (DOS) websites for the most up-to-date vaccination guidelines and information on finding a qualifying panel physician or civil surgeon. It is incumbent on applicants to ensure that they meet these requirements. In general, applicants seeking immigrant visas or adjustment of status should consult with an experienced immigration attorney for case-specific guidance on the medical examination requirement and vaccines specifically.