Vaccination Requirements for Refugees & Asylees

What are the vaccination requirements?

They are: mumps, measles, rubella, polio, tetanus, diphtheria toxoids, pertussis, influenza type B, hepatitis B, and any other vaccinations recommended by the Advisory Committee for Immunization Practices (ACIP). Current ACIP recommendations also include the varicella, haemophilus influenza type B, and pneumococcal vaccines.

How do the vaccination requirements affect refugees? 

Refugees are not required to comply with the vaccination requirements during the initial medical exam overseas. They must, however, comply when they apply for adjustment of status after they have been admitted to the United States . INS regulations state that refugees applying for adjustment of status at least 1 year after their initial admission are not required to repeat the entire medical examination performed overseas, unless there were medical grounds of inadmissibility (Class A medical conditions) that arose at that time. As a result, refugees generally need only the vaccination sign-off (not the whole medical exam) when they apply for adjustment of status. This vaccination sign-off must be obtained by an INS-designated civil surgeon. For information on finding an INS-designated civil surgeon, see “Designated Civil Surgeons.”

How do the vaccination requirements affect asylees?

Asylees applying for adjustment of status at least 1 year after the asylum application was approved are required to have the entire medical exam, including the vaccination assessment, by a designated civil surgeon. This is because asylees are not required to undergo any medical examination as part of their asylum application. To obtain the name and number of individual physicians in your area that are designated civil surgeons, you may call the INS Customer Service Centerat: 1-800-375- 5283.

How do refugees obtain the vaccination sign-off to complete their adjustment of status application?

The vaccination sign-off must be obtained from a civil surgeon. To make this process easier for refugees, INS has designated all state and local health departments as civil surgeons for those refugees who need only the vaccination sign-off. Participation by the health departments is voluntary. Contact your local voluntary agency or your refugee health program at the local or state level for more information.

What happens to refugees and asylees who do not have all the vaccinations, cannot prove they have them, or object to vaccinations?

INS is authorized to grant these waivers for humanitarian reasons, to assure family unity, or when it would otherwise be in the public interest.

How do refugees and asylees apply for a waiver of the vaccination requirements, if they need one?

INS has made it very easy to apply for the waiver. INS will grant the waiver without a separate application if: (1) you didn’t have all the vaccinations (or all the vaccination certificates) at first, but then receive the missing vaccinations, or find the missing certificates OR (2) the civil surgeon certifies that it would not be medically appropriate for you to have one or more of the required vaccinations. These are two examples of humanitarian reasons for granting the waiver. The civil surgeon will review your vaccination history with you to determine whether you have all the required vaccinations. Make sure you take your vaccination records with you to your medical appointment. Do not try to comply with these requirements before you meet with the civil surgeon, in case it is not medically appropriate for you to have one or more of the required vaccinations

What about refugees who object to the vaccination requirements because of religious or moral reasons?

If complying with the vaccination requirements would be against your religious beliefs or moral convictions, INS can also consider this as a humanitarian reason for granting the waiver. You must apply for the waiver by using a separate form, Form I-602, Application by Refugee for Waiver of Grounds of Excludability, but you do not need to pay a fee. In this case, you will need to show that: (1) you are opposed to vaccinations in any form; (2) you object because of religious or moral reasons; and (3) your objection is sincere. If you believe there is any other humanitarian reason why INS should waive the vaccination requirements for you, you need to submit Form I-602 with your adjustment of status application.