Conversation Guide: Immigration

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In response to updates from the US Centers for Disease Control and Prevention (CDC), US Citizenship and Immigration Services (USCIS) is requiring applicants subject to the immigration medical examination to complete the primary COVID-19 vaccine series (1 dose of Janssen, otherwise known as Johnson & Johnson, or 2 doses of all other approved formulations, currently commonly known as Pfizer and Moderna COVID-19 vaccines). This update is effective October 1, 2021, and impacts applicants for lawful permanent residence (LPR, green card) in the US and applicants for an immigrant visa overseas. Green card applicants must complete an approved primary COVID-19 vaccine series before a civil surgeon can complete Form I-693, Report of Medical Examination and Vaccination Record. Following this announcement, client-facing staff, particularly those providing immigration services, have received questions about this requirement. This guide is designed to assist staff in answering those questions with information from reliable and trusted sources, while also staying within their scope and role. 

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Is the COVID-19 vaccine required for me to become a lawful permanent resident (i.e., get my Green Card)?

Yes. Given the importance of the COVID-19 vaccine to keep us all safe, keep people at work, and keep kids in school, USCIS added the COVID-19 vaccine as one of the vaccines required for your adjustment of status (lawful permanent resident, or Green Card) application, Form I-485. Depending on which COVID-19 vaccine you receive (Moderna, Pfizer, or Johnson & Johnson), you will need up to two doses up to 4 weeks apart. In order to avoid delays, you should plan to finish the COVID-19 vaccine series by the time of your medical examination appointment. This is recommended by CDC and required by USCIS. If you have questions, consult with a health care professional.

Can I opt not to get the COVID-19 vaccine – is there a way to have an exemption?

You can request an exemption by applying for certain waivers if the COVID-19 vaccine is not recommended for you. Only a US medical official can determine if you qualify for the below waivers:

  1. The vaccine is not age-appropriate (for example, the person applying for adjustment of status is a child younger than the current approved age for the COVID-19 vaccine). This is subject to change based on recent developments in vaccines for children. Always check the USCIS website for the latest information.
  2. Due to health reasons or a previous reaction to the COVID-19 vaccine, it is not recommended for you (this is a very rare reason).
  3. The COVID-19 vaccine is not routinely available in your area. In the US, vaccines tend to be highly accessible so this would also be a rare reason.

If you do have a medical concern, you may find it helpful to talk to a trusted healthcare professional. There are very few underlying medical conditions that would prevent a person from getting the COVID-19 vaccine. In fact, people with medical conditions are often encouraged to get the vaccine because they are more at risk for serious illness and even death from COVID-19.

A person who does not want to receive the COVID-19 vaccine because of religious or moral reasons may request a specific exemption: a waiver of inadmissibility from USCIS (I-601 or I-602 depending on adjustment category). USCIS will consider an exemption when the following are met:

  • You are opposed to vaccinations in any form– that is, you cannot obtain a waiver based on an objection only as to the COVID-19 vaccination
  • Your objection must be based on religious beliefs or moral convictions; and
  • The religious or moral beliefs must be sincere.

Only USCIS can determine if this waiver will be granted, and generally, these waivers are rare.

If you have a cultural or religious concern, it may be helpful to talk with a trusted religious or cultural community leader. Many leaders support people getting the COVID-19 vaccine and from a religious perspective believe the vaccine is necessary to save lives. The COVID-19 vaccine is also halal.

Will my immigration status be negatively affected if I don’t get vaccinated?

You will not be able to apply for adjustment of status without either completing the COVID-19 vaccine series or meeting the criteria and having an approved waiver. Refugees are required to apply for a green card/LPR status after one year in the US. Lawful permanent residence is a necessary first step before applying for US citizenship.

If you do not complete the COVID-19 vaccination and do not meet the criteria and obtain a waiver, you will be inadmissible. This means that you are not eligible to become a lawful permanent resident (green card holder) and could be subject to removal (deportation) from the U.S.  

Why is the COVID-19 vaccine one of the required vaccines?

As of November 2021, the COVID-19 pandemic has killed over 5 million people and infected hundreds of millions of individuals. To date the vaccines have been given to hundreds of millions of individuals from different races, ethnicities, ages, and health conditions in the United States, including pregnant women. The vaccines have met the US Food and Drug Administration’s high scientific standards for safety, effectiveness, and manufacturing.

Because the vaccine is safe and is vital to protecting communities from COVID-19 outbreaks, the US government recommends that everyone who is eligible for the vaccine receives it. All of these reasons are why the COVID-19 has joined many other vaccines as required for adjustment of status and others seeking to enter the U.S. Data shows that the best way to protect yourself, your family, and your community from COVID-19 is to be fully vaccinated. If you are not vaccinated, you are much more likely to get infected with COVID-19, get dangerously ill, and spread it to others. Reducing the impact of COVID-19 through vaccination is a critical step to ensure we can work, go to school, and spend time with our family and friends with reduced risk of getting severely sick and/or dying from COVID-19.

How long will it be required? Can I wait to adjust my status until it’s no longer a requirement?

It is likely that the COVID-19 vaccine requirement will remain as long as COVID-19 continues to be a public health concern, and might become a permanent requirement. Adjusting your status is important to being able to live and work in the US permanently. People who have an adjusted status also have additional rights in the US. Refugees are required by law to apply to adjust status after one year in the U.S. If you opt to wait to apply for adjustment of status because of the COVID-19 vaccine requirement, the effect on your immigration status may vary depending on your personal circumstances. It is best to speak with an immigration expert about this.

Where can I get vaccinated? Do I have to pay for the vaccine?

You can get COVID-19 vaccines at your local pharmacy, doctor’s office, or through a mobile vaccination program or vaccination site. This website can help you find a vaccine.

COVID-19 vaccines are free for all, you do not need health insurance or an ID, and your immigration status does not matter. Additional talking points are available here.

What if I have only had 1 dose of the COVID-19 vaccine, can I still apply for adjustment of status?

Ideally you would have completed the series before you apply, whether this is 1 or 2 doses depending on the vaccine. Your civil surgeon can give you the second dose of COVID-19 vaccine when required.

For more specific questions about how the COVID-19 vaccine works, its safety and effects, addressing myths around the vaccine and more, you can visit the following conversation guides:


For a list of resources translated into different languages that you could share with clients, visit the following links:

Additionally, USCIS has videos on vaccine hesitancy in Dari and Pashto here.

This video, created by Protecting Immigrant Families, explains that anyone can get a COVID-19 vaccine, regardless of immigration status. Available in Arabic, Haitian Creole, English, French, Korean, Mandarin, Spanish, Tagalog, and Vietnamese. Watch the two-minute, one-minute and 30 second versions.