Fiance K-1 Visa Medical exam Vaccination Requirements

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You should take the optional Vaccines during the K visa medical exam. However, refusing them won’t affect your visa approval.

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During your K-1 visa medical exam, a doctor performs the routine exam — physical, blood, mental, etc. They ask a bunch of questions about your health and begin taking your vitals. Finally, they ask if you want the vaccinations.

For most of us, we say “sure… no problem” as we watch the doctor pull out the DS-3025 form to check off all the vaccines you need or don’t need. Then he/she gets the syringes ready.

But for a lot of us, before the physician sticks a needle in our arms, it’s important to know…

• – What are the vaccinations are for?
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• – Why are they given? Are they safe?
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• – What if you refuse — do you get denied a K-1 visa?

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So, let’s talk about what these vaccinations are, why we need them, and what happens if we refuse.

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Are K Visa Vaccinations Required?

Your Embassy’s K-1 visa application instructions clearly say you must undergo a medical exam. That’s normal and it’s not something you can avoid.

The vaccinations, however, are another story. The US law INA 212(A)(1)(A)(II) requires that all incoming immigrants MUST be vaccinated for a particular set of diseases before they’re granted a visa.

Here’s where the story gets interesting. Although vaccines are required for all immigrants, this rule doesn’t apply for K visa applicants because technically they’re non-immigrant visas.

Yes, it’s a technicality.

So, for fiance visa applicants, the vaccinations are OPTIONAL. But even though they’re not required to grant a visa, they’re still highly encouraged by the Embassy. Do you know why?

Take a look at the medical page of US Consulate from the UK as an example. Notice they say vaccinations are optional but highly recommended for K visa applicants.

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They remind you that vaccinations are optional right now. They’re required during your Adjustment of Status (I-485) for a Green Card / Permanent Residency after marriage (waivers available).

So, the point to remember is either (1) you can take the optional vaccinations now, or (2) postpone the issue until you come to the US to Adjust Status with the I-693. In which case you’ll have to revisit the requirement.

It’s recommended you take the shots during the K-1 visa medical exam to save time and money because vaccinations are expensive in the US.

(We’ll talk about waivers further below)

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What’s the process for K visa vaccinations?

Now that you know they’re optional, let’s step back to see the entire process — of what it looks like for typical cases. You know… where the K-1 applicant goes to the medical exam and gets the immunizations:

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1. You take medical exam and the optional vaccinations. The doctor determines your dosage requirements based on age, health, availability of vaccine, etc.
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2. Among other things in the medical exam, the physician fills out the DS-3025 to verify which vaccines were administered in which doses.
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3. He/she seals your medical documents and either hands them to you or sends them directly to the US Embassy for your K-1 visa interview.
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4. The Embassy reviews your medical files including your vaccinations during the K-1 visa interview. Once you’re approved, you get back a sealed medical packet with all documents, including the DS-3025 for the vaccination records.
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5. Hand carry this medical packet to the entry at the US Border when you land here. Customs will open and review the medical packet.
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6. After you’re married and file for the I-485 Adjustment of Status, you won’t take the vaccinations again because you’ve already been vaccinated. If it’s been more than 1 year since your medical exam, then the exam is expired. You may have to repeat the exam and get booster shots for the vaccinations.

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These steps happen for most people. It’s usually not an issue. But I want to go deeper with what the vaccinations are all about, starting with…

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Why take Vaccinations?

You mean to ask why are they important?

Well, for a number of reasons – the most important being that immunization is mandated by the US government (waivers are allowed). But for most cases, you need to show that you’re safe from certain vaccine-preventable diseases.

Remember that for K visas, vaccinations are optional.

But, that’s only for getting a visa. If you want to get a Green Card (I-485) after marriage (which I’m sure you do) then immunization becomes a requirement.

The vaccine shots required for the K-1 visa include:

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• Mumps
• Measles
• Rubella
• Polio
• Tetanus and diphtheria toxoids
• Pertussis
• Influenzae type b (Hib)
• Hepatitis B
• Varicella
• Pneumococcal and
• Influenza

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The big thing to realize is that vaccines are dependent on you. Meaning you will get certain vaccines based on your age, health, availability, etc. You will not get others if not needed. Here’s an excerpt from the table of the Centers for Disease Control website.

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The US Department of State follows the recommendations that the CDC sets for immigrant visa applications. As an example, the Polio vaccine is only given to K-2 visa applicants between the ages of 2 months to 18 years. So, not everyone gets all vaccines. Which brings me to the next point…

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How much do they cost?

The cost for getting vaccinated depends on what exactly you’re missing. You see, the physician won’t give you everything. Instead, it depends on your age, health, availability of the vaccine, etc.

Based on those criteria, you may take some, or a lot of vaccines. Since each one has a different price, you can end up paying a different fee than the other K-1 visa applicant next to you.

Single doses of vaccines can range from $0.50 (USD) all the way up to $100 (USD) per dose.

Other times, the approved clinic will include the price of vaccines within their entire medical exam cost. So, no additional payment is required above the flat fee. Here’s an example of the Philippines Medical clinic (St. Luke’s)

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For a typical K-1 visa applicant, the cost for the entire medical exam can range from $200 to $400 (USD) per applicant — not just for the vaccines, but the entire medical exam. Remember, that’s per person. Children will cost a similar amount per each.

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Should you take vaccines before the medical exam?

Do you need to go to your primary doctor to get the shots before coming to the K visa medical exam? You don’t have to. During your exam, the physician / civil surgeon determines which ones you need based on several criteria.

If you’ve gotten vaccinations before– from your primary physician, let’s say– then there are two possible scenarios

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1. If this doctor accepts your past vaccine history then he/she won’t administer those. It depends on if your previous records are documented and credible (i.e. come from a credible record enough that the approved physician accepts it). In some cases, you only require booster shots to get you up to speed.

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2. If the doctor doesn’t accept your vaccine history, he/she applies what’s most appropriate for you. In either case, the physician will make sure you meet the requirements.

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How do you know what you’ve already gotten and what the doctor’s going to accept?

Well, the best thing to do is to walk into the K-1 visa medical examination with your vaccination history and hand it to the doctor. He/she will figure the rest out.

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What if you have an existing medical condition and can’t take the K visa vaccinations?

If you have an existing medical condition which prevents you from taking a vaccine, it doesn’t automatically mean your K-1 visa will be denied. However, your condition will be investigated. If it’s one that poses a danger to others, you’ll be required to get treated.

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Pregnant woman

If you’re pregnant, you can talk to the physician about what vaccines are safe to administer. Note that physicians are actually given a technical manual to follow on how to proceed if you have certain conditions (like pregnancy). In general, doctors believe that most vaccines are safe during pregnancy.

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Age

Keep in mind that vaccines are based on your age and availability of vaccine. Like I mentioned earlier, your K-2 visa child will have a different set of vaccines than yours. So, if you’re concerned about your child receiving some shots, then realize it may not be the ones you’re thinking of.

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Contraindication (adverse reaction)

Contraindication is something that goes wrong due to a vaccine in a group of people. Some have allergic reactions, immuno-suppression issues, recipients of transplants, blood transfusions, etc. If you suspect you’re prone to adverse reactions, then you must inform the physician. He/she may have to perform additional antibody testing.

The immunization and K visa medical exam procedure is pretty straightforward for most people. But there are some gray areas which can cause you to run into issues.

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These physicians hold lots of authority over what needs to be administered as recommended by the CDC and ACIP.The best thing to do is to talk to the physician and work something out.

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If I don’t take the vaccines will my K visa be denied?

Let’s get one thing straight here – they’re optional. You can avoid vaccines for two reasons

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1. The doctor doesn’t think you need some of them.

The vaccine is not appropriate for your age, health, or lack of availability, etc. This is acceptable because the physician says that you don’t need the vaccine. In this case, he/she will check off the DS-3025 for one of the blanket waivers.

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2. You refuse to take any of them.

You refuse the vaccine due to religious beliefs, moral convictions, or flat refusal to take them for other reasons. This is where it gets tricky. Let’s talk about it below.
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If you refuse vaccines, then the doctor will check a box in the the DS-3025 to say one of that either you’re requesting a waiver on religious grounds, moral conviction, or flat refusal.

Consular officers won’t deny K visa applications for refusing vaccines. However, the fact that consular officers have complete authority and discretion on the approval of visa applications, there is no telling what their bias may tilt towards.

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And if you’re curious, check out the K visa denial statistics due to refusing the vaccines INA 212(a)(I)(A)(ii). Interesting isn’t it? There are 0 denials due to lacking vaccines for non-immigrants (including K visa applicants). Again, they’re not required and therefore cannot be enforced for visa issuance.

If you decline the shots, the Embassy attaches an addendum to your DS-3025 form saying that it’s been waived pending Adjustment of Status (i.e. when you submit the I-485 for a Green card, you must visit this vaccination requirement again).

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Do I need the vaccines for the I-485 Adjustment of Status?

Now, we’re going to talk about the hard part. Since the vaccines were optional for K visa applicants before the interview, what happens now for the I-485 Green Card — where the law actually says that it’s required for everyone?

Well, after you get married in the US, you’re no longer a K applicant, you’re someone trying to Adjust Status to Permanent Resident. Meaning nothing sets you apart from everyone else getting your Green Card (in terms of vaccines).

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For I-485 Adjustment of status, you must show that you meet vaccination requirements.

You can do this by showing proof of either the DS-3025 or I-693. Let me explain the difference between the two.

If you got the shots from the panel physician, you get the DS-3025 filled out and valid for 1 year. In which case, if you file the I-485 within that time frame, then your results are still valid and acceptable. You will send a copy of your DS-3025 with your I-485 packet.

If you don’t take the shots during the K visa medical exam, then you must get them now from a civil surgeon who fills out the I-693. This has to be done before you submit your I-485 Adjustment of Status so you can mail it together.

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You have to find a list of approved civil surgeons who perform the medical exam and administer your vaccines here in the US.

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Can I get a waiver for the I-485 vaccinations?

Waivers are allowed if for some reason you can’t (or won’t) take the vaccines.

You can get a waiver during the K visa medical exam but it’s not really required. Remember it vaccines are optional that point — so why have waivers? So you don’t go through the headache of trying to convince anyone why you shouldn’t take them.

But, during the I-485 Adjustment of Status, you have two options: either (1) take the vaccinations and send the I-693 now, or (2) apply for a waiver. Let’s talk about applying for a waiver

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There are two types of waivers

1. A “blanket waiver”. The physician or civil surgeon figures that you don’t need particular vaccines for some reason. He/she will write that down in the I-693.

• 1a. “Not medically appropriate”. The vaccinations aren’t required and the doctor gives you a waiver. You don’t have to do anything for this. You can submit your I-693 just the way the doctor has filled it out. You’re good to go.
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• 1b. “Contraindicated”. The vaccination will cause some harm or adverse reaction to the applicant (like we talked about earlier). The physician will waive some or all of the vaccines. You will get your I-693 filled out and ready to submit. You’re good to go.
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• 1c. “Insufficient time” between doses if the wait time is too long to record and submit the paperwork. This waiver means you don’t have all the vaccines, but they will be administered later. Right now you can send your I-485, but in the future, you come back for the remaining doses to complete the procedure.
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• 1d. Vaccine not available / not flu season / etc. This means you can’t get the vaccines due to some logistic reason or that it’s not in season. The doctor will note this down and hand you the I-693 ready to submit.

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2. A “religious belief or moral conviction” waiver is for those who have a non-medical reason for not taking the vaccinations. These are tougher to get approved by the USCIS.

• 2a. Your religious beliefs or moral convictions forbid you from taking any vaccination (not just the ones you don’t want).
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• 2b. It must be based on religious or moral convictions (non-”blanket waiver”).
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• 2c. The religious or moral conviction must be sincere
  

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The whole issue of getting a “religious belief or moral conviction” waiver is complicated. I won’t go into detail here. You can read further about it from the USCIS website. Sure enough, getting a “blanket waiver” is much easier than trying to get a “religious or moral” waiver.

If you’re granted a waiver, then the USCIS will process your Adjustment of status. Otherwise they can deny you the privilege based on the INA 212(a)(1)(A)(ii) inadmissibility.

And that’s the general idea behind getting vaccinated. For most of us, there’s no objection to getting vaccination. For others, it is a problem.

The two types of waivers “blanket waiver” or “religious belief or moral conviction” waiver are allowed if you don’t meet the vaccination requirements.

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Do you have any questions about the vaccination requirement for the K visa process?