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why an applicant does not complete a COVID-19 vaccine series:

Applicant may request a waiver based on religious or moral convictions. If an applicant objects to vaccination based on religious or moral convictions, it must be documented that the applicant is requesting an individual waiver based on religious or moral convictions. This is not a blanket waiver, and the applicant will have to submit a waiver request to US Citizenship and Immigration Services (USCIS). USCIS will determine if this type of waiver is granted, not the civil surgeon or CDC. Applicant refuses a COVID-19 vaccine series in part or entirety If an applicant refuses one or more doses of a COVID-19 vaccine series that is medically appropriate for the applicant, it should be documented that the vaccine requirements are not complete and that the applicant refuses vaccination. This applicant is Class A and is inadmissible to the United States.

Common signs and symptoms can include:

Fever Cough Tiredness Early symptoms of COVID-19 may include a loss of taste or smell. Other symptoms can include: Shortness of breath or difficulty breathing Muscle aches Chills Sore throat Runny nose Headache Chest pain Pink eye (conjunctivitis) Nausea Vomiting Diarrhea Rash

Blanket Waivers Applicable to COVID-19 vaccin

Not age-appropriate For COVID-19 vaccines, the age for which a particular vaccine can be administered differs by formulation. If the applicant is younger than the lowest age limit for the formulations in use (less than 12 years of age at the time of posting), this blanket waiver should be documented. Contraindication If an applicant has a contraindication or precaution to the COVID-19 vaccine formulation available, the “Contraindicated” reason should be documented, and the vaccine should not be administered. If the applicant has had a severe reaction to the first dose that is considered a contraindication to receiving a second dose, the first dose should be documented in addition to the blanket waiver. Please refer to Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States for COVID-19 specific information about contraindications and precautions. Not routinely available If no COVID-19 vaccine is routinely available in the state where the Civil Surgeon practices, the “Not routinely available” reason should be documented. If vaccine is available to the applicant but due to limited supply, it would cause significant delay for the applicant to receive their vaccination, then this situation would also be considered “Not routinely available.”

Certain medical conditions that may increase the risk of serious illness from COVID-19 include:

Serious heart diseases, such as heart failure, coronary artery disease or cardiomyopathy Cancer Chronic obstructive pulmonary disease (COPD) Type 1 or type 2 diabetes Overweight, obesity or severe obesity High blood pressure Smoking Chronic kidney disease Sickle cell disease or thalassemia Weakened immune system from solid organ transplants Pregnancy Asthma Chronic lung diseases such as cystic fibrosis or pulmonary fibrosis Liver disease Dementia Down syndrome Weakened immune system from bone marrow transplant, HIV or some medications Brain and nervous system conditions Substance use disorders

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