Getting vaccinated against Covid-19 will soon become unavoidable for those who harbour American dreams.

Starting October 1, all green card applicants will need to get Covid-19 vaccinations to clear their immigration medical exam and obtain permanent residence, a new order from the country’s Centers for Disease Control and Prevention has said. This vaccine joins a long list of the ones that are already required.

Green cards aspirants in the United States as well as immigrant visa applicants applying at US embassies and consulates abroad have to meet the criteria.

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Since applicants are medically screened well in advance of getting a green card, a negative screening for Covid-19 at the time of the medical evaluation does not mean the applicant will be Covid-free when they eventually become a permanent resident.

“A combination of vaccination and routine infection control practices will provide the best protection from Covid-19 for applicants and US communities,” the Centers for Disease Control and Prevention said.

Proof of valid documentation must be provided to the civil surgeon in person. This is what is and is not acceptable:

  • Official vaccination record
  • Copies of a medical chart
  • Record should include the dates (month, day, and year) the applicant received the vaccine
  • Name or manufacturer and lot number should be included if available
  • The document should not appear to have been altered
  • Self-reports of vaccination will not be accepted without written documentation

Exceptions to rule

As with all vaccinations, there are blanket waivers under special circumstances.

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These include:

  • If the vaccine may not be administered to a certain age group
  • If an applicant has a contraindication or precaution to the Covid-19 vaccine formulation available, meaning that it can have an adverse effect on them
  • If no Covid-19 vaccine is routinely available. For example, when there are severe delays due to limited supply

Outside of these circumstances, an applicant can request a religious or moral waiver but that will not be greenlit automatically. The authority to decide if this type of waiver is granted lies with the US Citizenship and Immigration Services, not the civil surgeon or CDC.

As for an applicant who refuses one or more doses of the Covid-19 vaccine without a valid reason, they become “inadmissible” to the US, the CDC said.

Mixed reactions

The reactions to CDC’s demand are currently mixed. On one hand, there is some outcry about how vaccines should be optional, but on the other, people have pointed out how vaccines have been a requirement for a host of things like attending school or practising medicine before, too.

In fact, the vaccine mandate is a small ask in a long and arduous green card process.

Indians in the queue for permanent residency who have a decades-long wait ahead of them even ruefully joked about it.

This article first appeared on Quartz.