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.”
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so there is a mandatory vaccination program for refugees, but it's not mandatory until they're in the States and they ask for "adjustment status" after arriving here.
I'm not even sure what that means