People applying to immigrate to the U.S. will have to show they’ve been vaccinated against COVID-19 as part of a required medical exam, the U.S. Citizenship and Immigration Services says. The new policy takes effect on Oct. 1.

The requirement includes an exception for children who are too young to receive the vaccine as well as for people with medical conditions that rule them out for the shot. It also outlines a waiver process for people who refuse to be vaccinated due to religious and other reasons.

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“If the applicant has not received any of the listed vaccinations and the vaccinations are age appropriate and medically appropriate, the applicant has a Class A condition and is inadmissible,” the USCIS said. The agency is part of the Department of Homeland Security.

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Anyone who “objects to vaccines based on religious or moral convictions” can request a waiver from the USCIS, the agency said. But there’s also a caveat: Prospective immigrants can’t pick and choose which vaccines they reject.

“The applicant needs to demonstrate opposition to vaccinations in all forms, not just certain vaccinations,” according to the agency.

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