I do understand what you mean, I think it is the physician that has to write that letter or something.
It says here that the officer will cross the right box once they know what waiver you are asking for:
Q. There is no mention of Vaccination on this document, so how can it be used for the exemption from vaccination?
A. The top of I-601 has a spot where a government officer can check the section under which the waiver is being applied for:
[Vaccination exemption = sect: 212(a)(1)]
Form I-601 can be found at:
http://www.uscis.gov/files/form/i-601.pdf What if I object to the vaccination requirements because of religious or moral reasons? The third waiver covers those applicants who believe that compliance with the vaccination requirements would be against their religious beliefs or moral convictions. Form I-601, Application for Waiver of Grounds of Excludability, with fee, is required. You must also meet the following three requirements:
(1) You oppose vaccinations in any form;
(2) The opposition is based on religious beliefs or moral convictions (whether or not as a member of a recognized religion); and
(3) The religious belief or moral conviction is sincere.
When the applicant is a child, the parent must meet all of these requirements. Where can I get the vaccination supplement? The civil surgeons and panel physicians have already received the vaccination supplement and instructions from the Centers for Disease Control and Prevention (CDC). Your civil surgeon or panel physician should contact CDC directly if he or she did not receive this mailing from CDC or visit CDC's website at:
http://www.cdc.gov/ncidod/dq/health.htm.
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God Bless America - God Bless Immigrants - God Bless Poor Misguided Souls Too

Mr S.U.