Why USCIS Requires Individual Vaccination Records

The immigration medical exam — and the Form I-693 that results from it — is a legal document submitted to USCIS as part of an individual's immigration application. Because it is tied to a specific person's case, every element of the form must reflect that individual's medical history. The vaccination section of Form I-693 documents which vaccines that specific applicant has received, which vaccines were administered at the exam, and which vaccines were waived or deferred. This information cannot be generalized across family members.

USCIS Technical Instructions require the civil surgeon to review each applicant's vaccination records and make a determination for each person individually. The civil surgeon is certifying, under penalty of law, that the information on the form accurately reflects the applicant's vaccination status. Sharing or combining records between family members would undermine this certification and could constitute a misrepresentation on a federal immigration form — a serious legal issue.

From a practical standpoint, vaccination histories are rarely identical even within the same family. Different family members may have received different vaccines at different ages, in different countries, or from different providers. Even siblings who grew up in the same household and saw the same pediatrician may have different vaccination records due to differences in age, health history, or the vaccines available at the time each child was born. Individual records ensure that each person's actual history is accurately captured.

What "Individual Records" Actually Means

An individual vaccination record is a document — or set of documents — that lists the vaccines received by one specific person, along with the dates those vaccines were administered. It should include the person's name and, ideally, their date of birth. The record can take many forms: an official immunization card, a printout from a healthcare provider's electronic health record system, a school immunization record, or a vaccination booklet issued by a foreign government.

The key requirement is that the record is specific to the individual applicant. A family vaccination summary — for example, a document that lists all vaccines received by all members of a household — is not acceptable as an individual record. Similarly, a parent's vaccination record cannot be used to document a child's vaccinations, even if the parent was present when the child received the vaccines.

If a family member's vaccination records are in a foreign language, they do not need to be officially translated before the appointment. Our civil surgeon is experienced in reviewing foreign vaccination records and can work with records in many languages. However, if the records are in a language our staff cannot read, we may ask you to provide a translation or to contact the issuing provider for a supplemental record.

• Records must list vaccines for one specific person by name
• Family summaries or household vaccination logs are not acceptable
• A parent's record cannot substitute for a child's record
• Records can be from any provider — clinic, school, or foreign government
• Foreign-language records are generally accepted; translation may be requested if needed

What to Do When Family Members Received Vaccines Together

It is very common for families to receive vaccines together — for example, at a travel clinic before an international trip, or at a community vaccination event. In these situations, the clinic or provider typically creates a separate record for each person who was vaccinated, even if they were seen at the same time. If your family received vaccines together, contact the provider and request individual vaccination records for each person.

Most healthcare providers — including pharmacies, clinics, and hospitals — can generate individual vaccination records on request. If the provider uses an electronic health record system, they can typically print or email a vaccination summary for each patient. If the provider has closed or is no longer reachable, check whether your state's immunization information system (IIS) has a record of the vaccines. Most states maintain a registry of vaccinations administered within the state, and you can request a copy of each family member's record from the state health department.

If you received vaccines in another country, the process for obtaining individual records depends on the country's healthcare system. In many countries, vaccines are recorded in a personal vaccination booklet (carnet de vaccination or equivalent) that the patient keeps. If each family member has their own booklet, those are the individual records you need. If vaccines were recorded in a shared family document, contact the provider or local health authority to request individual records for each person.

• Contact the provider and request individual records for each person vaccinated
• Most clinics and pharmacies can generate per-patient vaccination summaries
• Check your state's immunization information system (IIS) if the provider is unavailable
• Foreign vaccination booklets (one per person) are acceptable individual records
• Contact the local health authority if vaccines were recorded in a shared family document

How to Obtain Separate Records for Each Family Member

The most reliable source of vaccination records is the healthcare provider who administered the vaccines. If your family has a primary care physician or pediatrician, contact their office and request a complete vaccination history for each family member. Most providers can generate this as a printed or electronic document within a few days. If you have used multiple providers over the years, you may need to contact each one to compile a complete record.

For vaccines received at a pharmacy — such as annual flu shots or COVID-19 vaccines — the pharmacy chain's patient portal is often the easiest way to access records. Major pharmacy chains maintain vaccination records in their systems and can print or email individual records on request. Each family member who received vaccines at the pharmacy will have their own record in the pharmacy's system.

If you are unable to locate records for a family member, do not panic. Missing vaccination records are a common situation, and there are options. Titer testing — blood tests that measure immunity to specific diseases — can sometimes demonstrate that a person is already immune to a vaccine-preventable disease, which may satisfy the USCIS requirement without re-vaccination. Alternatively, if records are truly unavailable, the civil surgeon can administer any missing vaccines at the appointment. Call our office before your appointment to discuss the best approach for your family's specific situation.

• Contact your primary care physician or pediatrician for complete vaccination histories
• Pharmacy patient portals are a reliable source for pharmacy-administered vaccines
• State immunization registries can provide records for vaccines given in that state
• Titer testing can demonstrate immunity when records are unavailable
• Missing vaccines can often be administered at our office on the day of the exam

Special Situations: Adopted Children and Internationally Vaccinated Family Members

Families who have adopted children internationally, or who have family members who received all of their vaccines in another country, sometimes face additional challenges in obtaining individual records. International adoption records may include a vaccination history, but the completeness and reliability of these records can vary. If an adopted child's vaccination records are incomplete or of uncertain reliability, titer testing is often the recommended approach — it provides an objective measure of immunity regardless of what the records say.

Family members who received vaccines in countries with different vaccine schedules may have received vaccines that are not recognized by USCIS, or may have received vaccines under different brand names or formulations. Our civil surgeon is experienced in reviewing international vaccination records and can determine which vaccines satisfy USCIS requirements and which may need to be repeated or supplemented.

In some countries, vaccines are recorded in a shared family health booklet rather than individual records. If this is the case for your family, contact the issuing health authority or clinic to request individual records for each family member. If individual records cannot be obtained, bring the shared booklet to the appointment and our civil surgeon will review it and determine the best path forward for each person.

Arriving Prepared: A Checklist for Families

The best way to ensure a smooth appointment for your whole family is to gather individual vaccination records for each person before you arrive. Start this process as early as possible — tracking down records from multiple providers, especially for children who have seen several pediatricians or received vaccines in another country, can take time. We recommend beginning at least two to three weeks before your scheduled appointment.

When you arrive at our office, each family member's records should be kept separate and clearly labeled with that person's name. Do not combine records into a single folder or stack — keeping them organized by individual makes it easier for our clinical staff to review each person's history efficiently and reduces the chance of any mix-up.

If you discover that a family member's records are incomplete or unavailable, call our office before the appointment. We can advise you on whether titer testing is appropriate, whether missing vaccines can be administered at our office, or whether the appointment should be rescheduled to allow time to locate the records. Coming to the appointment without records is not ideal, but it is not necessarily a reason to cancel — our staff will work with you to find the best solution.

• Gather individual records for each family member at least 2–3 weeks before the appointment
• Keep each person's records separate and labeled with their name
• Do not combine family members' records into a single folder
• Call our office if any family member's records are incomplete or unavailable
• Titer testing or same-day vaccination are options when records are missing