Try to Recover Your Records First

Before assuming your records are lost, try to recover them from the following sources:

• Your childhood pediatrician or family doctor — many practices retain records for decades
• Your school health records — schools often maintain vaccination records
• Your country's national immunization registry — many countries maintain centralized vaccination databases
• Your local health department or government health authority
• Your employer's occupational health records (if you received vaccines through work)
• Military service records (if you received vaccines during military service)

Option 1: Titer Testing

For vaccines where titer testing is available and accepted, a positive titer result demonstrates immunity and satisfies the vaccination requirement without needing to be re-vaccinated. Titer testing is available for measles, mumps, rubella, varicella, hepatitis A, and hepatitis B.

Titer testing involves an additional blood draw and laboratory fee, and results take several days. If your titers are positive, you save the cost and inconvenience of re-vaccination. If your titers are negative, you will need to receive the vaccine anyway.

Option 2: Re-Vaccination

For vaccines where titer testing is not available or reliable (Td/Tdap, meningococcal, pneumococcal, influenza, COVID-19), re-vaccination is the only option when records are unavailable.

Re-vaccination is also a reasonable choice for vaccines where titer testing is available, if you prefer to avoid the additional cost and waiting time of titer testing. Receiving a vaccine you may have already had is generally safe — it will not harm you even if you are already immune.

What to Tell the Civil Surgeon

At your appointment, inform the civil surgeon that you do not have vaccination records. The civil surgeon will review the USCIS-required vaccination schedule and discuss your options for each required vaccine.

Be prepared to provide as much information as you can about your vaccination history — even without records, your recollection of vaccines received (especially childhood vaccines) can help the civil surgeon make informed decisions.

Planning Ahead

If you know you will need an immigration medical exam in the future, start gathering your vaccination records now. Contact your prior healthcare providers, schools, and health authorities to request copies of your records. Having complete records at your appointment saves time, reduces costs, and avoids the need for re-vaccination.