How the Civil Surgeon Evaluates Foreign Vaccines

The civil surgeon focuses on the disease the vaccine protects against, not the specific brand name or formulation. If a foreign vaccine protects against a disease on the USCIS-required list, it can generally be credited — provided the documentation meets the standard requirements (vaccine name, date, doses, provider).

For example, many countries use combination vaccines that include components not available as separate vaccines in the U.S. A DTP vaccine (diphtheria, tetanus, pertussis) given abroad is equivalent to the U.S. DTaP or Tdap vaccine for the purposes of Form I-693.

Common Foreign Vaccine Equivalents

The following are common examples of foreign vaccines that are equivalent to U.S.-required vaccines:

• BCG (Bacille Calmette-Guérin) — TB vaccine used in many countries; not required in the U.S. but does not cause problems
• DTP/DTPw (whole-cell pertussis) — equivalent to DTaP/Tdap for diphtheria, tetanus, and pertussis coverage
• OPV (oral polio vaccine) — equivalent to IPV (inactivated polio vaccine) for polio coverage in most contexts
• Pentavalent vaccines (DTP-HepB-Hib) — credited for diphtheria, tetanus, pertussis, hepatitis B, and Hib components
• Hexavalent vaccines — credited for all included components
• JE (Japanese encephalitis) vaccine — not required in the U.S.; does not affect USCIS requirements

What About BCG Vaccination?

BCG (Bacille Calmette-Guérin) is a tuberculosis vaccine widely used in countries where TB is common. BCG is not required for immigration and is not on the USCIS vaccination list.

However, BCG vaccination is important for TB testing interpretation. BCG can cause a false-positive tuberculin skin test (TST) result. If you received BCG as a child, inform the civil surgeon — this information affects how a positive TST result is interpreted. The IGRA blood test (QuantiFERON-TB Gold or T-SPOT) is not affected by BCG vaccination and is the preferred test for BCG-vaccinated individuals.

What If the Foreign Vaccine Schedule Differs From the U.S. Schedule?

Vaccination schedules vary by country. The number of doses, the ages at which vaccines are given, and the intervals between doses may differ from U.S. recommendations. The civil surgeon evaluates whether the doses you received meet the minimum requirements for protection.

In some cases, a dose given at a younger age or at a shorter interval than recommended may not be counted. The civil surgeon follows CDC and ACIP guidelines for evaluating dose validity.