What Needs to Be Completed After Delivery?

If you had your immigration medical exam during pregnancy, the following components may have been deferred and will need to be completed postpartum:

• MMR vaccine (measles, mumps, rubella) — if not previously immune
• Varicella vaccine (chickenpox) — if not previously immune
• Chest X-ray — if deferred due to pregnancy and still clinically indicated
• Any other components the civil surgeon noted as requiring follow-up

How Soon After Delivery Can I Get the Deferred Vaccines?

MMR and varicella vaccines can typically be administered immediately postpartum — even before hospital discharge. Many hospitals offer MMR and varicella vaccination to postpartum patients who are not immune.

If you received Rh immune globulin (RhoGAM) during or after delivery, there may be a waiting period before MMR and varicella vaccines are administered, because immune globulin products can interfere with the immune response to live vaccines. Your civil surgeon will advise you on the appropriate timing based on your specific situation.

Both MMR and varicella are safe to administer to breastfeeding mothers.

What to Bring to Your Postpartum Civil Surgeon Visit

When you return to the civil surgeon after delivery, bring the following:

• Your original Form I-693 (if you have a copy) or the civil surgeon's record of your prior exam
• Documentation of any vaccines received at the hospital after delivery
• Your vaccination records showing any vaccines received since the original exam
• Your government-issued photo ID

How Is Form I-693 Updated?

The civil surgeon will update Form I-693 to reflect the completed vaccinations and any other deferred components. In some cases, the civil surgeon may issue a new Form I-693; in other cases, the existing form may be supplemented with documentation of the completed components.

The updated Form I-693 must be sealed in a new envelope by the civil surgeon before it is submitted to USCIS. Do not open the sealed envelope.

Coordinating With Your Immigration Timeline

If you have a green card interview scheduled, coordinate the completion of your postpartum civil surgeon visit with your immigration attorney. USCIS may request the updated Form I-693 at or before your interview. Having the completed form ready before your interview date avoids delays.