Core Exam Components for Seniors

Applicants over 65 complete the same core immigration medical exam as all other adult applicants:

• Complete physical examination
• Medical history review, including chronic conditions and medications
• Tuberculosis testing (TST or IGRA)
• Blood draw for syphilis and gonorrhea testing
• Vaccination review and administration of any missing vaccines
• Mental health and substance use history review

Age-Specific Vaccine Requirements for Seniors

Applicants aged 65 and older have additional vaccine requirements compared to younger adults:

• Pneumococcal vaccines: PCV15 or PCV20 (pneumococcal conjugate) plus PPSV23 (pneumococcal polysaccharide) — required for all applicants 65+
• High-dose or adjuvanted influenza vaccine — recommended for adults 65+ (standard dose is acceptable if high-dose is unavailable)
• Shingles (zoster) vaccine — recommended but not required for immigration
• All standard adult vaccines (Td/Tdap, MMR, varicella, hepatitis A, hepatitis B, meningococcal) — required if not previously received

Chronic Conditions and the Medical Exam

Many seniors have chronic medical conditions such as hypertension, diabetes, heart disease, or arthritis. These conditions are generally not grounds of inadmissibility and do not prevent green card approval.

The civil surgeon will document significant chronic conditions on Form I-693 as Class B findings (conditions that are not grounds of inadmissibility). A Class B finding does not prevent USCIS from approving your application.

Bring a complete list of your current medications and any relevant medical records to your appointment. This helps the civil surgeon make an accurate assessment.

What to Bring to the Appointment

Senior applicants should bring the following to their civil surgeon appointment:

• Government-issued photo ID (passport, driver's license)
• Vaccination records (cartilla, yellow card, or other documentation)
• Complete list of current medications (name, dose, frequency)
• List of chronic medical conditions and treating physicians
• Any relevant medical records (recent lab results, specialist reports)
• Reading glasses if needed for paperwork