How Age Determines Vaccine Requirements

USCIS vaccination requirements for immigration follow the ACIP immunization schedule, which is organized by age group. The ACIP schedule reflects the optimal timing for each vaccine to provide maximum protection. For immigration purposes, the civil surgeon applies the age-appropriate schedule to each applicant, meaning that the vaccines required for a 2-year-old are very different from those required for a 65-year-old.

Requirements for Infants and Young Children (0–6 Years)

Infants and young children have the most extensive vaccination requirements, as this is the period when most of the childhood immunization series is administered. Required vaccines for this age group typically include:

• Hepatitis B — three-dose series beginning at birth
• DTaP (diphtheria, tetanus, pertussis) — five doses
• Hib (Haemophilus influenzae type b) — three or four doses
• IPV (inactivated polio vaccine) — four doses
• PCV (pneumococcal conjugate vaccine) — four doses
• MMR — first dose at 12-15 months
• Varicella — first dose at 12-15 months
• Hepatitis A — two doses beginning at 12 months
• Influenza — annually starting at 6 months

Requirements for School-Age Children and Adolescents (7–17 Years)

School-age children and adolescents have a different set of requirements, including completion of any childhood series not yet finished and new vaccines recommended for this age group:

• MMR — second dose (if not already received)
• Varicella — second dose (if not already received)
• Tdap — one dose at age 11-12
• Meningococcal (MenACWY) — first dose at age 11-12, booster at 16
• HPV — two or three doses beginning at age 9-12
• Influenza — annually

Requirements for Adults (18–64 Years)

Adult vaccine requirements focus on completing any series not finished in childhood and receiving vaccines recommended for adults:

• MMR — two doses if not previously vaccinated or immune
• Varicella — two doses if not previously vaccinated or immune
• Hepatitis B — three-dose series if not previously vaccinated
• Hepatitis A — two doses if not previously vaccinated
• Tdap — one dose if never received, then Td booster every 10 years
• HPV — through age 26 (shared clinical decision ages 27-45)
• Influenza — annually
• COVID-19 — per current ACIP recommendations

Requirements for Seniors (65 Years and Older)

Seniors have additional vaccine requirements beyond those for younger adults, reflecting the increased risk of certain diseases in older individuals:

• All adult vaccines listed above (as applicable)
• Pneumococcal vaccine — PCV20 or PCV15 followed by PPSV23
• High-dose or adjuvanted influenza vaccine (preferred over standard dose)
• Shingles (zoster) vaccine — two doses of Shingrix