Why the Number Varies

There is no single answer to how many vaccines you will need for your immigration medical exam. The number depends on your age, your vaccination history, the completeness of your records, and whether you have documented immunity through prior disease or titer testing. Two applicants of the same age can have very different vaccine needs depending on their vaccination history.

Applicants With Complete Records

If you have complete, documented vaccination records showing all age-appropriate vaccines, you may need very few or no additional vaccines. In this case, your immigration medical exam will focus on reviewing your records and confirming that all required vaccines are documented. You may still need the current season's influenza vaccine if your exam is during flu season and you have not yet received it.

Applicants With Incomplete Records

If your vaccination records are incomplete, the civil surgeon will identify which vaccines are missing and advise you on your options. The number of missing vaccines can range from one or two to a dozen or more, depending on your vaccination history.

For applicants who have never been vaccinated or have very limited records, the number of required vaccines can be substantial. Some vaccines require multiple doses over weeks or months, which may require follow-up appointments.

Typical Vaccine Needs by Situation

Here are some general scenarios to help you estimate your vaccine needs:

• Fully vaccinated adult with complete records: Likely only influenza (if in season) and possibly COVID-19 booster
• Adult with partial records: May need MMR, varicella, hepatitis B, and/or hepatitis A depending on gaps
• Adult with no records: May need 8-12 or more vaccines across multiple visits
• Child with U.S. vaccination history: Likely up to date; may need influenza and COVID-19
• Child with foreign vaccination history: Depends on country of origin and vaccine equivalence
• Senior (65+): All adult vaccines plus pneumococcal and shingles

Planning Ahead to Minimize Vaccines Needed

The best way to minimize the number of vaccines you need at your immigration medical exam is to gather all available vaccination records before your appointment. Contact your previous healthcare providers, check state immunization registries, and request records from your country of origin if applicable. If you believe you may be immune to certain diseases, discuss titer testing with our office before your appointment.