USCIS Vaccination Requirements for Immigration Medical Exams

USCIS requires two doses of MMR (measles, mumps, rubella) for most applicants aged 12 months and older. Applicants born before 1957 may qualify for presumptive immunity to measles and mumps. Serologic testing can confirm immunity when records are unavailable.

A complete Hepatitis B series is required for all immigration applicants. The standard series is 3 doses over 6 months; adults 18+ may use the faster 2-dose Heplisav-B series. Serologic evidence of immunity may substitute for vaccination.

Two doses of varicella (chickenpox) vaccine are required unless the applicant has documented evidence of prior disease or laboratory evidence of immunity. Applicants born before 1980 may have presumptive immunity in some circumstances.

One lifetime dose of Tdap (tetanus, diphtheria, pertussis) is required for all applicants who have never received it — regardless of when their last Td booster was given. Td boosters are then required every 10 years.

Annual influenza vaccination is required during flu season (October through March) for applicants aged 6 months and older. Exams scheduled between April and September are typically exempt. The current season's vaccine must be used.

USCIS requires COVID-19 vaccination for all eligible immigration applicants. Accepted vaccines include Pfizer, Moderna, Novavax, and J&J. International vaccines on the WHO Emergency Use Listing may also be accepted. Requirements are updated periodically.

Pneumococcal vaccination is required for applicants aged 65 and older, and for younger applicants with certain medical conditions such as asplenia, immunocompromising conditions, or chronic illness. The specific vaccine type depends on age and health status.

A complete inactivated polio vaccine (IPV) series is required for all applicants. Adults who have never been vaccinated need a primary 3-dose series. Those with an incomplete series must complete it. One-time IPV booster for adults with prior complete series.

HPV (human papillomavirus) vaccination is required for applicants aged 9 through 26. Applicants who start the series before age 15 need 2 doses; those who start at 15 or older need 3 doses. The vaccine is recommended (not required) for ages 27–45.

Rotavirus vaccination is required for infants aged 2 through 8 months at the time of the exam. The series is brand-specific: Rotarix requires 2 doses; RotaTeq requires 3 doses. The series cannot be started after 15 weeks of age.

Haemophilus influenzae type b (Hib) vaccination is required for children aged 2 months through 4 years. The number of doses (3 or 4) depends on the vaccine brand and the child's age at first dose. Children aged 5 and older generally do not require Hib.

MenACWY vaccination is required for applicants aged 11 through 18, with a booster at age 16 if the first dose was given before 16. MenB vaccination is recommended for ages 16–23. Older applicants with certain risk factors (asplenia, complement deficiency) also require meningococcal vaccines.

A 2-dose Hepatitis A series is required for applicants aged 12 months and older. The second dose must be given at least 6 months after the first. Serologic evidence of immunity (anti-HAV IgG) may substitute for vaccination documentation.

RSV (respiratory syncytial virus) vaccination requirements follow current ACIP recommendations and are subject to USCIS policy updates. Requirements vary by age group — including infants (nirsevimab) and adults 60+. Confirm current requirements at your appointment.