Why Hepatitis B Vaccination Is Required
Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). Chronic hepatitis B can lead to liver cirrhosis, liver failure, and liver cancer — making it one of the most consequential vaccine-preventable diseases worldwide.
USCIS requires Hepatitis B vaccination for all immigration medical exam applicants because it is an ACIP-recommended vaccine for all age groups. The vaccine is safe, highly effective, and provides long-lasting protection against HBV infection and its serious complications.
Important: Hepatitis B vaccination is required for ALL immigration applicants — regardless of age or prior health history.
The Standard 3-Dose Series
The standard Hepatitis B vaccine series (Engerix-B or Recombivax HB) consists of 3 doses administered over approximately 6 months. The minimum intervals between doses must be observed for the series to be considered valid.
Standard 3-Dose Schedule (Engerix-B / Recombivax HB)
Dose 1
Day 0
Initial dose
Dose 2
Month 1
≥4 weeks after Dose 1
Dose 3
Month 6
≥8 weeks after Dose 2 ≥16 weeks after Dose 1
Minimum Required Intervals
Plan Ahead — The Series Takes 6 Months
A complete 3-dose Hepatitis B series takes approximately 6 months. If you have not started the series, plan for multiple appointments.
The 2-Dose Heplisav-B Option
Heplisav-B is a newer Hepatitis B vaccine approved for adults 18 years and older. It requires only 2 doses and is accepted by USCIS for eligible adults, offering a significantly shorter series than the standard 3-dose regimen.
Standard Series
- 3 doses total
- Series spans ~6 months
- All ages eligible
- Engerix-B or Recombivax HB
Heplisav-B
Faster- 2 doses total
- Series spans ~1 month
- Adults 18+ only
- USCIS-accepted for eligible adults
Dose 1 is given on Day 0. Dose 2 is given 1 month later. Heplisav-B is not approved for individuals under 18 — children and adolescents must receive the standard 3-dose series.
Proving Prior Vaccination or Immunity
If you have already completed a Hepatitis B vaccine series, you do not need to repeat it — provided you can document the prior vaccination. Acceptable documentation includes:
Official vaccination records showing all doses with dates
The most reliable form of documentation. Records must show the vaccine name, dates of each dose, and the administering provider.
School immunization records
Schools maintain detailed immunization records. Contact your school district or university health center to obtain a copy.
Records from a prior healthcare provider
Records from a U.S. or international physician, clinic, or health department. International records are accepted even if in another language.
Tip: Bring all vaccination records to your appointment. Even partial records help — we can determine exactly what you still need.
Serologic Testing for Hepatitis B Immunity
Serologic testing (Hepatitis B surface antibody, or anti-HBs) can confirm immunity to Hepatitis B through a simple blood test. A positive result may substitute for vaccination documentation.
Serology Ordered
Anti-HBs blood test drawn at your appointment
Positive (≥10 mIU/mL)
Immune — no additional vaccine doses required
Negative
Not immune — vaccine series required
Active or Chronic Hepatitis B Is Different
Serology showing prior infection (Hepatitis B surface antigen positive) is different from immunity. Applicants with active or chronic Hepatitis B infection require evaluation by the Civil Surgeon and additional documentation on Form I-693.
Incomplete Series — What to Do
If you have received some but not all doses of the Hepatitis B series, you do not need to start over. The Civil Surgeon will review your records and determine exactly which doses remain.
Bring records of all doses received to your appointment
The Civil Surgeon will determine which doses are still needed
Remaining doses can be administered at our clinic
The cost of all required doses is included in our flat fee
Do not restart the series. If you have received 1 or 2 doses of Hepatitis B vaccine, you do not need to restart the series. Bring your records and we will complete the series from where you left off.
Frequently Asked Questions
Related Articles
Medical & Legal Disclaimer: The information on this page is provided for general educational purposes only and does not constitute medical or legal advice. Hepatitis B vaccine requirements, USCIS policies, and ACIP recommendations may change without notice. Always consult a USCIS-designated Civil Surgeon and a qualified immigration attorney for guidance specific to your individual case.