Why USCIS Requires Vaccinations
Under the Immigration and Nationality Act (INA), applicants for lawful permanent residence must show they have received all vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) that are age-appropriate and medically appropriate. This requirement exists to protect U.S. public health by ensuring immigrants are protected against vaccine-preventable diseases.
The Civil Surgeon reviews your vaccination history and administers any missing vaccines during your immigration medical exam. The results are documented on Form I-693, which is submitted to USCIS as part of your green card application.
Important: Vaccination documentation is one of the most common reasons immigration medical exams take longer than expected. Bring every vaccination record you have — even partial records help.
The Complete USCIS Vaccine Schedule
USCIS requires all 14 vaccines currently on the ACIP-recommended schedule that are age-appropriate and medically appropriate for the applicant. The table below lists every required vaccine, the standard dose schedule, and applicable age ranges.
| Vaccine | Doses | Ages | Notes |
|---|---|---|---|
| MMR (Measles, Mumps, Rubella) | 2 doses | Ages 12 months+ | Presumptive immunity for those born before 1957 |
| Hepatitis B | 3-dose series | All ages | Serology may substitute |
| Varicella (Chickenpox) | 2 doses | Ages 12 months+ | Prior disease or serology may substitute |
| Tdap (Tetanus, Diphtheria, Pertussis) | 1 dose Tdap + Td booster every 10 years | All ages | |
| Influenza | Annual | Ages 6 months+ | Seasonal requirement (Oct–Mar) |
| COVID-19 | Current series per USCIS guidance | All eligible ages | |
| Pneumococcal | PCV15/PCV20/PPSV23 | Ages 65+; younger with risk factors | |
| Polio (IPV) | Complete series | All ages | |
| HPV | Dose count depends on age at series start | Ages 9–26 (recommended 27–45) | |
| Rotavirus | Brand-specific series | Ages 2–8 months | |
| Hib | Brand-specific series | Ages 2 months–4 years | |
| Meningococcal (MenACWY) | Booster at 16 if first dose before 16 | Ages 11–18 | |
| Hepatitis A | 2-dose series | Ages 12 months+ | 6 months between doses |
| RSV | Per current ACIP recommendations | Age-specific |
MMR (Measles, Mumps, Rubella)
Hepatitis B
Varicella (Chickenpox)
Tdap (Tetanus, Diphtheria, Pertussis)
Influenza
COVID-19
Pneumococcal
Polio (IPV)
HPV
Rotavirus
Hib
Meningococcal (MenACWY)
Hepatitis A
RSV
Age-Specific Requirements
The vaccines required at your immigration medical exam depend on your age. The Civil Surgeon applies the ACIP-recommended schedule for your age group and reviews your vaccination history to identify any gaps.
Infants
2–8 months- Rotavirus
- Hib
- Hepatitis B
- Polio
- DTaP
Children
12 months–10 years- MMR
- Varicella
- Hepatitis A
- Hepatitis B
- Hib
- Polio
- Influenza
- COVID-19
Adolescents
11–18 years- All childhood vaccines
- HPV
- Meningococcal (MenACWY)
- Tdap
- COVID-19
Adults
19+- MMR
- Varicella
- Hepatitis B
- Tdap
- Influenza
- COVID-19
- Pneumococcal (65+)
- HPV (through 26)
- Polio
What to Bring to Your Appointment
The most important thing you can do before your immigration medical exam is gather every vaccination record you have. The Civil Surgeon needs to review your complete immunization history to determine what vaccines you still need.
Original vaccination records
Yellow WHO card, shot records, school immunization records — any official documentation of vaccines received.
Records from your home country
International vaccination records are accepted. Bring them even if they are in another language — translated if needed.
Prior serology (blood test) results
Any blood test results showing immunity to MMR, Varicella, Hepatitis B, or other diseases.
Your passport or photo ID
Required for identity verification before the Civil Surgeon can complete your exam.
Tip: Even partial vaccination records help. Bring whatever you have — our Civil Surgeons will review everything and determine exactly what you need.
What Happens If You Are Missing Vaccines
Our clinic administers all USCIS-required vaccines on-site. If you are missing vaccines, here is what happens:
- The Civil Surgeon reviews your records and identifies gaps in your vaccination history.
- Missing vaccines are administered at your appointment — no need to visit a separate pharmacy or clinic.
- Some multi-dose series may require follow-up appointments (e.g., the Hepatitis B series requires 3 doses spaced over several months).
- The cost of all required vaccines is included in our all-inclusive flat fee.
Plan ahead: Some vaccine series (like Hepatitis B) require multiple doses spaced weeks apart. If you need a multi-dose series, plan for follow-up appointments.
Vaccine Waivers
USCIS allows waivers in specific circumstances. If a waiver applies, the Civil Surgeon documents it on Form I-693 with supporting clinical justification. USCIS reviews all waiver requests.
For a detailed breakdown of each waiver type and how to qualify, see our full guide:
Vaccine Waivers and ContraindicationsVaccines Included in Our Flat Fee
All required vaccines administered at your immigration medical exam are included in our all-inclusive flat fee. No surprise charges. If you have insurance that covers vaccines, we can bill your insurance and pass the savings to you — but you will never pay more than the flat fee.
All-Inclusive Flat Fee
Exam + required lab work + all required vaccines. No surprises.
Physical Exam
Full USCIS-required medical examination by a designated Civil Surgeon.
Required Vaccines
All USCIS-required vaccines administered at your appointment.
Insurance Billing
We bill your insurance for covered vaccines and pass the savings to you.
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. USCIS vaccination requirements, ACIP recommendations, and immigration policies may change without notice. Always consult a USCIS-designated Civil Surgeon and a qualified immigration attorney for guidance specific to your individual case.