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Vaccinations and I-693 Medical Exam
The U.S. Citizenship and Immigration Services (USCIS) requires immigration applicants, including anyone in process of lawful permanent resident status (Green Card) or refugee status to meet specific vaccination requirements. Immunization requirements are based on CDC recommendations and dependent on the applicant age. Vaccination requirements are part of the I-693 medical examination paperwork.
Updates to the necessary vaccines do change from time-to-time, so it’s best to speak with a medical office experienced in Immigration I-693 Medical Exams like Destination Health Clinic. For example, in 2024, USCIS changed the polio vaccine requirements, and is now necessary for everyone to have proof of vaccination. Previously, only children were required to have record of polio vaccination.
What Vaccines are Required by USCIS for the Immigration Exam?
Specific vaccination requirements depend on your age group, more on that below. But first, here is a full list of vaccinations USCIS may require;
- COVID
- Influenza (flu)
- Haemophilus influenzae type b (Hib)
- Hepatitis A
- Hepatitis B
- Measles, Mumps Rubella (MMR)
- Meningococcal (meningitis)
- Pneumococcal (pneumonia)
- Polio
- Rotavirus
- Tetanus, Diphtheria, Pertussis
- Varicella (chickenpox)
Please bring any shot records you have since some vaccines may still be valid. USCIS also provides a helpful guide on immunization requirements.
Vaccination Requirements for Immigration Exam Applicants 18 through 64 Years
USCIS mandates immunization by age; everyone in the 18 through 64 year group is required to show proof of the following vaccines:
- COVID
- Influenza
- Hepatitis B *not required after age 60
- Measles, Mumps, Rubella (MMR)
- Polio
- Tetanus/Diphtheria (Td) or Tetanus/Diphtheria/Pertussis (Tdap)
- Varicella (chickenpox)
Vaccination Requirements for Immigration Applicants 65 Years and Older
For people 65 years and older, immigration immunization requirements are similar to the 18 through 64 year old group, with the addition of the pneumonia vaccine and the removal of the Hepatitis B vaccine and MMR vaccine (for most individuals).
Please note, the MMR vaccine is only needed for people born after 1956, meaning many immigration applicants over 65 are exempt from this vaccine requirement.
- COVID
- Influenza
- Measles, Mumps, Rubella (MMR) *only if born after 1956
- Pneumonia
- Polio
- Tetanus/Diphtheria (Td) or Tetanus/Diphtheria/Pertussis (Tdap)
- Varicella (chickenpox)
Vaccination Requirements for Immigration Exam Applicants 11 through 17 Years
Adolescent requirements vary slightly from adult requirements with the addition of the Hepatitis A and meningitis vaccines.
- COVID
- Influenza
- Hepatitis A
- Hepatitis B
- Measles, Mumps, Rubella (MMR)
- Meningitis
- Polio
- Tetanus/Diphtheria/Pertussis (Tdap)
- Varicella (chickenpox)
Vaccination Requirements for I-693 Exam Applicants from Birth through 10 Years
Vaccination requirements are similar for this group when compared with adolescents/adults, except with the addition of Haemophilus influenzae type b (Hib), Pneumonia, and Rotavirus for certain ages. Another difference includes use of the DTaP vaccine to protect against tetanus, diphtheria, and pertussis instead of Tdap. If your child is up-to-date on their regular vaccines from their pediatrician for pre-school or school, they have likely met all USCIS required vaccines.
I Lost My Vaccine Record, Do I Need to Repeat My Vaccinations for the Immigration Exam?
Instead of repeating vaccinations, a titer test, also known as an immunity test, can be completed for some immunizations. For example, immunity testing for Hepatitis A, Hepatitis B, MMR, and Varicella (chickenpox) is available. A sample of blood is taken from the arm, with results in 24-72 hours. However, titer testing is not available for all immunizations, so without an official vaccine record, some vaccines may need to be repeated. During a visit with Destination Health Clinic, we’ll help you determine the vaccines necessary to meet Immigration Medical Exam requirements and provide these immunizations or testing you need.
Can I Receive Vaccines From a Clinic Other Than the Civil Surgeon?
Yes, per USCIS, vaccines you receive at another clinic are acceptable for your Immigration Exam. Some Civil Surgeon offices do not offer immunizations and only provide the physical exam and paperwork. Only the Civil Surgeon office can add vaccinations records to the I-693 paperwork, so you must take your vaccine record to your appointments.
Are Childhood or School Vaccine Records Acceptable Proof of Vaccination for My Immigration Exam?
This depends on the vaccine type and how long ago you received your vaccinations. Some immunizations protect for lifetime, while other vaccines need additional doses or boosters to be considered valid. A review of your vaccination record is needed to determine which count for USCIS requirements.
My Vaccine Records are in a Language Other Than English, Will They Be Accepted for My I-693 Paperwork?
Your Civil Surgeon office is not required to accept vaccination records in a language other than English. Contact your Civil Surgeon office directly to ask about their policy.
What Are the COVID and Flu Vaccine Requirements for the I-693 Exam?
All Immigration Exam applicants 6 months and older are required to have the COVID and flu vaccines. The flu vaccine is readily available early fall through spring. If your Immigration Exam appointment is during summer months when the influenza vaccine is not available, then it is not required.
Some Vaccines Require Multiple Doses, Do I Need to Complete the Full Series Before I Can Submit the Immigration Medical Exam?
USCIS only requires you to receive a single dose, even if it is normally given in a series. This rule avoids unnecessary delays to your application. Keep in mind, if you have a delay longer than a few weeks from the time of your vaccinations to the submission of your Medical Exam, you may need to take another dose. Regardless, you are highly encouraged to complete the vaccine series on schedule to be fully protected after your Civil Surgeon submits the I-693 paperwork.
Contact Destination Health Clinic for Your Immigration Exam Vaccinations
We keep vaccines in-stock at all three of our Massachusetts locations; Braintree – South Shore, Springfield – Longmeadow, or Natick – Framingham office.