The required vaccines are those recommended by the Advisory Committee for Immunization Practices (ACIP) and determined by the CDC to be in the public health interest for immigrants. The core list includes:

• Mumps, Measles, and Rubella (MMR)
• Polio
• Tetanus and Diphtheria toxoids (Td/Tdap)
• Pertussis
• Haemophilus influenzae type B (Hib)
• Hepatitis A and Hepatitis B
• Varicella (Chickenpox)
• Rotavirus
• Influenza (during flu season)
• Pneumococcal and meningococcal disease (age-appropriate)

Note: As of January 2025, COVID-19 vaccination is no longer required for the U.S. immigration medical exam.

Yes, you should bring your official immunization records to your medical appointment. This helps the civil surgeon (or panel physician) determine which vaccines you have already received and which ones you may still need to meet the requirements.

If you do not have vaccination records, you are not necessarily required to get all vaccines again. The civil surgeon can often perform a blood test (titre) to check for immunity to certain diseases like measles, mumps, rubella, and hepatitis B. . If the titer shows you are immune, you won't need that vaccine. If the titer shows you are not immune, or if a titer isn't available for that disease, you will need to receive the vaccination during the exam.

Yes, absolutely. If you are missing any required vaccines, the civil surgeon's office can usually administer them on-site during your visit. This allows you to complete the requirement in one appointment.

Yes, showing proof of required vaccinations is mandatory for obtaining a green card (permanent residence). Failure to provide documentation or receive the necessary vaccines can make you inadmissible to the United States. The only exceptions are for adopted children under 10 (with a signed affidavit from the parent) or if a medical waiver applies.

The requirements are established by U.S. law. The Centers for Disease Control and Prevention (CDC) , in consultation with the Advisory Committee for Immunization Practices (ACIP) , determines the list of vaccine-preventable diseases that are relevant for immigration. U.S. Citizenship and Immigration Services (USCIS) then enforces these requirements through the Form I-693 medical exam.

Yes, children must also meet the vaccination requirements based on their age. The vaccines required are age-appropriate and follow the standard CDC immunization schedule. The only special provision is for adopted children 10 years or younger, where a parent's affidavit can temporarily waive the requirement upon admission, with the understanding the child will be vaccinated within 30 days.

Vaccinations are recorded on the official immigration forms. For applicants inside the U.S., they are recorded on Form I-693 (Report of Immigration Medical Examination and Vaccination Record) . For applicants outside the U.S. going through consular processing, they are recorded on Form DS-3025 (Vaccination Document Worksheet). The civil surgeon or panel physician will complete and sign these forms.on-site during your visit. This allows you to complete the requirement in one appointment.

Technically, you can refuse, but doing so would likely result in your application being denied. The civil surgeon cannot complete the medical form as required if you refuse to receive a mandatory vaccine for which you have no medical contraindication. This would make you inadmissible on health grounds. A refusal based on religious or moral beliefs is generally not accepted as a valid reason for a waiver under current immigration law.

To prepare for the vaccination portion of your medical exam, you should:

• Gather Records: Find and bring any official vaccination records you have.
• Review Requirements: Familiarize yourself with the vaccine list (see question 1) so you know what to expect.
• Schedule an Appointment: Find a USCIS-authorized civil surgeon (if in the U.S.) or a panel physician (if abroad) to conduct the exam.
• Be Ready to Vaccinate: Be prepared to receive any missing vaccines during your appointment to avoid delays.
• Bring ID:Bring a government-issued photo ID and your appointment letter.