Find out what vaccinations you need to immigrate to the United States
When you apply to immigrate to the United States, a medical examination is typically required as part of the process. The rules and conditions for the medical exam vary from country to country, so make sure that you check the individual requirements for the medical exam with your local U.S. embassy or consulate.
However, one consistent requirement during the medical exam is that you must show proof that you have had certain vaccinations. This guide explains what vaccinations you need, if there are exemptions, and what the process is if you don’t have proof of vaccination.
Important: If you’re applying from within the United States, you will see a civil surgeon designated by U.S. Citizenship and Immigration Services (USCIS). If you’re applying from abroad, you will see a panel physician authorized by the U.S. Department of State. For this article, we use the term “physician” to describe the doctor that administers your medical examination for visa-related purposes. For more in-depth information about the medical examination, check out our guide on how to prepare for the medical exam.
This guide will cover the following questions:
What vaccinations do I need?
The following vaccinations are required when applying to immigrate to the United States:
- Tetanus and Diphtheria Toxoids
- Haemophilus influenzae type B
- Hepatitis B
- Seasonal flu vaccine (only if your appointment is during the yearly flu season of October 1 to March 31)
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Who decides what vaccines are required?
The vaccinations that are required are determined by the Advisory Committee for Immunization Practices (ACIP), which recommends immunizations for the general U.S. population.
The ACIP also recommends new vaccines for the general U.S. population, and the CDC will assess whether these vaccines should be required for immigration purposes on a regular and on an as-needed basis according to specific criteria set by CDC.
How do they decide which vaccines are required for immigration purposes?
Some of the vaccines that are required are specifically listed in the Immigration and Nationality Act. These include mumps, measles, rubella, polio, tetanus and diphtheria toxoids, pertussis, haemophilius influenza type B, and hepatitis B.
In addition to these, the statute also requires that an individual receive any other vaccinations recommended by the ACIP. CDC uses the following criteria in determining which of these recommended vaccines should be required for immigration purposes:
- The vaccine must be age-appropriate as recommended by the ACIP for the general U.S. population, and
- At least one of the following:
- The vaccine must protect against a disease that has the potential to cause an outbreak; or
- The vaccine must protect against a disease eliminated in the United States, or is in the process of being eliminated in the United States.
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How do I know which vaccines are required?
The physician that carries out your medical exam can provide information on which vaccines you require. They must review all your vaccination records and, if the documentation appears valid, record the vaccination history and vaccines given during the medical exam on Form I-693 (Report of Medical Examination and Vaccination Record).
You can find the physician’s information by contacting the U.S. embassy or consulate that you will interview at or by checking their website. You can then contact the physician and ask them about your specific requirements.
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Do I have to receive all the vaccines on the vaccination list?
No. Only the ones that are deemed age-appropriate for you.
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Do I have to receive all the required vaccines, even though I have been vaccinated before?
No. The physician will review your vaccination records during your medical exam to see whether you have proof of earlier vaccinations against vaccine-preventable diseases that are appropriate for your age category.
It is important that you take any written vaccination documents you might have to the physician when you have your immigration medical examination. If you lack any vaccinations required for your age category, the physician will administer the vaccines as needed.
You can also choose to obtain the required vaccines from your private healthcare provider. However, you must return to the physician with the proof that you have received the missing vaccines. If you’d prefer to use a private healthcare provider, make sure that you get the vaccines before the medical exam and bring proof of this to the physician. This will likely cause less delay to your visa application.
Can I get vaccinated before the medical examination?
Often, if you don’t have proof of a vaccination, it can be quicker to get vaccinated before your medical examination. However, make sure that you contact the physician that will carry out your medical examination and check what proof or paperwork they require.
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Certain vaccines can only be completed with multiple visits to the physician. Do I have to go multiple times?
You only need to have the first dose at the physician’s office. The physician will then complete Form I-693. Afterwards, you should follow up with other doses by using your private healthcare providers to complete the vaccine, but you will not be required to show proof to U.S. officials.
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I’m pregnant and don’t want to receive any vaccinations. Is this a problem?
The physician follows Centers for Disease Control and Prevention (CDC) guidelines on which vaccinations can be administered during pregnancy. If they cannot safely administer a required vaccine, they will annotate Form I-693 by marking the vaccine as contraindicated.
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Do I need a seasonal flu vaccine?
Yes, you require a seasonal flu vaccine if your medical appointment occurs during flu season. Flu season starts on October 1 and ends on March 31 each year.
Who pays for the vaccinations?
The applicant is responsible for all costs associated with the medical examination and the vaccines that are required.
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Can I be denied a visa if I refuse to get vaccinated?
It is possible that unless the applicant has moral or religious objections to vaccinations, their refusal to take any of the required vaccines could cause a potential denial of their visa application.
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What happens if I refuse to receive one or all of the required vaccines?
Tell the physician if you don’t wish to receive the required vaccines or a particular vaccine. You should also tell the physician the reason that you do not wish to receive the vaccines.
A waiver could be available to you, but only under the following circumstances:
- You are opposed to vaccinations in any form;
- Your objection must be based on religious beliefs or moral convictions; and
- The religious or moral beliefs must be sincere.
The form used to apply for a waiver depends on the adjustment category under which you are seeking legal permanent residence status.
For example, if you are seeking adjustment of status as a result of an approved Form I-130 or Form I-140, then you would file Form I-601 (Application for Waiver of Grounds of Inadmissibility).
What happens if the vaccine is not currently available?
Ask the physician whether another healthcare provider has the vaccine. If another physician or department or pharmacy carries the vaccine and can administer the vaccine, you should get the vaccine and request documentation that you have received the vaccine.
Bring the written record back to the physician so that they can complete Form I-693.
Will USCIS accept a Form I-693 if the vaccination chart is incomplete?
No. The vaccination chart should have at least one entry in each row for each vaccine. If the vaccination chart is not properly completed at the time of the medical exam, USCIS might return the Form I-693 to you with instructions on how to correct it.
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