What If I Already Have the Vaccines Required for a Green Card?
The immigration medical examination includes a review of your vaccination history. A designated civil surgeon reviews your records and determines whether you have received the vaccines appropriate for your age and immigration process.
If your vaccination records show that you are up to date, the civil surgeon generally does not need to repeat vaccines that you have already received.
What Vaccines Are Required for a Green Card?
For applicants adjusting their status in the United States, the Centers for Disease Control and Prevention (CDC) establishes vaccination requirements that civil surgeons must follow during the immigration medical examination.
Depending on the applicant's age and applicable recommendations, the required vaccines may include those for:
- Diphtheria.
- Tetanus.
- Pertussis (whooping cough).
- Polio.
- Measles.
- Mumps.
- Rubella.
- Rotavirus.
- Haemophilus influenzae type b (Hib).
- Hepatitis A.
- Hepatitis B.
- Meningococcal disease.
- Varicella (chickenpox).
- Pneumococcal disease.
- Influenza (flu).
Not every applicant is required to receive every vaccine on this list. Requirements depend on factors such as age and current vaccination recommendations.
What If I Already Have All My Vaccines?
If you already received the vaccines required for your age and have reliable written documentation, you generally do not need to receive those vaccines again.
During the medical examination, the civil surgeon reviews your vaccination history and determines whether you are up to date.
For example, if your records show that you completed the appropriate measles, mumps, and rubella vaccination requirements, you generally would not need another dose simply because you are applying for a Green Card.
The important point is that you should be able to document your vaccination history.
Why Are Vaccination Records So Important?
One of the most important parts of the immigration medical examination is providing written vaccination records.
The CDC states that civil surgeons must review the applicant's vaccination documentation. Simply telling the doctor that you received a particular vaccine may not be sufficient if you do not have reliable documentation.
Your records should ideally include:
- Name of the vaccine.
- Date the vaccine was administered.
- Number of doses, when applicable.
- Your identifying information.
- Information identifying the healthcare provider or facility when available.
Keeping these records can help prevent unnecessary vaccinations and make the medical examination process easier.
What If I Received My Vaccines in Another Country?
Vaccines received outside the United States can generally be accepted if the records are reliable and the vaccination schedule is consistent with applicable recommendations.
This is particularly important for immigrants who received most or all of their childhood vaccinations in their home country.
Your records do not necessarily have to come from a U.S. doctor.
However, the civil surgeon must determine whether the documentation is credible and whether the vaccines and dates meet the applicable requirements.
What If My Vaccination Records Are in Spanish?
Vaccination records issued in another language may need to be translated when required for the medical examination or immigration process.
A reliable English translation can help the civil surgeon understand:
- Which vaccines you received.
- When you received them.
- How many doses you received.
- Whether the vaccination schedule was completed.
It is important not to alter or recreate vaccination records. If information is unclear or missing, discuss the issue with the civil surgeon.
What Happens If I Do Not Have My Vaccination Records?
If you cannot locate your vaccination records, you should discuss your situation with the civil surgeon.
Depending on the vaccine and circumstances, the doctor may consider other forms of evidence.
For certain diseases, laboratory evidence of immunity may be acceptable under CDC requirements.
For example, laboratory evidence can be used in certain circumstances to demonstrate immunity to diseases such as:
- Measles.
- Mumps.
- Rubella.
- Hepatitis A.
- Hepatitis B.
- Polio.
- Varicella.
Not every laboratory test automatically satisfies the immigration requirements. The civil surgeon must determine whether the evidence meets the applicable CDC criteria.
Will I Have to Repeat Vaccines If I Already Had Them?
Generally, vaccines that are properly documented and meet the applicable requirements do not need to be repeated simply because you are undergoing an immigration medical examination.
However, there may be situations in which another dose is required.
For example, you may have received the first dose of a vaccine series but still need additional doses because the recommended series has not been completed.
The civil surgeon will evaluate your vaccination history and determine what is still required.
What If I Have Started a Vaccine Series but Have Not Finished It?
Some vaccines require multiple doses separated by specific minimum intervals.
If you have already received the first dose but the required waiting period before the next dose has not passed, you may not need to wait until the entire series is completed before continuing with your immigration process.
In certain circumstances, receiving at least one age-appropriate dose may be sufficient for the medical examination when additional doses cannot yet be administered because of the required interval.
The civil surgeon will document the situation on the appropriate medical examination paperwork.
What About the Flu Vaccine?
Influenza vaccination is included among the vaccines considered for immigration medical examinations.
However, the requirement can depend on factors such as the time of year and vaccine availability.
The CDC provides specific guidance for situations in which the influenza vaccine is not available or when it is outside the applicable vaccination season.
This means that applicants should not assume that they must receive a flu vaccine regardless of the circumstances.
What If I Am Pregnant?
Pregnancy can affect whether certain vaccines are appropriate.
Some vaccines may be contraindicated during pregnancy, depending on the specific vaccine and medical circumstances.
The civil surgeon evaluates medical contraindications and follows CDC technical instructions when determining whether a particular vaccine should be administered.
You should inform the civil surgeon if you are pregnant or believe you may be pregnant.
What If a Vaccine Is Not Appropriate for My Age?
Not every vaccine is required for every applicant.
The immigration vaccination requirements are based in part on age-appropriate recommendations.
Therefore, a vaccine that is recommended for children may not be required for an adult.
The civil surgeon evaluates the applicant's age and vaccination history when determining which requirements apply.
What If I Have a Medical Contraindication?
There are circumstances in which a vaccine may not be medically appropriate.
The CDC recognizes certain medical contraindications and other circumstances that can result in a vaccine requirement being waived under the applicable rules.
Examples can include certain medical conditions or situations in which administering a vaccine would not be appropriate.
The civil surgeon must document the applicable circumstances according to the CDC requirements.
What Is Form I-693?
Form I-693, Report of Immigration Medical Examination and Vaccination Record, is used in certain immigration processes to document the immigration medical examination.
The designated civil surgeon completes the medical examination and vaccination information according to the applicable requirements.
The civil surgeon does not decide whether you will receive a Green Card. USCIS makes the immigration eligibility determination.
Therefore, having the required vaccinations is an important part of the medical examination, but it is only one part of the overall immigration process.
What If I Am Missing One of the Required Vaccines?
If the civil surgeon determines that you are missing a vaccine that is required for your age and circumstances, you may be instructed to receive the appropriate dose.
In some cases, the missing vaccine can be administered during the medical examination.
If a vaccine series requires multiple doses, the civil surgeon will determine what can be documented at the time of the examination and what additional doses may be necessary.
The CDC recognizes that some vaccine series take months or longer to complete.
What Happens If I Refuse a Required Vaccine?
If a required vaccine is medically appropriate and you refuse it, the vaccination requirements may not be considered complete.
There are specific rules concerning religious or moral objections, and these situations may involve a separate waiver process.
A general refusal without an applicable waiver may affect whether the medical examination satisfies the vaccination requirements.
For this reason, it is important to discuss any concerns with the civil surgeon before refusing a required vaccine.
What Should I Bring to the Immigration Medical Examination?
To make the vaccination review easier, consider bringing all available vaccination documentation.
You may want to bring:
- Childhood vaccination records.
- Records from doctors or clinics.
- School vaccination records.
- Military vaccination records, if applicable.
- Vaccination cards.
- Laboratory immunity results, when applicable.
- Reliable translations of records issued in another language.
- Any documentation showing previous vaccination doses.
If you have records from several doctors or countries, organize them chronologically when possible.
What If I Lost My Vaccination Records?
If your original vaccination records are lost, do not assume that you automatically need to repeat every vaccine.
First, try to locate replacement records through:
- Previous doctors.
- Clinics.
- Hospitals.
- Schools.
- Public health departments.
- Government vaccination systems, when available.
If records cannot be recovered, discuss the available options with the civil surgeon.
Depending on the vaccine, laboratory evidence of immunity or additional vaccination may be considered under the applicable CDC requirements.
Does Having All the Required Vaccines Guarantee a Green Card?
No. Having the required vaccinations is an important part of the immigration medical examination, but it does not by itself guarantee approval of a Green Card.
USCIS considers the applicant's overall immigration eligibility and other requirements applicable to the specific immigration process.
The civil surgeon's role is to conduct the medical examination and properly document the vaccination requirements. USCIS makes the final immigration determination.
Tips for Your Immigration Medical Examination
If you already received the vaccines required for your Green Card medical examination, consider taking the following steps:
Gather your records
Look for all available vaccination documentation before your appointment.
Check the dates
Make sure the records clearly indicate when each vaccine was administered.
Keep foreign records
Do not discard vaccination records simply because they were issued outside the United States.
Ask about missing information
If a record is incomplete or difficult to understand, ask the civil surgeon what additional documentation may be needed.
Do not assume you need every vaccine
Vaccination requirements depend on age and other circumstances.
Do not repeat vaccines unnecessarily
If you already have reliable documentation showing that you received a required vaccine, provide the documentation to the civil surgeon before receiving another dose.
Follow the civil surgeon's instructions
The civil surgeon will evaluate your vaccination history according to the applicable CDC requirements.