Vaccines Required for the Green Card Medical Exam

Do You Need Vaccines for the Green Card Medical Exam?

If you file Form I-485 inside the U.S., you need a medical exam by a USCIS-designated civil surgeon. The results go on Form I-693, Report of Immigration Medical Examination and Vaccination Record. Vaccines are one part of that form.

The vaccine part is not a fixed list. It depends on your age, your health history and what your records show. Some people need a few shots. Others need none, because their records or blood tests show they are already protected.

If you are applying from outside the U.S., you will see a panel physician chosen by the U.S. Department of State, not a civil surgeon. The vaccine review still happens, but the process is different.

COVID-19 Is No Longer Required

COVID-19 vaccination is no longer required for Form I-693. USCIS dropped that requirement on January 22, 2025.

That means you do not need to show a COVID-19 card to complete the exam. If you have one, bring it with your other records. The civil surgeon may still note your history, but a missing COVID-19 shot will not hold up the form.

Other vaccines are still part of the exam. The exact ones depend on your age and history, so ask the civil surgeon's office what they expect in your case before your visit.

Which Vaccines May Be Required, by Age Group

The civil surgeon checks the schedule for your age, then compares it with your records and test results. Here is a rough picture of what may come up. This is not a complete list, and it is not something you can apply yourself.

• Children: MMR, polio, varicella, hepatitis A and B, Hib, rotavirus, pneumococcal and others may be checked. Many of these are routine in childhood.
• Teens and young adults: MMR, varicella, hepatitis B and Tdap or Td often come up.
• Adults: Tdap or Td boosters, MMR, hepatitis B, varicella and others may be needed if records are missing.
• Older adults: pneumococcal may be on the list, along with other age-based vaccines.
• Flu season: influenza may be required if your exam falls during flu season.
• Any age: the civil surgeon may add vaccines based on your health history or lab results.

How Your Vaccine Records Are Checked

The first step is a review of your medical and vaccine history. Bring every record you can find. Old childhood cards, school records, military records, pharmacy printouts and records from another country all help.

The civil surgeon or staff will read the dates and match them to the schedule for your age. A record that shows a full series counts. A record that shows one shot of a two-shot series may not.

If you have no records, that is common. Many applicants lost their childhood papers or never had them. In that case, the civil surgeon may use blood tests, or you may get the vaccine again. Getting a vaccine you already had is generally not a problem, but ask the civil surgeon about your own situation.

Bring a written list of your current medicines too. Some health conditions change what is recommended.

How Blood Tests Can Show You Are Already Immune

Some vaccines are not needed if a blood test shows you are already immune. This is called evidence of immunity. The civil surgeon may order a test for diseases like measles, mumps, rubella, varicella or hepatitis B.

If the test shows protection, that can be written on Form I-693 instead of a vaccine. If it shows no protection, you may need the vaccine.

Not every vaccine has an easy immunity test, and not every civil surgeon orders the same tests. Ask the office before your visit whether they use blood tests for immunity in your case.

The exam also includes other lab work. For applicants age 2 and older there is a tuberculosis blood test (IGRA). For applicants age 18 to 44 there is a blood test for syphilis. For applicants age 18 to 24 there is a urine test for gonorrhea. A chest X-ray is done only if needed. There is also a mental health and substance use screening.

What to Bring and How Long It Takes

Blood test results usually take a few days to two weeks. The civil surgeon needs those results before the form can be completed. Plan for that wait when you set your timeline.

USCIS generally requires Form I-693 to be filed together with Form I-485. A filing without it can be rejected. The civil surgeon must sign the form no more than 60 days before you file, so do not start too early.

When the exam is done, you get the completed I-693 in a sealed envelope. Do not open it. Send it with your I-485.

• A government photo ID, such as your passport
• All vaccination records you have
• A list of current medicines
• Past chest X-ray results, if you have them
• Payment for the exam

Confirm the Rules and Compare Civil Surgeons

Vaccine schedules and USCIS rules can change. Before you book, check the USCIS "Find a Civil Surgeon" tool on uscis.gov to confirm the doctor is designated. You can also confirm current form rules there.

USCIS does not set the price. Each civil surgeon sets their own fee. Total cost commonly runs from about $200 to $500 or more, depending on your city, lab tests and how many vaccines you need. Health insurance often does not cover it.

You can compare civil surgeons by city on our site at uscivilsurgeons.com. Ask about vaccine costs and immunity testing when you call, so there are no surprises.

An immigration lawyer is not required for a green card. Some people hire one for complex cases, such as past visa problems, criminal records, prior denials or removal proceedings.