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If you’re getting ready for your green card medical exam, the green card vaccine requirements are probably what feels most confusing right now. USCIS actually asks for more shots than most people expect, though not every one on the list applies to you.
That list pulls from a federal mix: some vaccines come from a statute Congress wrote decades ago, and others reflect current CDC guidance that shifts over time. A shot that mattered a few years ago might not apply to your exam today.
Many applicants coordinate with green card lawyers before their appointment, since a civil surgeon can flag missing records that would otherwise delay your Form I-693.
Which vaccines does the law specifically require
USCIS follows a list of green card vaccine requirements that combines decades-old law with modern health policy. These requirements are divided between those set by Congress in the Immigration and Nationality Act (INA) and those added by the CDC.
The INA requirements are considered statutory, meaning they are a permanent part of the law and rarely change regardless of the current medical climate.
Statutory requirements from the INA
The INA lists specific vaccines that have been the foundation of immigration medical screenings for decades. These include Measles, Mumps, and Rubella (MMR), Polio, and Tetanus and Diphtheria toxoids.
You must also show protection against Pertussis, usually a Tdap or Td booster if it has been more than 10 years since your last one. Haemophilus influenzae type B (Hib) only applies within a narrow age window, mainly infants and toddlers, so most adult applicants see it marked as not required.
Hepatitis B belongs on the statutory side of the green card vaccine requirements too, not just CDC guidance. The INA itself requires it, as USCIS confirms in its Policy Manual, and we cover what that means for older applicants next.
Hepatitis B updates
We often see confusion about the Hepatitis B vaccine for adult applicants. Since April 2022, it has been required for everyone from birth through age 59, not just children. Applicants over 60 are no longer required to show it.
How age and season affect what vaccines are required for green card status
You are not required to receive every vaccine on USCIS manuals. What you actually need depends on your age on exam day and, for one vaccine, the time of year. This exam is also separate from your biometric screening, which USCIS schedules on its own to confirm your identity.
If columns extend beyond the view, swipe the table horizontally or focus it and use the arrow keys.
| Vaccine | Age Group Requirement | Seasonal Timing |
|---|---|---|
| Rotavirus | Infants (6 to 32 weeks) | Not seasonal |
| Flu shot | 6 months and older | September 1 to March 31 |
| Pneumococcal | 65 years and older | Not seasonal |
| Hepatitis B | Birth through age 59 | Not seasonal |
| Polio (IPV) | Adults without proof of childhood series | Not seasonal |
COVID-19 is no longer on this list. USCIS removed the vaccination requirement in 2025, so civil surgeons no longer ask about it during the exam.
The flu shot is the most common cause of timing delays we see. If your exam falls between September 1 and March 31, you need the current season’s dose, and missing that window can pause your application until the civil surgeon confirms it.
Your I-693 validity does not run on a fixed two-year clock. Under current USCIS policy, a Form I-693 signed on or after November 1, 2023 stays valid only while the application you filed it with remains pending.
If that application is withdrawn or denied, the I-693 stops being valid too. Most applicants still plan the vaccine visit close to when they file the rest of their green card paperwork.
What vaccines are required for green card when you have no records
Missing paperwork is a common hurdle, but it does not automatically mean you must be re-vaccinated. Many applicants lose time because they assume childhood records from their home country are automatically accepted without English translations or proper validation. USCIS requires objective evidence of either a vaccine record or biological immunity confirmed by a doctor.
If you cannot locate your original records, the civil surgeon can order a blood test known as a titer test. This lab report proves you have the necessary antibodies for diseases like Measles or Varicella. This is a common alternative for those who cannot access records from closed clinics or foreign health departments.
We find this is often the most efficient path for adults who know they were vaccinated but lack the papers. For Varicella, a general memory of having had chickenpox is not enough alone; the civil surgeon needs a documented link to a confirmed case or a lab test showing immunity.
Gathering these documents ahead of time also keeps your I-485 green card application on schedule:
- Certified English translations of any foreign vaccination records.
- Childhood immunization cards or “yellow cards” from your home country.
- Lab reports for any titer tests you have already completed.
When can you apply for a vaccine waiver
For some, the vaccination requirement conflicts with deeply held beliefs or specific medical conditions. USCIS recognizes two separate paths for green card vaccine requirements, a religious or moral exemption and a medical exemption, and they work differently. Neither one is granted for general preferences; both require specific, legally recognized reasons involving sincere convictions.
Religious or moral objections
This is the path that runs through Form I-601. You can apply if you hold a sincere religious or moral objection to vaccinations overall, not just to one shot. Working through this with an attorney early helps show that your beliefs are sincere and consistently held.
Medical contraindications
If a specific vaccine is medically dangerous for you, such as a severe allergy to a vaccine component, the civil surgeon marks it as contraindicated on your Form I-693. This exemption is automatic. Under USCIS policy, it does not require Form I-601 or a separate fee, unlike the religious or moral waiver above.
Clearing this up before your green card interview keeps one less variable in play.
Sorting out your vaccine records ahead of time also means fewer surprises later. If you are unsure how a medical condition, a religious objection, or a missing childhood record affects your case, contact our team and we will look at it with you.
Frequently asked questions about green card vaccines
Can I get my vaccines from my own doctor before the exam?
You can often receive required vaccinations from your primary care physician or a local pharmacy to save on costs. However, you must bring official documentation of these doses to your appointment with the civil surgeon. Records should clearly show the date, dose, and manufacturer so the doctor can accurately transfer them to your Form I-693.
What happens if I am pregnant and cannot take certain shots?
If you are pregnant, the civil surgeon may determine that certain vaccines, such as the MMR or Varicella shots, are medically contraindicated. These are typically live-virus vaccines that are not recommended during pregnancy. The doctor will note this specific medical reason on your form, which generally allows you to proceed without receiving those specific doses during your physical exam.
Do I need to redo my vaccines if my medical exam expires?
Most vaccination records do not expire once they are properly documented on a signed Form I-693. The exam itself does not run on a fixed two-year clock either. It stays valid only while the application you filed it with remains pending, so a new physical is only needed if that case is withdrawn or denied. You generally will not need to repeat lifetime shots either way.
What if I have only started a multi-dose vaccine series like Hepatitis B?
USCIS generally requires you to have completed the full series or at least the first dose available at the time of the exam, depending on the specific vaccine. For Hepatitis B, the civil surgeon often monitors whether you are on schedule. Starting the series is often sufficient for the doctor to sign off on your form.
Will USCIS accept a handwritten vaccination note from another country?
USCIS typically requires official immunization records rather than informal notes. If your records are from another country, they must be accompanied by a certified English translation. These documents should include the clinic’s official seal or letterhead, as the civil surgeon must be able to verify the authenticity of your medical history before signing your paperwork.
Is the flu shot required if my medical exam is in the summer?
The flu shot requirement is strictly seasonal, applying only to medical exams conducted between September 1 and March 31. If your appointment with the civil surgeon occurs during the summer months, you are generally not required to receive the influenza vaccine. However, the current date should be confirmed closely, as delays in scheduling could push your appointment into the mandatory window.
