Form I-693 · Vaccination Requirements
I-693 vaccine requirements
Vaccine & Immunization Requirements
Form I-693 requires the vaccines the CDC sets for your age on exam day. Polio (IPV) is required at every age from 2 months, including adults. MMR and varicella start at 12 months. You also need DTaP, Tdap or Td, plus hepatitis B through age 59. Hepatitis A, meningococcal, Hib, rotavirus, pneumococcal and flu apply only to certain ages or seasons. COVID-19 is not required.
USCIS requires proof of age-appropriate vaccination before Form I-693 can be certified. Here is exactly what’s required. You will see how your current records are checked. You will also see where to get any missing vaccines at low cost.
Will USCIS accept vaccines I received in my home country?
The single biggest worry we hear: “Will I have to repeat vaccines I already received in my home country?” The answer is no, as long as your records can be validated.
Bring your official immunization records with a certified English translation. During your exam, we check every documented dose. We hold it up against the CDC’s age-specific requirements for immigrants. Doses that meet the rule are accepted. They are recorded on Form I-693. You only get vaccines you are truly missing. For some vaccines, a blood titer test (a blood test for immunity) can prove you are already immune. Then you do not need the shot again.
What vaccines are required for a green card, by age?
This follows the CDC Technical Instructions for Civil Surgeons (Vaccination), effective March 11, 2025. What you need depends on your age on the day of the exam.
| Vaccine | Who needs it | Notes |
|---|---|---|
| DTaP / DTP / DT (pediatric formulation) | 2 months through 6 years | Children under 7 only. From age 7 the Tdap/Td requirement applies instead |
| Tdap / Td (tetanus, diphtheria, pertussis) | 7 years and older | Sometimes needed at ages 7–10, depending on history. Required from 11 upward. Adults without a documented primary series need one |
| Polio (IPV) | 2 months and older, including adults | One dose unless a complete series is documented. OPV given after April 1, 2016 does not count. A titer must cover all three poliovirus types |
| MMR (measles, mumps, rubella) | 12 months and older, if born in 1957 or later | Titer accepted as proof of immunity |
| Varicella (chickenpox) | 12 months and older | Documented history of disease or titer can qualify |
| Hepatitis B | Birth through 59 years | Expanded from age 18 to age 59 in April 2022. Adult applicants often miss it. Titer accepted |
| Hepatitis A | 12 months through 18 years | 2-dose series |
| Meningococcal (MenACWY) | 11 through 18 years | Adolescents only |
| Hib (Haemophilus influenzae type b) | 2 through 59 months | Children only |
| Rotavirus | 6 weeks through 8 months | Infants only. It cannot be started at 15 weeks of age or older |
| Pneumococcal | 2 through 59 months, and 65 years and older | PCV for children. For adults 65+, the type depends on prior doses |
| Influenza (flu) | 6 months and older | Only if your exam falls in flu season, September 1 – March 31 |
| COVID-19 | Not required | USCIS waived the COVID-19 vaccination requirement for adjustment of status effective January 22, 2025. CDC removed it from the Technical Instructions on March 11, 2025. It has not been reinstated |
Blanket waivers — not age-appropriate, contraindication, insufficient time interval between doses, or influenza vaccine out of season — are documented by the civil surgeon directly on Form I-693 when they apply. Pregnancy is a precaution for IPV and is recorded as a contraindication.
Source: CDC, Technical Instructions for Civil Surgeons — Vaccination, Table 1 (effective March 11, 2025). Reviewed against the current instructions on August 8, 2026.
Where can I get missing vaccines near St. Louis?
Finish missing vaccines before your exam to save time and money. Low-cost options near St. Louis:
St. Louis County Department of Public Health
6121 N Hanley Rd, Berkeley, MO 63134
St. Charles County Department of Health
St. Charles, MO
Madison County Department of Health
Madison County, IL
Frequently asked questions
What happens if I don’t have vaccination records for my green card exam?
You will not be turned away. The civil surgeon notes which vaccines you still need. You can get them at our office or at a county health department, often the same week. For some vaccines, a blood titer test can prove you are already immune. Then you do not need the shot again. Bring the record of every new dose to your I-693 appointment. Then it can be entered on your form the same day.
Is the COVID-19 vaccine required for a green card?
No. USCIS waived the COVID-19 vaccination requirement for adjustment of status effective January 22, 2025. The CDC removed it from the Technical Instructions for Civil Surgeons on March 11, 2025. It has not been reinstated. You do not need a COVID-19 shot or COVID-19 records to complete your Form I-693.
Do adults need the polio vaccine for Form I-693?
Yes. Since May 1, 2024, every applicant from 2 months of age upward must receive one dose of IPV. That includes adults 65 and older. The exception is when a complete polio series is documented. A remembered childhood shot is not enough. Oral polio vaccine (OPV) given anywhere after April 1, 2016 does not count. A titer can qualify only if it covers all three poliovirus types.
Have your records ready? Let’s finish your I-693.
Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP — USCIS-designated civil surgeon (CSID 111051), board certified in Anesthesiology, Pain Medicine, Interventional Pain Management, Addiction Medicine, and Obesity Medicine. Last reviewed September 2026.