Vaccination gaps are the most common cause of delay in the immigration medical exam. They are also the most preventable. The fix happens before you ever book.
Why aren’t my routine adult vaccines enough for immigration?
Most people assume they’re “up to date” because of a physical last year or their childhood shots. But the CDC immunization requirements for immigration are their own standard. They are specific and absolute. They get updated from time to time. Requirements people commonly miss include these. Tdap (not just an old tetanus shot). Varicella. Polio, which since May 1, 2024 applies to adults who cannot document a complete childhood series. And hepatitis B, required through age 59 since April 2022.
Do I have to repeat vaccines if I have records?
Here’s the part that saves money and needles. A documented dose counts; a remembered dose doesn’t. Records in any language are acceptable. Before booking, gather every vaccine record you can find. That means childhood cards, school records, employer health files, pharmacy printouts, and records from your home country. What you can document, you don’t repeat.
How do I check my vaccine records before I book?
Line your records up against the current CDC Technical Instructions for civil surgeons (the vaccine section is public). Note the real gaps. Then book. Either fill the gaps first with your own provider, or plan to finish them at the exam. People who do this check routinely turn a multi-visit process into a single appointment.
Related reading: I-693 Foreign Vaccination Records · Organize Medical Records for Your I-693
Frequently Asked Questions
Which vaccines do immigration applicants most often miss?
Tdap and varicella are the ones most commonly missed. Two adult rules trip people up. The first is polio. Since May 1, 2024 it applies at any age. The exception is when a complete series is documented. The other is hepatitis B, required through age 59. See the age-by-age vaccine requirements.
Are vaccine records from another country acceptable?
Yes. Written records in any language are accepted as evidence of vaccination. Documented doses do not need to be repeated.
Can I get missing vaccines at the exam?
Missing vaccines can typically be given or set up during the process. But coming with complete records is always faster and cheaper.
Do I need the hepatitis B vaccine for a green card?
Yes, if you are in the age range. Hepatitis B has been required through age 59 since April 2022. It is one that people most often miss. If you already had the series, bring the written record. A documented dose counts and does not need to be repeated. A dose you only remember does not count.
Do adults need the polio vaccine for the immigration exam?
Since May 1, 2024, the polio requirement applies to adults who cannot document a complete childhood series. Do you have a record showing the full series? It could be your childhood vaccine card, a school record, or a record from your home country. Bring it. Records in any language are acceptable. What you can document, you do not repeat.
What counts as proof of vaccination for the I-693?
Written records count. Gather childhood vaccine cards, school records, employer health files, pharmacy printouts and records from your home country. Records in any language are acceptable. A documented dose counts toward the requirement. A remembered dose does not. Bring every record you can find to the exam. That way, doses on paper are not given again.
Can missing vaccines delay my green card medical exam?
Yes. Vaccination gaps are the most common cause of delay in the immigration medical exam. They are also the most preventable. Before you book, line your records up against the CDC Technical Instructions. Note the real gaps. Then fill them with your own provider, or plan to finish them at the exam. That check routinely turns a multi-visit process into one appointment.
Watch the full video above, and explore the rest of the series on our YouTube channel.
Schedule Your Exam in St. Louis
Schedule Your Exam Text (314) 886-5902 Call (314) 960-9100
Dr. Gurpreet Padda, MD — USCIS-Designated Civil Surgeon (CSID 111051)
4477 Woodson Rd, Suite 102, St. Louis, MO 63134 — minutes from St. Louis Lambert International Airport
🌐 ImmigrationExam.us
🕗 Mon–Wed 8:00am–5:00pm · Thu 8:00am–12:00pm · Closed Friday & federal holidays
💵 I-693 exam $390 · Follow-up visit $190 · N-648 case review $400 (credited toward evaluation) · N-648 evaluation from $1,400
This article is educational information about the immigration medical examination process. It is not legal advice and does not create a physician–patient relationship. For legal questions about your case, consult a licensed immigration attorney.
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.
