Form I-693 · Vaccination Requirements
Vaccine & Immunization Requirements
USCIS requires proof of age-appropriate vaccination before Form I-693 can be certified. Here is exactly what’s required, how your existing records are validated, and where to get any missing vaccines at low cost.
Your foreign vaccination records count
The single biggest worry we hear: “Will I have to repeat vaccines I already received in my home country?” The answer is no — if your records can be validated.
Bring your official immunization records with a certified English translation. During your exam, we cross-check every documented dose against the CDC’s age-specific requirements for immigrants. Doses that meet the requirement are accepted and recorded on Form I-693. You only receive vaccines that are genuinely missing, and for some vaccines a blood titer test can prove existing immunity instead of revaccination.
Required vaccines by age group
Per 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 — frequently missed by adult applicants. 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; cannot be started at 15 weeks of age or older |
| Pneumococcal | 2 through 59 months, and 65 years and older | PCV for children; the formulation for adults 65+ 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, and 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 to get missing vaccines
Complete 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