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. Requirements depend on your age on the day of the exam.
| Vaccine | Who needs it | Notes |
|---|---|---|
| Tdap / Td (tetanus, diphtheria, pertussis) | All ages (age-appropriate series) | Booster required if last dose was more than 10 years ago |
| MMR (measles, mumps, rubella) | 12 months through 64 years | Titer accepted as proof of immunity |
| Varicella (chickenpox) | 12 months through 64 years | Documented history of disease or titer can qualify |
| COVID-19 | Per current CDC/USCIS guidance at the time of your exam | Bring any vaccination card or digital record |
| Polio | 2 months through 17 years | Foreign OPV/IPV series accepted with records |
| Hepatitis A | 12 months through 18 years | 2-dose series |
| Hepatitis B | Birth through 18 years | Titer accepted as proof of immunity |
| Hib (Haemophilus influenzae type b) | 2 months through 4 years | Children only |
| Rotavirus | 2 months through 7 months | Infants only |
| Pneumococcal | 2 months–4 years, and 65+ | Age-dependent |
| Influenza (flu) | All ages 6 months+ | Only if your exam is during flu season, October 1 – March 31 |
Blanket waivers (e.g., not age-appropriate, contraindication, or vaccine not available) are documented by the civil surgeon directly on Form I-693 when they apply.
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