The historic Ellis Island immigration station in New York.

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Immigration medical exam (Form I-693) and required vaccinations

Complete guide to the USCIS medical exam for green card and other immigration benefits. Required vaccines, civil surgeons, panel physicians abroad, costs, waivers, exemptions. 11 required vaccines explained. Updated 2026.

Immigration medical exam (Form I-693) and required vaccinations

Most green card applicants and certain other immigration applicants must complete a medical exam (Form I-693) with a USCIS-designated civil surgeon. The exam includes a physical, mental health screening, communicable-disease screening (TB, syphilis, gonorrhea), and proof of required vaccinations.

This cluster explains every vaccine USCIS currently requires, where to get them affordably, how to use blood tests (titers) when records are missing, and the exemption process.

Who needs the medical exam

  • Adjustment of status (I-485) — green card from inside US
  • Refugee or asylum applicants — within 1 year of arrival or status grant
  • Visa Waiver Program — NOT required
  • Consular processing — use panel physician abroad, NOT civil surgeon
  • DACA renewal — NOT required (DACA is not adjustment of status)
  • TPS — NOT required for TPS itself

Required vaccines (11 total)

USCIS requires the following per CDC Civil Surgeon Technical Instructions (updated March 2025):

Important policy notes (2025–2026)

  • COVID-19 vaccine is NO LONGER required. The COVID-19 requirement was added in October 2021 and rescinded January 22, 2025. Civil surgeons cannot require it for I-693.
  • No vaccine “catch-up” required for very expensive series if you are missing only 1–2 doses of a multi-dose series and would face severe hardship; consult your civil surgeon about medical waivers.
  • Pregnant women receive deferrals on live vaccines (MMR, varicella) and must complete after delivery.
  • People born before 1957 are presumed naturally immune to measles, mumps, rubella — MMR not required with proof of birth year.

Supporting topics

Civil surgeon vs panel physician

If you are…Use…
Inside US adjusting statusCivil surgeon (USCIS-designated US doctor)
Outside US (consular processing)Panel physician at US embassy/consulate list
Refugee inside USCivil surgeon

Find a civil surgeon: USCIS Find a Doctor tool. Cost of the full I-693 exam typically $200–$500 depending on city and which vaccines you need. Vaccines are charged ON TOP of the exam fee.

Bringing your medical exam to USCIS

  • Civil surgeon will seal the I-693 in an envelope
  • DO NOT OPEN THE ENVELOPE — USCIS will reject an opened I-693
  • Submit with I-485 application or bring to your interview
  • Valid for 2 years from the date the civil surgeon signs

Last verified: 2026-05-25. CDC Civil Surgeon Technical Instructions updated March 11, 2025.

General procedural and health information. Not medical or legal advice. Consult your physician for medical decisions and a licensed immigration attorney for case-specific guidance.

Frequently asked questions

What is the immigration medical exam?
It is a required health screening (recorded on Form I-693) for most green-card applicants. It checks for certain communicable diseases, reviews your vaccination record, and screens for conditions that affect admissibility.
Who can perform the immigration medical exam?
Inside the US, only a USCIS-designated civil surgeon. Outside the US, a State Department panel physician. A regular family doctor cannot complete the form unless they hold that designation.
Which vaccinations are required?
USCIS follows the CDC/ACIP list, which includes vaccines such as MMR, Td/Tdap, polio, hepatitis A and B, varicella, influenza (in season), COVID-19 policy aside, and others. The civil surgeon reviews your records and gives any you are missing.
How much does the exam cost?
Cost varies widely by provider and which vaccines you still need, often ranging from about $100 to several hundred dollars. Vaccines may be cheaper at a health department; ask the civil surgeon what records they will accept.

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General information, not legal advice. MigrantUSA is an independent publisher and is not a law firm; using this site does not create an attorney-client relationship, and this content is not a substitute for advice from a licensed attorney about your specific situation. US federal, state, and local government procedures, fees, and forms change. Always verify current details directly with the relevant agency before acting. For immigration, tax, or other legal matters specific to your situation, consult a licensed attorney or BIA-accredited representative.