MMR (Measles, Mumps, Rubella) — Immigration medical exam vaccine

MMR (Measles, Mumps, Rubella) requirement for Form I-693 USCIS medical exam. Who needs it, doses, cost, side effects, exemptions, blood test alternative. Updated 2026.

MMR (Measles, Mumps, Rubella)

Required for Form I-693 (USCIS medical exam) for adjustment of status, refugee/asylee status, and certain other immigration benefits.

What it protects against

Measles, mumps, rubella.

Who must receive it

Ages 12 months and older. Adults born in 1957 or later need at least 1 dose; ages 12 months–12 years need 2 doses.

Dose schedule

1–2 doses depending on age and prior history.

Cost

$0 with most insurance (ACA preventive). Without insurance: $90–$200/dose at private offices; FREE at county health departments for uninsured adults in many states.

See Where to get immigration vaccinations for free and low-cost options.

Side effects

Sore arm, mild fever, rash 7–12 days after dose. Serious reactions extremely rare.

Blood test alternative (titer)

Yes — if you don’t have records, civil surgeon may accept blood test (titer) showing immunity instead of revaccinating. Titer cost: $50–$150.

Important notes

Born BEFORE 1957? You are presumed immune from natural exposure and the vaccine is NOT required by USCIS. Bring documentation of birth year. Pregnant women cannot receive MMR — deferral granted.

Bring to your civil surgeon

  • Yellow international vaccination card (cartilla de vacunacion) if vaccinated abroad
  • Pediatrician/clinic records from any US doctor visits
  • State immunization registry printout if available
  • Translation NOT required for vaccine cards — doses and dates are universal

Civil surgeons can administer missing doses during your I-693 exam, but pricing is typically HIGHER than going to a county health department or pharmacy beforehand.


Last verified: 2026-05-25.

General health and procedural information from CDC Civil Surgeon Technical Instructions and USCIS Policy Manual. Not medical or legal advice. Consult your physician for medical guidance and a licensed immigration attorney for case-specific questions.

USCIS Form I-693 medical exam context (2025-2026)

The USCIS Form I-693 (Report of Immigration Medical Examination and Vaccination Record) is required for adjustment-of-status applicants (Form I-485) and certain refugee/asylee categories. Civil Surgeons designated by USCIS conduct the exam. Find a Civil Surgeon at uscis.gov/tools/find-a-civil-surgeon. Costs range from $100-$500 (with average $200-$350) depending on region — NOT covered by USCIS or any government program.

CDC’s Technical Instructions for Civil Surgeons (most recent major update 2023) specify required vaccinations: tetanus-diphtheria, pertussis (Tdap/DTaP), MMR (measles-mumps-rubella), polio, varicella (chickenpox), influenza (seasonal), pneumococcal (age-dependent), Hib (children), Hepatitis A + B, rotavirus + meningococcal (children), HPV (age 9-26 catch-up). Adults typically need 4-8 vaccines; full pediatric schedule for children. Form I-693 results are valid for 2 years from signature date.

H.R.1 / OBBBA changes (2026-05-29) did NOT affect I-693 procedures, but USCIS Form Fee changes effective 2026-05-29 may affect related adjustment-of-status processing — verify USCIS Fee Schedule at uscis.gov/g-1055 (Form G-1055) before filing I-485. Tuberculosis (TB) screening required for all I-693 applicants 2+ years old; chest X-ray for positive skin/blood tests.

For Civil Surgeon designation questions or vaccination requirement disputes: USCIS Contact Center 1-800-375-5283 Monday-Friday 8:00am-8:00pm Eastern Time. For sealed I-693 transport (DO NOT OPEN — Civil Surgeon places in sealed envelope; USCIS rejects opened envelopes): submit with I-485 or in response to RFE within 60 days. Lost or expired I-693 requires fresh examination ($$$$ again).

For low-cost / free vaccination sources: community health centers (FQHCs at /benefits/community-health-centers-by-state/) provide vaccines on sliding-fee scale; many counties offer free immunization clinics. CDC Vaccines for Children (VFC) program: 1-800-232-4636 (1-800-CDC-INFO) for children whose parents/guardians cannot afford vaccines.

Frequently asked questions

Do I have to get the MMR (Measles, Mumps, Rubella) vaccine for my green card?
Ages 12 months and older. Adults born in 1957 or later need at least 1 dose; ages 12 months–12 years need 2 doses. If you fall in the required age range and don’t have proof of prior vaccination or natural immunity, yes — the civil surgeon will require it for I-693.
Can I use a blood test instead of getting vaccinated?
Yes — if you don’t have records, civil surgeon may accept blood test (titer) showing immunity instead of revaccinating. Titer cost: $50–$150.
How much will this vaccine cost me?
$0 with most insurance (ACA preventive). Without insurance: $90–$200/dose at private offices; FREE at county health departments for uninsured adults in many states.
What are the side effects?
Sore arm, mild fever, rash 7–12 days after dose. Serious reactions extremely rare.