Immigration vaccine costs
Total cost for completing all USCIS-required vaccines varies dramatically by where you go and what you already have. Adult immigrant with no records can expect:
- With insurance: $0 (all ACA-compliant plans cover required vaccines as preventive care)
- Without insurance, county health department: $0–$200 total for entire series
- Without insurance, pharmacy: $400–$800 total for entire series
- Without insurance, civil surgeon: $600–$1,500 total for entire series
Plus the I-693 exam itself: $200–$500 depending on city and civil surgeon.
Cost per vaccine, per venue (uninsured cash price)
| Vaccine | County Health Dept | Pharmacy (Costco/Walmart) | Civil Surgeon |
|---|---|---|---|
| MMR | $0–$25 | $90–$130 | $120–$200 |
| Tdap | $0–$25 | $40–$70 | $60–$110 |
| Polio (IPV) | $0–$25 | $35–$70 | $50–$100 |
| Influenza | $0–$25 | $20–$50 | $35–$80 |
| Varicella | $0–$50 | $130–$170 | $180–$250 |
| Hep A | $0–$25 | $40–$80 | $70–$130 |
| Hep B | $0–$25 | $50–$120 | $80–$170 |
| Meningococcal | $0–$50 | $130–$170 | $180–$250 |
| Pneumococcal | $0–$50 | $150–$300 | $200–$400 |
| Hib | $0–$25 | $30–$50 | $40–$80 |
| Rotavirus | Limited — most go via pediatrician | $90–$130 | $120–$200 |
Note: prices vary by region. California, New York, and other high-cost states trend toward the high end. Texas, Florida, and Midwest trend lower.
Insurance coverage
Under the Affordable Care Act, ALL non-grandfathered health plans must cover the following preventive services at $0 out-of-pocket:
- Adult vaccines per CDC ACIP recommendations
- Pediatric vaccines per CDC ACIP recommendations
This means ALL 11 USCIS-required vaccines are covered at $0 if you have:
- Marketplace insurance (HealthCare.gov, state exchanges) — yes
- Medicaid — yes
- CHIP (children) — yes
- Employer-based insurance — yes (vast majority)
- Medicare Part B — most vaccines covered (Tdap covered under Part D in some cases)
NOT covered at $0 by Marketplace plans: cost of the I-693 exam itself, TB blood test, syphilis blood test — these are immigration-related, not preventive care.
Without insurance — best cost strategy
- County health department first — cheapest, no questions on status
- Costco pharmacy for any vaccines county doesn’t offer (Costco is typically cheapest retail)
- FQHC sliding scale if income is very low
- Civil surgeon LAST for only the exam itself and any final touch-ups
Cost-saving tactics
- Use titers (blood tests) instead of revaccinating for MMR, varicella, Hep A, Hep B — titer typically $50–$150 vs full 2-3 dose series at $200–$400. If immune, you save a lot.
- Birth certificate before 1957? Skip MMR entirely.
- Walmart $4 vaccine days — check local Walmart for periodic discount events.
- Texas Vaccines for Adults and similar state programs for low-income uninsured adults — search “[your state] adult immunization program”.
- VFC for children under 19 — 100% free at participating providers (FQHCs, many pediatricians).
Charity care
Most hospital systems have charity-care policies that cover vaccinations for patients below certain income thresholds. Ask the hospital’s financial counselor. Documentation usually pay stubs (or sworn statement of income if cash-paid).
Related
- Immigration medical exam (Form I-693) overview
- Where to get immigration vaccinations
- Vaccines for Children (VFC) program
- Vaccine exemptions and waivers
- Community health centers by state
- CHIP eligibility by state
Last verified: 2026-05-25.
Cost estimates from CDC vaccine price list, GoodRx, and pharmacy surveys 2025–2026. Actual prices may vary. Not medical or legal advice.
Related procedural information
- Consulate of your country in the US — passport renewal, consular ID, document apostille
- ITIN — file federal taxes without SSN — required regardless of immigration status
- USCIS form library — federal immigration forms (I-130, I-485, N-400, etc.)
- Find an immigration attorney — pro bono lists + AILA + BIA-recognized
- Know Your Rights — ICE encounters — constitutional protections
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.