Immigration vaccine costs — with and without insurance
Complete cost breakdown for the 11 USCIS-required immigration vaccines. Pharmacy retail, county health department, civil surgeon, and insurance-covered pricing. Save $500+ by getting vaccines BEFORE the I-693 exam. Updated 2026.
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.
Frequently asked questions
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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.