Varicella (Chickenpox) — Immigration medical exam vaccine

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

Varicella (Chickenpox)

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

What it protects against

Varicella zoster (chickenpox).

Who must receive it

Ages 12 months and older without evidence of immunity.

Dose schedule

2 doses, given 4–12 weeks apart (ages 12 months–12 years can be 3 months apart).

Cost

$0 with insurance. Without insurance: $130–$200/dose at private offices; lower at county health departments.

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

Side effects

Sore arm, mild rash near injection site 1–2 weeks after. Fever uncommon.

Blood test alternative (titer)

Yes — varicella titer accepted as proof of immunity. Significantly cheaper than 2 doses.

Important notes

If you had chickenpox as a child (very common in Latin America), you have NATURAL immunity. A blood test (varicella titer) costing $50–$150 can prove immunity instead of vaccinating. Many adult immigrants from Mexico, Guatemala, El Salvador have natural immunity from childhood infection.

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 Varicella (Chickenpox) vaccine for my green card?
Ages 12 months and older without evidence of immunity. 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 — varicella titer accepted as proof of immunity. Significantly cheaper than 2 doses.
How much will this vaccine cost me?
$0 with insurance. Without insurance: $130–$200/dose at private offices; lower at county health departments.
What are the side effects?
Sore arm, mild rash near injection site 1–2 weeks after. Fever uncommon.