This page is general information about the vaccination part of the immigration medical exam. It does not tell any individual which vaccines they personally need — that determination is made by a civil surgeon under the current federal instructions.

What is the Form I-693 medical exam?

Form I-693, the Report of Immigration Medical Examination and Vaccination Record, is the form used to show an adjustment of status applicant is not inadmissible on health-related grounds. According to USCIS, it must generally be submitted together with the Form I-485 application, in a sealed envelope completed by a civil surgeon.

Who performs the immigration medical exam?

The exam is performed by a USCIS-designated civil surgeon, a physician authorized to conduct immigration medical examinations inside the United States. Per USCIS, the civil surgeon records the exam results — including the vaccination assessment — on Form I-693 and places the completed form in a sealed envelope.

Which vaccines are part of the immigration requirement?

Federal law under INA section 212(a)(1)(A)(ii) requires proof of certain vaccinations, plus others recommended by the CDC's Advisory Committee on Immunization Practices (ACIP). As of the CDC Technical Instructions for Civil Surgeons dated March 11, 2025, the required set covers these vaccine-preventable diseases:

• Diphtheria
• Tetanus
• Pertussis
• Polio
• Measles
• Mumps
• Rubella
• Rotavirus
• Haemophilus influenzae type b (Hib)
• Hepatitis A
• Hepatitis B
• Meningococcal disease
• Varicella
• Pneumococcal disease
• Influenza (seasonal)

This list reflects the diseases named in the current CDC Vaccination Technical Instructions. The CDC updates this set over time, so the cited sources are the authoritative version on any given date.

How does a civil surgeon decide which vaccines apply to a person?

Not every vaccine on the list applies to every applicant. The CDC criteria require a vaccine to be age-appropriate as recommended by ACIP, and to protect against a disease with outbreak potential or one being eliminated in the United States. The civil surgeon applies a CDC age-based table and the applicant's medical history to assess the record.

Is the COVID-19 vaccine still required?

No. According to USCIS, as of January 20, 2025, applicants for adjustment of status are no longer required to provide documentation of a COVID-19 vaccination, and the requirement does not apply to any adjustment application pending on or after that date.

What about the seasonal flu vaccine?

The seasonal influenza vaccine is part of the required set, but it is tied to flu season. USCIS states the civil surgeon administers it from September 1 through March 31 when it is available. An exam completed outside that window, when the vaccine is unavailable to the civil surgeon, does not require documentation of the flu vaccine for immigration purposes.

What if a required vaccine is missing or declined?

USCIS describes several pathways the civil surgeon records on Form I-693, including age or medical reasons a vaccine may not be appropriate, and a waiver process for religious or moral objections — which can make a person inadmissible unless a waiver is granted. These are case-specific determinations. A licensed immigration attorney can advise on how a missing or declined vaccine interacts with a particular application.

How does the vaccination record fit into the I-485 filing?

The vaccination record is part of Form I-693, which is generally filed with the Form I-485 application. The 10-document consultation checklist covers the broader set of records an applicant gathers before meeting an attorney, and the intake walkthrough helps organize them.

Next Steps

The official USCIS Vaccination Requirements page and the CDC Technical Instructions are the canonical sources for the current required list. A licensed immigration attorney or a USCIS-designated civil surgeon can advise on how the requirements apply to a specific person. Find an AILA attorney to start a consultation.

Updated June 10, 2026.