Vaccinations for the USA

Dengue, hepatitis & co: the US has special vaccination requirements for immigrants and travelers that you should know about before entering the country. Learn which vaccinations you need and what to expect during the medical exam as part of the Green Card process.

Immunization requirements for immigrants to the United States

If you are applying for a Green Card to live and work in the US, you must undergo a Green Card medical exam by a U.S. Department of State (DOS) approved panel physician.

US government contract physicians receive specific instructions from the CDC (Centers for Disease Control and Prevention), which include immunization requirements for US immigrants.

Mandatory vaccinations under US immigration law apply to Green Card aspirants in the consular process (i.e., from abroad) and to individuals already in the US applying for Adjustment of Status.

The required immunizations for US immigrants are age-based. Therefore, if you win the Green Card Lottery and move to the US with your entire family, different vaccinations may be required for each family member.

Before immigrating to the US, you will usually need to be vaccinated against the following diseases:

• COVID-19
• Hepatitis A
• Hepatitis B
• Influenza
• Influenza type b (Hib)
• Measles
• Meningococcal
• Mumps
• Pneumococcus
• Pertussis
• Polio
• Rotavirus
• Rubella
• Tetanus and diphtheria toxoids
• Varicella
• Other vaccine-preventable diseases recommended by the ACIP

ACIP recommendations may include current influenza vaccines or other seasonal vaccines.

Will the panel physician vaccinate me?

You should have your private health care provider (e.g., primary care physician) administer the missing vaccines for your immigration to the US. Still you may also receive them at your official appointment with the panel physician.

Please note that the “Report of Your Medical Examination for US Immigration” (Form I-693) can only be completed by the officially appointed panel physician. Therefore, you must provide the doctor with proof of all immunizations for your immigration medical report to be completed.

I have been vaccinated. Do I need to do it again for the Green Card?

If you have already received the required vaccinations for immigration to the US, you do not need to be vaccinated again.

The panel physician will review your immunization records during your medical examination. Therefore, bring all records in your possession to your “Green Card Medical Examination” appointment.

Do I have to see the panel physician more than once for multiple vaccinations?

For vaccines that require multiple doses, you will only be administered one dose by the contract physician. You will then be responsible for completing the vaccinations with your primary care physician or other health care professional.

An exception is made for COVID-19 vaccines. For immigration to the United States, you must provide proof of complete immunization against COVID-19.

COVID-19 vaccination must be complete

For immigration to the United States, you must be fully immunized against COVID-19. You are considered fully immunized two weeks after your last vaccination. Vaccines currently approved by the US Food and Drug Administration (FDA) include:

• Pfizer/BioNTech
• Moderna
• Johnson & Johnson
• AstraZeneca
• Covishield
• BIBP/Sinopharm
• Sinovac
• Covaxin

Cross-vaccination of licensed vaccines is also considered a complete vaccination.

What are the vaccine requirements?

Vaccines administered by contracted physicians to US immigrants must be age-appropriate vaccines as recommended by the ACIP for the general US population. They must protect against a disease that has the potential to cause an outbreak or that has been eradicated or is in the process of being eradicated in the United States.

Exceptions to US vaccination requirements

If you know you have permanent immunity to certain vaccine-preventable diseases (e.g., measles or rubella), you may be able to waive the specific vaccination as an immigration requirement with written proof of immunity.

The medical officer will make the final decision as to whether you are exempt from a particular vaccination requirement. They will note the exemption in his medical report.

Do I need to be vaccinated if I have a contraindication?

If you have a medical condition that prevents you from receiving a vaccine appropriate for your age, the panel physician will note this on Form I-693. However, it is up to the doctor to determine whether you have this condition.

Do I have to be vaccinated if I am pregnant?

If you are pregnant, special instructions from the CDC apply to the panel physician. If a required vaccine cannot be safely administered, this will be noted as a contraindication on the I-693 form. Check out the "Guidelines for Vaccinating Pregnant Women" on the CDC website.

Suppose the instructions state that a particular vaccine is not contraindicated in pregnancy, but you still want to wait until after pregnancy to get the vaccine. In that case, you can delay the completion of the immigration medical examination.

However, this is only recommended for “Adjustment of Status” or Green Card applications that do not have short deadlines, as waiting will delay the processing of your application.

What is the cost of immunizations for US immigration?

The cost and coverage of immunizations depend on your country of origin and health insurance. Suppose you do not qualify for coverage through one of the various sources (e.g., health insurance, public health, or occupational health provided by your employer). In that case, you will be responsible for the cost.

Check with your physician for the cost of each immunization, as rates may vary from physician to physician. You may be charged anywhere from $ 30 to approximately $ 230 per vaccination.

What happens if I refuse a vaccination?

If you refuse to get the vaccinations required for your Green Card, your application for permanent residence in the US may be denied. Non-medically based exemptions from the vaccination requirement are only available, if at all, under the following circumstances:

• You are adamantly opposed to all vaccinations in any form (an exemption cannot be granted if you are opposed to only certain vaccinations).
• Your objection is based on sincerely held religious or moral beliefs.

Applying for a vaccination exemption

The US government provides two different forms for different categories of immigrants to apply for mandatory vaccination exemptions:

Vaccinations for travel to the United States

If you do not want to emigrate, but only stay in the USA for a certain period of time, you are not subject to the same vaccination requirements as US immigrants. The US government has ended the COVID vaccination requirement for international travelers. US entry is possible for unvaccinated persons again since May 12th, 2023.

COVID-19 vaccination no longer required for US travel

The United States has declared its COVID-19 vaccination requirement for international travelers to end concurrently with the expiration of the public health coronavirus emergency, according to a White House announcement.

Other vaccinations for travel to the USA

Following the elimination of mandatory COVID-19 vaccinations, there are no mandatory vaccinations for travel to the United States anymore. However, visitors are advised to be up to date on standard vaccinations and to update them as necessary.

Recommended travel vaccinations include hepatitis A and, for longer stays, hepatitis B, rabies, and meningococcal disease (ACWY).

Studying in the USA: required vaccinations

Certain vaccinations are also required for study in the US - not by the US government, but usually by the educational institutions themselves.

The most common vaccinations required for study in the United States include

• MMR (measles, mumps, and rubella)
• Tetanus-Diphtheria-Petussis (TDAP)
• Varicella (chicken pox)
• Hepatitis B
• Polio

Other vaccinations such as meningococcal B (meningitis), HPV, flu shot, tuberculosis (TB) test may be required.

How to be safe in the USA

Before you travel to the USA, don't just think about your vaccinations but also about a good international health insurance policy that is valid for the entire duration of your trip or, in the case of immigrants, until the start of your American insurance coverage.