As of July 2026, the vaccines required for a U.S. immigrant visa medical exam are determined by the Advisory Committee on Immunization Practices (ACIP) in conjunction with specific CDC criteria. It is important to note that not every vaccine recommended by the ACIP for the general U.S. population is required for immigration. The CDC has established a specific list of vaccine-preventable diseases that are mandatory for immigrant visa applicants, based on the potential for outbreaks or diseases that have been eliminated in the U.S.. This means that while many ACIP-recommended vaccines are required, others, such as the routine Hib vaccine for adults, are not mandatory for immigration purposes. The list of required vaccines is then applied according to the applicant's age, with the specific vaccines and doses detailed in the CDC's Technical Instructions.
Key Rule: The ACIP does not require all its recommended vaccines for immigration. The CDC limits the required vaccines to a specific list of diseases that have outbreak potential or have been eliminated in the U.S. The specific vaccines you need are based on your age and are detailed in the CDC's Table 1.
Understanding the ACIP's Role in Immigration Vaccine Requirements
The ACIP provides recommendations for vaccines for the general U.S. population. However, for immigration purposes, the CDC uses a specific set of criteria to determine which of these vaccines are mandatory for applicants. A vaccine must be age-appropriate as recommended by the ACIP and must also protect against a disease that either has the potential to cause an outbreak or has been eliminated in the United States. This is why the list of required vaccines for immigrants is a subset of the broader ACIP recommendations, limited to a specific set of diseases.
The CDC regularly reviews ACIP recommendations to decide which vaccines should be required for immigration. As of 2026, the required vaccines are limited to the following diseases:
- Diphtheria
- Tetanus
- Pertussis
- Polio
- Measles
- Mumps
- Rubella
- Rotavirus
- Haemophilus influenzae type b (Hib)
- Hepatitis A
- Hepatitis B
- Meningococcal disease
- Varicella
- Pneumococcal disease
- Influenza
Based on this list, the specific vaccines required for an individual applicant are determined by their age, as defined in the CDC's Table 1.
Core Vaccines Required for Most Applicants
While the complete list of required vaccines is age-dependent, several core vaccines are commonly required for most applicants. These include:
- MMR (Measles, Mumps, Rubella) – Typically requires 2 doses unless immunity is proven.
- Varicella (Chickenpox) – Typically requires 2 doses unless immunity or prior disease is documented.
- Tdap / Td (Tetanus, Diphtheria, Pertussis) – A booster is required within the last 10 years for adults.
- Polio – Required for all age groups.
- Influenza (Seasonal Flu) – Required during flu season (typically September 1 to March 31).
It is important to note that the COVID-19 vaccine is no longer required for immigration medical exams. As of January 22, 2025, USCIS and the CDC have waived the COVID-19 vaccination requirement for adjustment of status applicants.
Age-Based Vaccine Requirements (CDC Table 1)
The specific vaccines required for an applicant depend on their age at the time of the medical exam. The CDC provides a detailed table (Table 1) that outlines vaccine requirements according to applicant age. Below is a summary of the vaccines typically required for different age groups.
| Age Group | Commonly Required Vaccines | Notes |
|---|---|---|
| Birth – 1 year | Hepatitis B, Rotavirus, DTaP, Hib, Polio, Pneumococcal conjugate | Rotavirus and Hib vaccines are not required for older children or adults. |
| 1 – 6 years | MMR, Varicella, DTaP, Polio, Hepatitis B, Hepatitis A, Pneumococcal conjugate | Hepatitis A is required for children up to age 18. |
| 7 – 18 years | Tdap, Polio, MMR, Varicella, Hepatitis B, Hepatitis A, Meningococcal | Meningococcal vaccine is required for adolescents. |
| 19 – 59 years | Tdap, MMR, Varicella, Polio, Hepatitis B, Influenza | Hepatitis B is required for adults up to age 59. |
| 60+ years | Tdap, Influenza, Pneumococcal (if age-appropriate) | MMR and Varicella may be required based on immunity status. |
For the most up-to-date and detailed age-based requirements, applicants and physicians should refer to the official CDC Table 1.
Exemptions and Special Circumstances
Not all applicants are required to receive every vaccine. There are several valid reasons a vaccine may be marked as "not medically appropriate":
- Not age-appropriate: The vaccine is not required for your age group.
- Documented immunity: You have proof of prior vaccination or laboratory evidence of immunity (e.g., titer test).
- Medical contraindication: You have a condition that would make the vaccine unsafe (e.g., severe allergic reaction to a previous dose).
- Vaccine not available: In some cases, a vaccine may not be available in your region.
If a vaccine is marked as "not medically appropriate" on Form I-693 or the DS-3025, USCIS or the consular officer will automatically waive that requirement. For religious or moral objections, a separate waiver application is required and is not automatically granted.
Frequently Asked Questions
Q: Does ACIP require all its recommended vaccines for immigrant visa applicants?
A: No. The CDC limits the required vaccines to a specific list of diseases that have outbreak potential or have been eliminated in the U.S.. Not all ACIP-recommended vaccines are required for immigration.
Q: What vaccines are required for most adult immigrant visa applicants?
A: Most adult applicants are required to have the MMR, Varicella, Tdap, Polio, and Influenza (during flu season) vaccines. Hepatitis B is required for adults up to age 59. The specific requirements depend on your age and medical history.
Q: Is the COVID-19 vaccine still required for the immigration medical exam?
A: No. As of January 22, 2025, the COVID-19 vaccine is no longer required for immigration medical exams for adjustment of status applicants.
Q: Do I need to complete the full vaccine series before the medical exam?
A: No. You are only required to receive at least one dose of each age-appropriate vaccine during the exam. You can complete the remaining doses after arriving in the U.S..
Q: What if I have a medical condition that prevents me from getting a vaccine?
A: The civil surgeon or panel physician will assess whether the vaccine is "not medically appropriate" for you. If so, they will mark it on the form, and the requirement will be automatically waived. You do not need to file a separate waiver for medical reasons.
Q: Are vaccines from other countries accepted for the immigration medical exam?
A: Yes. The civil surgeon or panel physician can accept official vaccination records from any country, as long as they include dates and are legible. If the records are not in English, you should provide a certified translation.