DV Lottery Medical Exam: What to Expect, Vaccinations Required, and Timing

Every DV lottery applicant must complete an immigration medical examination before receiving a visa. This isn't a standard health check — it's a specific government-mandated exam performed by an approved physician, evaluating communicable diseases and vaccination history against a CDC-mandated list.

Getting the timing wrong on the medical exam is one of the more common ways applicants create unnecessary risk for their case. Here's what you need to know.

Who Performs the Exam

You cannot use your personal doctor. Immigration medical examinations must be performed by a panel physician — a doctor authorized by the U.S. embassy or consulate in your country to conduct immigration physicals.

The list of approved panel physicians for your specific embassy is published on the embassy's website or in your interview appointment letter from the KCC. Contact the physician's office to schedule well in advance — in high-volume posts like Lagos, Nairobi, Kathmandu, and Cairo, appointments are often booked weeks out.

What the Exam Includes

Physical examination. The physician reviews your overall health with particular attention to communicable diseases. They'll review your medical history and conduct a general physical.

Blood tests. Syphilis testing is standard for adults over 15. Additional tests may be ordered depending on age and clinical presentation.

Tuberculosis (TB) screening. This is the most significant potential complication. The method varies by country and age:

• Tuberculin skin test (TST) or interferon-gamma release assay (IGRA) blood test for certain age groups
• Chest X-ray for adults or those with a positive skin/blood test result

If your TB screening is positive or indeterminate, the physician orders a sputum culture — a follow-up test that takes 8 to 12 weeks to return results. For a DV applicant with an interview scheduled in July or August, a sputum test is a near-guarantee of missing the September 30 deadline.

If you have a history of TB exposure or lung issues, or if you've received the BCG vaccine (common in many countries), there's an elevated chance of a positive initial screening. This is worth knowing before your appointment, not after.

Required Vaccinations

The CDC and USCIS mandate specific vaccinations for all immigrants, including DV lottery applicants. The exam includes a review of your vaccination history. Missing vaccinations must be administered — either before or at the time of the medical exam.

Vaccinations required for age-appropriate applicants:

Bring your vaccination records to the exam. If you have records showing prior vaccinations, you won't need to repeat them. If you have no records, the physician will administer what's required — which may require returning for a second appointment for a multi-dose series.

How Much the Medical Exam Costs

Costs vary by country and by the specific physician's office. Typical ranges:

• Basic exam: $100–$250
• Vaccinations: $50–$200 additional, depending on what's needed
• Total: $150–$500 per applicant

These fees are paid directly to the panel physician, not to the embassy or USCIS. They're non-refundable even if your visa is ultimately not issued.

If you have a spouse and children immigrating with you, each person needs their own separate medical exam — multiply these costs by your family size.

Exam Results and How They're Submitted

The medical exam results are sealed in an envelope by the panel physician. You do not open this envelope. You bring it to your consular interview and hand it directly to the consular officer, who opens it.

Results are also typically transmitted electronically by the panel physician to the embassy before your interview date, but the physical sealed envelope serves as backup.

Timing: When to Schedule the Medical Exam

Do not schedule too early. Medical exam results are typically valid for 12 months from the date of the exam. If you schedule your exam in May but your interview isn't until February of the following fiscal year, your results may expire.

Do not schedule too late. The exam must be completed before the interview, and in high-volume posts, physician appointments fill up quickly. If you try to schedule within two weeks of your interview date, you may not get an appointment in time.

The right window: Schedule the exam once you have your interview appointment letter from the KCC — typically 6–8 weeks before your interview date. This gives you enough time to complete the exam, receive results, and address any issues (like missing vaccinations requiring multiple doses) before the interview.

TB exception: If you have any reason to suspect a potential TB complication, consider getting a private TB screening before your official appointment. An 8–12 week sputum culture delay could push your case past September 30.

What a "Class A" Medical Condition Means

If the physician finds a "Class A" medical condition — active tuberculosis, certain communicable diseases, or untreated syphilis — the result is a finding of inadmissibility. This doesn't necessarily mean permanent denial, but it means additional treatment and a repeat exam are required before a visa can be issued.

For DV applicants, a Class A finding that requires treatment lasting more than a few weeks can be incompatible with the September 30 deadline. Early medical screening is valuable precisely because it gives you time to address problems before they become time-fatal.

The US Diversity Visa Lottery Guide covers the medical exam as part of a full post-selection timeline, including how to coordinate the exam with your interview appointment and what to do if your results flag an issue that requires follow-up.