Vaccines Required for Immigration to the US: Full 2026 List

The U.S. has the most extensive vaccination requirement of any destination country for immigration. Unlike Canada, Australia, or the UK — where the medical exam focuses primarily on communicable disease screening — the U.S. requires civil surgeons to verify compliance with the CDC's full age-based immunization schedule. Missing a dose or lacking documentation triggers on-the-spot vaccination at clinic prices, or a referral to return for a follow-up appointment.

Understanding which vaccines apply to your age group, what documentation is accepted, and how to close gaps before your appointment can save you hundreds of dollars and avoid a second visit.

The Legal Basis and Who Enforces It

Vaccination requirements for U.S. immigration are governed by the Immigration and Nationality Act (INA) and implemented through the CDC's Technical Instructions for Civil Surgeons. The list of required vaccines follows recommendations from the Advisory Committee on Immunization Practices (ACIP) — the same body that sets vaccination schedules for the general U.S. population.

The civil surgeon is responsible for documenting your vaccination status on Form I-693. If you lack proof of vaccination or immunity, the civil surgeon must either:

• A vaccine is not age-appropriate, is contraindicated, or there is insufficient time to complete the series
• Document that a vaccine is "medically contraindicated" (e.g., MMR during pregnancy, live vaccines for immunocompromised patients)
• Record a religious or moral objection, which requires a separate waiver process

Required Vaccines by Age Group (2026)

The following vaccines are required for U.S. immigration in 2026. Age ranges determine whether each vaccine applies to you — vaccines outside your age group are not required.

Note on influenza: The requirement depends on whether influenza vaccine is available in the United States at the time and location of your exam. CDC says it is usually given from fall through early spring in temperate areas and often is not available in summer. Your civil surgeon determines local availability. If it is available, you need it — but it's one of the cheapest and most widely available vaccines, typically $20–$65.

What "Proof of Immunity" Means in Practice

For several vaccines, you don't need to get vaccinated again if you can prove existing immunity. Two types of evidence are accepted:

Vaccination records. Official documentation from a pediatrician, pharmacy, or national immunization registry. Must include the vaccine name, date administered, and administering provider. If your records are in another language, they may need to be translated — but many civil surgeons can read date formats and vaccine names in standard international abbreviations.

Titer tests (serological evidence). A blood test measuring antibody levels. Accepted for MMR (measles, mumps, rubella individually), Hepatitis A, Hepatitis B, and Varicella. Titer panels cost $80–$200 at a commercial lab. If the result confirms immunity, no vaccination is needed. If the result is negative, you still need the vaccine — so run the numbers before assuming titers are cheaper than just getting the shot.

Titers are most useful when you have credible reason to believe you're immune but lack documentation: people who grew up in countries with high natural disease exposure (measles, varicella), adults who received childhood vaccines but have no surviving records, or individuals who had a documented infection (chickenpox) in childhood.

The Multi-Dose Problem: Hepatitis B and Series Vaccines

Hepatitis B vaccine schedules include 2-, 3-, and 4-dose series, depending on the vaccine product or medical condition. For example, the common three-dose adult schedule is at 0, 1, and 6 months. An applicant who has never received the series may not be able to complete it before a civil surgeon appointment scheduled within weeks. This is a common point of confusion.

The CDC's Technical Instructions address this directly: civil surgeons give at least one due dose of each required vaccine that is not up to date; the full series does not need to be complete for the exam. If you need Hepatitis B vaccine, the civil surgeon gives the first due dose and documents it on the I-693. You complete any remaining doses with a clinician according to the schedule for the vaccine used.

The same logic applies to other series vaccines: civil surgeons are signing off on the current state of compliance, not waiting for you to finish a multi-year immunization catch-up.

Age-Based Exemptions

Several vaccines are explicitly not required outside their designated age ranges:

• Hepatitis B: Not required for applicants age 60 and older (the CDC immigration table covers applicants through age 59)
• HPV: Not included in the required immigration vaccine list
• MMR: Not required for applicants younger than 12 months or born before 1957
• Meningococcal: Not required for applicants 19 and older (outside the 11–18 range)

Always verify your specific age group against the current CDC Technical Instructions. The schedule is updated periodically, and what applied to someone's application two years ago may have changed.

How to Prepare Before Your Appointment

Step 1: Gather all existing records. Pull every vaccination record you can find — childhood immunization cards, pediatrician records, pharmacy printouts, employer vaccination records, school health records, military records. Prioritize documentation for MMR, varicella, hepatitis B, and Tdap, as these are the most commonly flagged.

Step 2: Cross-reference against the CDC schedule for your age. Identify which vaccines apply to you based on your age and which ones you have documented. For any gaps, determine whether titer testing or re-vaccination makes more sense.

Step 3: Get catch-up doses before your appointment. Pharmacies (CVS, Walgreens, Rite Aid) and community health centers offer most required vaccines at standard prices — significantly cheaper than civil surgeon clinic rates. Bring the official pharmacy printout or signed immunization record to your appointment.

Step 4: Understand seasonal timing. If influenza vaccine is unavailable where your civil surgeon practices, the requirement is waived; it is often unavailable in summer in temperate areas. Confirm local availability with the civil surgeon.

The Form I-693 and Vaccination Records

Form I-693 includes a vaccination section that the civil surgeon must complete. The key fields are: vaccine name, date of administration, series number, and a checkbox for whether the dose was administered by the civil surgeon or documented from prior records.

The form must use the edition dated 01/20/25, which became mandatory on July 3, 2025. Any I-693 submitted on an older edition after that date is rejected.

The civil surgeon signs and seals the completed I-693. You submit the sealed envelope with your I-485 — the form is now invalid if the envelope has been opened.

Vaccination Requirements Outside the US

For context, Canada, Australia, and the UK do not impose the same comprehensive vaccination mandate as part of the immigration medical exam:

• Canada: Vaccination is voluntary and not required as part of the immigration medical exam. If you consent, the panel physician records and shares your vaccine history. The standard exam usually includes a chest X-ray for applicants age 11 and older, and syphilis, HIV (for applicants who have not self-reported as HIV positive), and serum creatinine tests for applicants age 15 and older.
• Australia: Similarly focused on disease screening. Vaccination is not a standard part of the eMedical assessment for most visa subclasses.
• UK: Only the TB test is required for most visa categories — no vaccination verification.

If you're applying to multiple countries simultaneously, or you're a U.S. applicant who has previously gone through the process in Canada or Australia, be aware that clearing those medicals does not satisfy U.S. vaccination requirements.

The Immigration Medical Exam Preparation Guide includes a fillable vaccination checklist organized by age group, a titer-versus-vaccination cost comparison tool, and a step-by-step vaccination catch-up planner for the six most commonly missing vaccines.