Vaccine records for your I-693

Vaccine records from any country count toward Form I-693 if they are legible and show the name of each vaccine and the date it was given. For several vaccines, an immunity blood test (titer) is accepted instead of a record. Polio is the exception: it has no titer option. Anything your records don't cover is given or tested for as part of the exam.

What makes a vaccine record acceptable?

• The vaccine name for each dose, such as "MMR" rather than just "injection".
• The date of each dose. A record with no dates can't be used.
• Legibility. The civil surgeon has to be able to read and verify it.

A childhood vaccination card, a school or employer record, a record from a clinic or pharmacy, or a state immunization registry printout can all work. A note that just says you are "fully vaccinated", without listing vaccines and dates, does not. Neither does your own recollection.

Are vaccine records from my home country accepted?

Yes. Records from outside the United States are accepted on the same terms: legible, with vaccine names and dates. If they are in another language, sending a clear photo of every page helps the reviewer match each entry.

Can a blood test replace a vaccine?

For some vaccines, yes. A titer (an immunity blood test) showing you are already immune is accepted in place of the vaccine for several diseases, such as measles, mumps and rubella. A positive titer means you don't need that vaccine at all.

Polio is different. Immunity tests are not accepted for polio. Without a written record of polio vaccination, adults generally need one dose of polio vaccine.

What if I don't have my vaccine records?

You still qualify. The civil surgeon either gives the missing vaccines or, where a titer is accepted, tests for immunity. You don't have to wait to finish a multi-dose series before filing: when the next dose isn't due yet, the civil surgeon records it as not medically appropriate because of the time interval, and USCIS waives it.

It is worth looking before you give up, though. Old records often turn up with parents, past schools, previous employers, a former doctor's office, or your state's immunization registry. Each one you find can mean a vaccine you don't need to repeat.

Is the flu shot required for I-693?

Only during flu season, which USCIS defines as October 1 through March 31. When it is required, it must be the current season's vaccine; a flu shot from a previous season doesn't count. Outside flu season the civil surgeon marks it as not required.

Is the COVID-19 vaccine required for I-693?

No. USCIS stopped requiring COVID-19 vaccination for applications pending on or after January 20, 2025.

What if a vaccine isn't right for me?

The civil surgeon can mark a vaccine as not medically appropriate, for example because it isn't suited to your age, you have a medical contraindication (live vaccines during pregnancy are a common one), the next dose isn't due yet, or it is outside flu season. USCIS then waives that vaccine, with no separate application. Declining a vaccine for religious or moral reasons is different: it requires a waiver request on Form I-601.

Children under 2

Very young children are reviewed individually against the CDC schedule rather than against a standard age-group list, because what they need depends on exactly which doses they have already had.

Get your records checked, free

Upload what you have with the form on our home page, as PDFs or photos. Our team checks each record against your age group's requirements at no charge and emails you what's still missing, before you go to your exam.

Sources: CDC, technical instructions for civil surgeons; USCIS Policy Manual, Volume 8, Part B, Chapter 9 (vaccination requirement).