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Vaccination Requirements

For Immigrant Visa Applicants Only, not for K visa applicants

U.S. immigration law requires immigrant visa applicants to obtain certain vaccinations (listed below) prior to the issuance of an immigrant visa. Panel physicians who conduct medical examinations are required to verify that immigrant visa applicants have met vaccination requirements, or that it is medically inappropriate for the visa applicant to receive one or more of the listed vaccinations:

Diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, rotavirus, hib, hepatitis A, hepatitis B, meningococcal, varicella, pneumococcal, influenza

In order to assist the panel physician and to avoid delays in the processing of an immigrant visa, all immigrant visa applicants should have their vaccination records available for the panel physician’s review at the time of the immigrant medical examination. Visa applicants should consult with their regular health care provider to obtain a copy of their immunization record, if one is available. If you do not have a vaccination record, the panel physician will work with you to determine which vaccinations you may need to meet the requirements. Certain waivers of the vaccination requirement are available upon the recommendation of the panel physician. Only a physician can determine which of the listed vaccinations are medically appropriate for you, given your age, medical history, and current medical condition.

IMPORTANT INFORMATION FOR APPLICANTS

The medical examination consists of the following components: IGRA Test for all children ages 2-14, chest x-ray for adults ages 15 and older, blood test for syphilis for adults ages 15 and older, urine test for gonorrhea for adults ages 15 and older, general physical examination, and vaccinations.

The medical screening for tuberculosis of those applying for U.S. immigration is an essential component of the medical evaluation. According to CDC (Centers for Disease Control and Prevention) guidelines, any applicant for whom the clinical suspicion of tuberculosis is high enough to warrant treatment for tuberculosis disease, regardless of laboratory results, is considered to have tuberculosis disease and is Class A for Tuberculosis (inadmissible to United States health condition).

All adult applicants ages 15 and older that have a chest x-ray with findings suggestive of tuberculosis have signs and symptoms of tuberculosis should provide three sputum specimens to undergo microscopy for Acid Fast Bacilli (AFB), as well as culture for Mycobacteria Tuberculosis. The results of chest x-ray readings are available the same day.

All applicants 2-14 years of age should have an IGRA Test. The results of IGRA test are available in 24-48 hours. If the IGRA test result is positive or if the applicant has signs and symptoms of tuberculosis, a chest x-ray should be performed. Applicants who have a chest x-ray suggestive of tuberculosis, signs and symptoms of tuberculosis should provide three sputum specimens to undergo microscopy for AFB, as well as culture for Mycobacteria Tuberculosis. Applicants 2-14 years of age with a documented previous history of tuberculosis disease should have a chest x-ray, even if their IGRA test result is negative. All applicants between 2-14 years of age with previous documented positive TST result are not required to do a new TST or IGRA but must do an x-ray instead.

Many applicants may have previously received the BCG (Bacille Calmette-Guérin) vaccination. Prior receipt of BCG does not change the screening requirements or the required actions based on those results.

Applicants 10 years of age or younger who require sputum cultures, regardless of HIV infection status, may travel to the United States immediately after sputum smear analysis while culture results are still pending, provided none of the following conditions exist: sputum smears have already been reported as positive; x-ray findings include one or more cavities or extensive disease; respiratory symptoms include forceful and productive cough; known contact with a person with multidrug-resistant tuberculosis who was infectious at the time of contact.

All applicants 2 years of age and younger must have a physical examination and history provided by a parent. Those applicants who have signs or symptoms suggestive of tuberculosis should have an IGRA test. If the result of IGRA test is positive a chest x-ray should be performed. Applicants who have a chest x-ray suggestive of tuberculosis, signs and symptoms of tuberculosis should provide three sputum specimens to undergo microscopy for AFB, as well as culture for Mycobacteria Tuberculosis.

Sputum smear results are normally available the next day after the last sputum specimen collection. Sputum cultures require a minimum of eight weeks to complete.

Women who are pregnant are required to have a chest x-ray to immigrate but may choose to postpone the chest x-ray until after delivery, but prior to immigration. Pregnant women must provide written consent for the chest x-ray. Pregnant women receiving chest radiographs will be provided abdominal and pelvic protection with double-layer, wrap-around lead shields.

Applicants with HIV infection will have three sputum specimens sent to the laboratory for AFB microscopy and culture. These applicants will not be cleared for travel until the results of the laboratory investigation are available.

Laboratory examination for tuberculosis disease will consist of at least three sputum specimens, which will undergo microscopy for AFB as well as culture for Mycobacteria Tuberculosis. Specimens reported as negative will be cultured for a minimum of six weeks, with a final report available within eight weeks of collection. Positive Mycobacteria Tuberculosis cultures will undergo Drug Susceptibility Testing (DST) for first-line TB medications. DST results will be available within 10-12 weeks of sputum collection. Positive cultures that are resistant to first-line TB drugs will undergo drug susceptibility testing on second-line tuberculosis medications.

The medical evaluation is complete when all required aspects of the medical examination have been completed, including a final report of culture results, and the applicant can be assigned a Tuberculosis Classification. Travel clearances are valid for six months from the time the evaluation is complete for applicants who have no Tuberculosis Classification and who do not have HIV infection. Travel clearances are valid for three months from the time the evaluation is complete for applicants who have any kind of Tuberculosis Classification or who have HIV infection. Applicants who do not travel within the clearance period will need to re-do the entire medical examination. Any applicant diagnosed with pulmonary or laryngeal tuberculosis who needs treatment will not be cleared for travel until completion of successful treatment.

All applicants with pulmonary or laryngeal tuberculosis disease who need treatment will need to complete a minimum of 180 days of Directly Observed Therapy (DOT) prior to U.S. immigration. Applicants with positive sputum smears or positive cultures who do not want to be treated will not travel to the United States. Panel physicians will notify the Consulate of any Tuberculosis disease applicants refusing tuberculosis treatment at a designated DOT facility approved by CDC. Panel physicians will also notify the appropriate public health officials in Ukraine when they diagnose an applicant with tuberculosis disease.

Applicants diagnosed with tuberculosis disease by panel physicians, who are not treated at the designated DOT facilities approved by CDC, but receive treatment at other health care facilities will not be cleared for travel to the United States. These applicants will need to repeat their medical screening examination one year after DOT treatment was completed.

In exceptional medical situations, applicants undergoing pulmonary tuberculosis treatment may petition for a Class A waiver. Form I-601 must be completed. These petitions are reviewed by the Department of Homeland Security (DHS) on an individual basis and considered in situations with extenuating medical circumstances, and also sent to CDC for review. CDC reviews the application and provides an opinion regarding the case. DHS then has the final authority to adjudicate the waiver request.

Please be informed that the information provided above is a general overview of TB screening component of the medical exam. Any case specific interpretations of Technical Instructions can be done only by panel physicians and CDC. More detailed technical information is available at this link: cdc.gov

IMPORTANT INFORMATION FOR APPLICANTS ON MEASLES VACCINATION:

If you have not previously received measles vaccination, please make sure that you are vaccinated prior to your medical examination appointment. During the medical examination there will be separate test to verify that you have received measles vaccination. If the result of this test is negative you will be required to receive measles vaccination and this may delay your medical clearance and travel to the United States.

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