Attachment C(3)237881-C PhysicansPanelTool3

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UPDATED VACCINATION REQUIREMENTS FOR IMMIGRANTS

DGMQ and Vaccines:
CDC’s Division of Global Migration and Quarantine (DGMQ) writes Technical Instructions for medical examinations of
immigrants and refugees. Proof of vaccination is a required part of the immigrant assessment to protect the public
and individuals from specific preventable diseases.

Vaccination Criteria for Immigrants:
DGMQ uses the criteria for ACIP*-recommended vaccines at regular periods, as needed, to decide
which vaccines will be required for U.S. immigration:
●● The vaccine must be age-appropriate* for the immigrant applicant, AND
●● The vaccine must protect against a disease that has the potential to cause an outbreak, OR
●● The vaccine must protect against a disease that has been eliminated or is in the process of being eliminated in
the United States.
*ACIP recommends vaccines for the general U.S. population. These ACIP recommendations are used to decide which vaccines are age-appropriate for
immigrant applicants.

Physicians with questions regarding which vaccines should be required of an immigrant
applicant can refer to the vaccination chart (back of form) and the following websites:
http://www.cdc.gov/vaccines/schedules and
http://www.cdc.gov/immigrantrefugeehealth/exams/ti/panel/vaccination-panel-technical-instructions.html

Vaccination Requirements:
As of December 14, 2009, proof of vaccination against these diseases is required*:
●● Haemophilus influenzae type B (Hib)
●● Hepatitis A
●● Hepatitis B
●● Influenza
●● Measles, Mumps, and Rubella
●● Meningococcal Disease

●● Pneumococcal Disease
●● Polio
●● Rotavirus
●● Tetanus, Pertussis, and Diphtheria
●● Varicella

*As of December 14, 2009 the human papillomavirus (HPV) and zoster vaccines are not required for immigrants.

General Vaccination Tips:
●● For vaccines that entail a series of doses, only one dose is required for admission
to the United States.
●● Multiple vaccines may be given simultaneously, but multiple body sites should be used.
There is no limit to the number of vaccines that may be given simultaneously.

Department of State (DS)-3025 Vaccination Documentation Worksheet:

237881-C

●● The panel physician should not sign the Worksheet until after vaccines are administered.
●● Every row should have at least one notation or check mark.
●● Most applicants will require a blanket waiver (no application needed).
●● The panel physician should provide a copy of the DS-3025 Worksheet directly to
each applicant.

National Center for Emerging and Zoonotic Infectious Diseases
Division of Global Migration and Quarantine

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NO

NO

NO

NO

NO

NO

Birth–1 month

NO

YES, through 18 years old

YES
12 through
23 months old

YES

11–17 years
NO

18–64 years

≥65 years

NO

NO

YES

Yes
11 through
18 years old

YES, if born in 1957 or later

NO

NO

NO

YES (administer PPSV)

NO

NO

NO

“YES. For ≥ 11 years old, Tdap required; if Tdap not available, Td acceptable.”

“YES. For 7 through 10 years old, Tdap required if not fully immunized with DTaP;
if Tdap not available, Td acceptable.”

7–10 years

YES, ≥ 6 months (annually each flu season in country of exam).

YES, 2 through 59 months old (administer PCV)

NO

NO

YES

12 months–6 years

YES
2 through 59 months old

YES
6 weeks to
8 months

NO

NO

2–11 months

*Rotavirus vaccination should not be initiated for infants aged 14 weeks 6 days or older.

Adapted from ACIP recommendations.

DTP= pediatric formulation diphtheria and tetanus toxoids and pertussis vaccine; DTaP= pediatric formulation diphtheria and tetanus toxoids and acellular pertussis vaccine;
DT=pediatric formulation diphtheria and tetanus toxoids; Td=adult formulation tetanus and diphtheria toxoids; Tdap=adolescent and adult formulation tetanus and
diphtheria toxoids and acellular pertussis vaccine (Boostrix for persons ≥ 10 years old; Adacel for persons 11through 64 years old); IPV=inactivated poliovirus vaccine (killed);
OPV=oral poliovirus vaccine (live); Hib=Haemophilus influenzae type b conjugate vaccine; MCV=meningococcal conjugate vaccine; PCV=pneumococcal conjugate vaccine;
PPSV=pneumococcal polysaccharide vaccine.

Influenza

Pneumococcal

Varicella

Meningococcal
(MCV)

Hepatitis B

Hepatitis A

Hib

Rotavirus*

Measles, Mumps,
and Rubella

Polio (IPV/OPV)

Td/Tdap

DTP/DTaP/DT

Vaccine

Age

Table: Requirements for routine vaccination of immigrants examined overseas who are not fully vaccinated or lack documentation.

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