I-485 Adjustment of Status Applicants must complete a medical examination. The medical examination must be performed by a civil surgeon, not the applicant’s private physician. For immediate relatives of U.S. citizens, the examination must be completed by the interview date. For employment-based applicants, the completed examination must be submitted with the petition to the appropriate INS Service Center.

During the required medical examination, the alien must present proof of vaccination against the following diseases:
mumps, measles, rubella, polio, tetanus and Diphtheria toxoids, pertussis, influenza type B, hepatitis B, varicella (chickenpox), haemophilus influenza type B, and pneumococcal vaccines.

Civil surgeons must review the applicant’s written vaccination history in addition to lab evidence of immunity certain diseases. Civil surgeons will also review the applicant’s record to determine whether the applicant has received a complete series of each vaccine.

If the applicant’s records indicate that she or he has not received a complete series of each vaccine and there is a lack of other evidence of immunity, the civil surgeon will administer a single dose of each missing vaccine at the time of the medical examination. If the dose administered during the examination does not complete the vaccine series, the civil surgeon will certify the alien’s eligibility for a “not medically appropriate” waiver.