Immediate Relative Status for Children of U.S. Citizens

Unmarried children under 21 years of age who are the biological, adopted, or stepchildren of U.S. citizens are classified as immediate relatives. Like other immediate relatives, they have immediate visa availability and can often file I-485 without a long wait.

Children of U.S. citizens who file I-485 must complete an immigration medical examination with a USCIS-designated civil surgeon. The exam follows age-appropriate protocols based on the child's age at the time of the examination.

Age-Appropriate Exam Protocols for Children

The immigration medical exam for children follows age-appropriate protocols that differ from adult requirements. Children under 15 are not required to undergo syphilis and gonorrhea testing. Children under 2 years old are not required to undergo TB testing. Children aged 2–14 receive a TB skin test or IGRA blood test.

The vaccination requirements for children follow the age-appropriate USCIS vaccination schedule, which is based on the CDC childhood immunization schedule. The civil surgeon will review the child's vaccination records and administer any missing required vaccines.

• No syphilis or gonorrhea testing for children under 15
• No TB testing for children under 2 years old
• TB skin test or IGRA for children aged 2–14
• Age-appropriate vaccination schedule
• Parental consent required for all minors

Parental Consent and What to Bring

A parent or legal guardian must accompany the child to the civil surgeon appointment and provide consent for the examination. Bring the child's passport or birth certificate for identification, all available vaccination records (including records from the home country), and any relevant medical records.

If the child has received vaccinations in another country, bring those records to the appointment. The civil surgeon may be able to accept foreign vaccination records if they are properly documented. If records are not available, the civil surgeon can order titer tests or administer vaccines as needed.

Making the Exam Comfortable for Children

The immigration medical exam can be stressful for children, particularly if they are unfamiliar with medical settings. ImmigrationMedicalExams.com provides a child-friendly environment and experienced staff who are accustomed to working with pediatric patients. You can explain the exam process to your child in advance and bring a comfort item if needed. The exam typically takes 30–60 minutes for children.