Immediate Relative Status for Parents of U.S. Citizens

Parents of U.S. citizens are classified as immediate relatives under the Immigration and Nationality Act. This is the most favorable family-based immigration category because there is no annual visa quota — a visa number is always immediately available. U.S. citizens who are at least 21 years old can petition for their parents.

Despite the expedited availability of visa numbers, the immigration medical exam requirement is the same as for all other adjustment of status applicants. Parents must complete an examination with a USCIS-designated civil surgeon and submit Form I-693 as part of their I-485 package.

Age-Specific Vaccine Requirements for Older Adults

The vaccination requirements for immigration vary by age. Older adults have specific vaccine requirements that differ from those for younger applicants. For example, the pneumococcal vaccine is required for adults aged 65 and older, and the shingles (zoster) vaccine is recommended for adults aged 50 and older.

The influenza vaccine is required annually for all applicants aged 6 months and older. The civil surgeon will review the parent's vaccination records and administer any missing required vaccines. Older adults should bring all available vaccination records to their appointment.

• Pneumococcal vaccine required for adults aged 65+
• Influenza vaccine required annually for all ages
• Shingles vaccine recommended for adults aged 50+
• Hepatitis B vaccine series required for adults under 60 (unless immune)
• HPV vaccine not required for adults over 26

Senior Health Considerations

Older adults may have chronic health conditions that are relevant to the immigration medical exam. The civil surgeon will evaluate whether any conditions constitute grounds of inadmissibility under the Immigration and Nationality Act. Most chronic conditions — such as diabetes, hypertension, or heart disease — do not make an applicant inadmissible.

If a parent has mobility limitations or other accessibility needs, contact the civil surgeon's office in advance to discuss accommodations. ImmigrationMedicalExams.com is fully accessible and can accommodate patients with mobility limitations.

What to Bring to the Appointment

Parents should bring their passport or government-issued photo ID, all available vaccination records (including records from their home country), and any relevant medical records for chronic conditions. If vaccination records are not available, the civil surgeon can order titer tests to check immunity or administer vaccines as needed. Bring a list of all current medications, as the civil surgeon will review your medication history.