How Hidden Vaccine Fees Work

USCIS requires that all immigration medical exam applicants demonstrate immunity to a specific list of vaccine-preventable diseases. If your vaccination records are incomplete or if titer testing shows insufficient immunity, the civil surgeon must administer the missing vaccines before completing Form I-693.

At clinics that use à la carte pricing, vaccines are not included in the advertised exam fee. Each vaccine is billed as a separate line item, often at the clinic's standard retail rate. This means the total cost of your exam can increase significantly depending on how many vaccines you need.

Which Vaccines Are Required and What They Cost

USCIS requires proof of immunity to a range of vaccine-preventable diseases. The exact vaccines required depend on your age and vaccination history. Common vaccines that may be needed include:

• MMR (measles, mumps, rubella): $80–$150 per dose
• Varicella (chickenpox): $100–$180 per dose
• Tdap (tetanus, diphtheria, pertussis): $50–$80
• Hepatitis B series: $50–$100 per dose (3 doses)
• Hepatitis A series: $60–$100 per dose (2 doses)
• Meningococcal vaccine: $120–$200
• COVID-19 vaccine: varies

How Much Hidden Vaccine Fees Can Add Up

If you need three or more vaccines — which is common for applicants who have incomplete vaccination records or who have never received certain vaccines — the additional cost under à la carte pricing can range from $300 to $600 or more on top of the base exam fee.

This means an exam advertised at $175 could realistically cost $500 or more by the time all required vaccines are administered and billed separately.

Questions to Ask Before Scheduling

To avoid hidden vaccine fees, ask these questions before booking your appointment.

• Are vaccines included in your exam fee, or are they billed separately?
• If vaccines are billed separately, what is your per-vaccine charge?
• Do you offer a flat fee that includes all required vaccines?
• What happens if I need multiple vaccines — is there a cap on vaccine costs?

The Flat-Fee Alternative

A clinic that offers a true all-inclusive flat fee includes vaccine administration in the base price, regardless of how many vaccines you need. This eliminates the risk of hidden vaccine fees and gives you complete cost certainty before your appointment. When comparing clinics, always ask whether vaccines are included — not just whether the exam fee is low.