Every I-693 vaccination review starts the same way: the civil surgeon asks for your written vaccination records, and if you cannot produce them, the exam gets more complicated, not less. Many applicants arrive assuming that simply telling the civil surgeon which vaccines they remember getting as a child will be enough. It will not. Before you accept a full revaccination schedule or a round of blood draws, it is worth spending a few days doing a proper records search, because a real paper trail is usually easier to find than people expect, and it saves both time and needles at your appointment.
This guide walks through the order most civil surgeons and immigration medical staff actually recommend when a vaccination record has gone missing, and what has to happen if the search comes up empty.
Why "I remember getting the shot" is not proof
USCIS requires documented proof or medical verification for each vaccine on the required list, not a verbal recollection or a signed statement describing what you believe happened decades ago. A civil surgeon cannot accept a signed affidavit alone as evidence that a vaccine was administered. That rule exists because a civil surgeon’s certification carries legal weight in your adjustment of status case, and USCIS has no way to independently confirm an applicant’s memory of a childhood clinic visit. So even a detailed, honest recollection has to be treated the same as no record at all: it does not satisfy the requirement on its own. The practical upshot is that the search for paperwork is not a formality you can skip by being persuasive at the appointment. It is the only thing that actually moves your case forward without additional vaccines or blood draws.
Where to look first: your state’s immunization registry
If you or your children ever saw a pediatrician, school nurse, or public health clinic in the United States, there is a reasonable chance the doses were logged into your state’s immunization registry, sometimes called an immunization information system. These state-run databases exist specifically so that vaccination history is not lost when a family changes doctors, insurance plans, or clinics, and many states allow adult patients or parents to request a copy of their own record directly from the state health department. This is usually the fastest and cleanest source, because the printout comes on an official form with dates, vaccine names, and administering provider, exactly the format a civil surgeon is looking for. If you were vaccinated in the U.S. as a child, checking your state registry before doing anything else is worth the phone call or online request.
Other paper trails worth chasing
A state registry will not cover everyone, especially applicants who were vaccinated overseas or before electronic registries existed. In those cases, several other sources are commonly accepted:
- School enrollment files. Most schools require proof of immunization to enroll a child, and many keep that file for years after the student leaves, sometimes permanently in the district’s archive.
- Military medical records. Anyone who served, in the U.S. or another country, typically has a service medical record that lists administered vaccines, and those files are usually retrievable through the relevant service branch or veterans’ records office.
- Foreign clinics, hospitals, and health ministries. A record from a pediatrician’s office, hospital, or national health authority abroad is acceptable, even in a language other than English, as long as it is legible and translated. The civil surgeon will need to keep the original document used for translation in your file, so bring the original, not just a translated copy.
- Employer or immigration-related medical files. If a prior visa, exchange program, or job required a health screening, that intake paperwork sometimes includes a vaccination summary you can request from the sponsoring institution.
A record does not need to be perfect to be useful. What a civil surgeon is looking for is your full name, the specific vaccine, a complete date of administration, and an identifiable provider or authority. A partial record covering some vaccines is still worth bringing, since it can narrow down what actually needs to be addressed at the exam instead of starting from zero.
When the search comes up empty
If none of the above produces anything, the exam still has two paths forward, and the civil surgeon will choose between them based on the specific vaccine in question. The first is a blood test, or titer, that checks whether you already carry immunity to certain diseases; if the result comes back positive, the civil surgeon can document that immunity on Form I-693 without giving you the vaccine again. Titer testing is commonly used for measles, mumps, rubella, varicella, hepatitis B, and polio. The second path, used when titers are not appropriate or not conclusive, is simply receiving the missing, age-appropriate vaccines during or shortly after the exam. Either way, this decision is a separate step from the records search covered here, and it is worth discussing directly with your civil surgeon once you know exactly which records you were and were not able to recover.
Building the file you bring to your appointment
Once you have gathered whatever records exist, organize them by vaccine before your appointment rather than handing over a loose stack of documents. Note which vaccines you have full documentation for, which you have partial or ambiguous documentation for, and which have no record at all. This lets the civil surgeon focus the visit on exactly the gaps that remain, instead of treating your entire vaccination history as unknown. If you obtained any vaccines from an outside provider while trying to fill in gaps ahead of time, bring that proof as well; the civil surgeon still has to review and document it as part of the same I-693.
A missing vaccination record feels like a dead end the first time you’re asked for one, but for most applicants it turns out to be a solvable research problem rather than an automatic trip to the needle. Working through registries, schools, military files, and foreign providers before your I-693 exam is the difference between a fast appointment and one that starts with a long conversation about what has to happen next.