Why Titer Tests Matter for Your I-693 Medical Exam

NOTE: TITER TESTS MUST BE ORDERED BY YOUR CIVIL SURGEON. TESTS DONE OUTSIDE OF THE PROCESS ARE NOT VALID FOR IMMIGRATION MEDICAL PURPOSES.

Applying for a U.S. green card involves several crucial steps, one of which is completing the Form I-693 immigration medical examination. This exam, conducted by a USCIS-designated civil surgeon, ensures that applicants do not pose a public health risk to the United States. A key component of the I-693 exam is verifying your vaccination status, particularly for vaccine-preventable diseases like measles, mumps, and rubella (MMR), and Hepatitis B and Varicella (Chickenpox). But what happens if you’ve lost your childhood immunization records or never had access to them in the first place? Fortunately, there’s an alternative to re-vaccination: titer testing.

What Are Titers?

A titer test is a type of blood test that checks for the presence of antibodies, which are proteins your immune system produces in response to infections or vaccinations. 

Why Titers Are Important for the I-693 Immigration Medical Exam

The U.S. Citizenship and Immigration Services (USCIS) has strict vaccination requirements for green card applicants. The MMR, Hepatitis B, and Varicella vaccines are mandatory for most applicants unless an applicant can provide acceptable proof of prior immunization.

Here’s why opting for a titer test can be beneficial:

Avoid Unnecessary or Redundant Vaccines

If you’re already immune, receiving another dose of vaccine is not medically necessary. Titer tests help you avoid duplicate vaccinations, which may come with potential side effects or complications.

Safer for Pregnant Women and Those Planning Pregnancy

The MMR and Varicella vaccines are not recommended during pregnancy due to theoretical risks to the fetus. Women of childbearing age, especially those who are pregnant or planning to conceive soon, can benefit greatly from titer testing. It allows them to determine immunity without being exposed to a live vaccine unnecessarily.

When Should You Consider Titer Tests?

There are several scenarios where titer testing is a smart, proactive choice during the green card medical exam process:

• You’ve Lost Your Immunization Records: If you no longer have access to your childhood vaccination history, a titer test can fill the gap.
• You’ve Had a Previous Infection: Maybe you had measles, mumps, or rubella as a child but don’t have medical documentation to prove it. A titer test can confirm your natural immunity.
• You Know You Were Vaccinated, But Can’t Prove It: Titer testing allows you to confirm immunity without restarting the vaccination series.
• You Have Medical Conditions That Make Additional Vaccines Risky: If you have problems with your immune system, allergies, or concerns about vaccine interactions or safety, titers offer a logical alternative.
• You Want to Minimize Shots: Some applicants simply prefer to limit how many vaccines they receive during the I-693 process. Titer tests may help reduce that number.

What to Expect During the Titer Testing Process

The titer test is a quick, routine blood draw that can usually be completed in a few simple steps:

1. The Blood Draw: Almost all applicants will require blood testing anyway. The additional blood  needed for titer testing may be drawn with the same jab.
2. Positive Results Mean No Further Action: If your titer shows a sufficient level of antibodies, no vaccination is required for that disease. The civil surgeon will note this on your I-693 form.
3. Negative Results Require Vaccination: If one or more results are negative—meaning you’re not immune—you’ll need to receive the vaccine in question to comply with USCIS guidelines. The civil surgeon will guide you through the next steps. Note that you must have positive immunity to all three viruses in the MMR vaccine in order to avoid the MMR.

Conclusion

Titer testing for measles, mumps, and rubella, and Hepatitis B and Varicella is a logical option for completing the I-693 medical exam process, especially if you lack vaccination records or want to avoid unnecessary shots. 

Stay proactive and ahead of the process by scheduling your medical exam with Dr. Steven Wittenberg Gordon, an expert & trusted civil surgeon who will help guide you through every step of the process.