I-693 and Immunizations
 

Hi All,

I am British and have been living in the USA for the past 4.5 years under an L1-B and my wife is Thai and has been here on L2 since September 2019.

Current Status

Our I94s expire in the middle of May and the PEDs on our visas are also mid May. Fragomen have applied for L1/2 extensions and an EAD for my wife to recapture time spent outside the USA which will (if approved) take us to April 2021. Our I485s were filed back in February along with I131 and I765 and we both have received our combo cards.

Question

Today, We both received an initial RFE from USCIS. The RFE is looking for the I693. Does anyone know where or hot to go about getting my immunization records please? I've had all the childhood immunizations and the BCG when I was at school in the UK, I also had some Hepatitis and Yellow fever jabs when I was travelling to Africa in 90s. I checked online and am going to call up my last GP from the UK (in 2012) and see if they give me access to my records. Is the UK NHS IT system all joined up and connected so that all my immunizations at different surgeries/ school etc can be viewed in one place please?

Does anyone know the rough cost of immunizations here in the USA please and are they shots covered by insurance?

Thanks,

Re: I-693 and Immunizations
 

Re the cost and possibility of coverage, I suggest you ask your insurer. No one knows what coverage you have and policies differ widely.

Re: I-693 and Immunizations
 

I got my I-693 done back in 2010 at a place that specialized in them. The office was right across the road from the USCIS office in downtown Manhattan. I only had very old records as well, and was not able to get the records I needed in English because I was not born in the UK. For most the doctor ticked the waiver “ not age appropriate” for Td and MMR it was easier to get a booster than get the records. I think it was maybe $450 or so for the whole thing, maybe $300 for the exam and another $150 for the booster shots. I just expensed it all since it was faster to do it there on the day and it was “visa” related rather than a true healthcare thing.

https://www.greencardmedicalexam.com...at-our-office/

for travel to India I needed extra shots, and got them all done at Passport Health:
https://www.passporthealthusa.com/

A place like that may be an option to get immunizations if your doctor can’t do it, but may be closed right now.

Re: I-693 and Immunizations
 

Where are you located? You need to find a Civil Surgeon (the ones authorised to complete and sign your I693) and talk to them about what they are happy to accept from you. My (EU) spouse and I did not have any immunisation records but guestimated when we would have had the necessary ones and she was totally happy with that, noting that as EU citizens we would have been subject to most of the required vaccinations. The only ones we *had* to do were syphilis test and TB test (do the quantiferon test rather than the prick test as, if you've had the BCG, you'll probably show a false positive and be required to do an Xray). Our insurance covered all of the tests.

Re: I-693 and Immunizations
 

This is pretty much what we did when we had our physical for adjusting status to LPR, but knew we had not had the MMR so chose to have that and had our Tdap boosters too, as we were sure they were overdue. Steveq and I had the quantiferon test for TB but our son just had the skin test as he had not had the BCG. Again for us our insurance covered the tests and jabs.

Re: I-693 and Immunizations
 

Thankyou everyone for taking the time to respond.

We are about 20 miles north of Charlotte, NC. I did take a look here earlier today - https://my.uscis.gov/findadoctor. It suggested this outfit - Carolina Passport Health, PLLC. I tried calling but no answer I'll try again tomorrow. Thanks again.

Re: I-693 and Immunizations
 

You should be able to get this from your NHS doctor in the UK.
However - My NHS UK medical records had been destroyed by the time I needed to show all vaccinations so I took the I693 to my US GP. We did a mix of titers to show current immunisation status and boosters. It didn't cost me anything since immunisations were covered 100% by our health insurance.
If you go to the civil surgeon, ask about the cost of getting this done before making appointments.

Re: I-693 and Immunizations
 

The NHS might have some of your records but they certainly won't have your wife's Thai health records.

The immunization chart and the vaccinations required NOW are based on where you lived as a child and your current age. Being that you are a UK Citizen and raised in the UK, it is assumed by the USCIS panel doctor that you have had the required immunizations that children who attend school normally have and might only need the booster shots. Your wife might need many more than you.

Go to the panel doctor, bring whatever records you have or can get, and they will tell you what you need.

If you already know what you need, get them from your own doctor and get the paperwork from the office showing that you have had them and give that to the panel doctor.

Re: I-693 and Immunizations
 

The NHS might - no - the NHS WILL have his medical records. They might make a charge for providing them.
https://www.bma.org.uk/advice-and-su...health-records
"England, Wales, and Northern Ireland Retain for 10 years after death.
Electronic patient records (EPRs) must not be destroyed, or deleted, for the foreseeable future.
Scotland For the patient's lifetime and 3 years after the patient's death.
Electronic patient records (EPRs) must not be destroyed, or deleted, for the foreseeable future"

Our civil surgeon required proof of having had all vaccinations - and the report from our GP was needed.
This is noted on the instructions for form i693 , page 9:
"9. What are the health-related grounds of inadmissibility?
U.S. immigration law divides the health-related grounds of inadmissibility into the following four general categories:
A. Communicable diseases of public health significance;
B. Lack of proof of having received required vaccinations;
C. Physical or mental disorders with associated harmful behavior or a history of associated harmful behavior;
and D. Drug abuse or addiction "

We left Scotland in 2002 - our records had not been digitized at that point and were automatically destroyed after being unused for 10 years. Records are now digitized and subject to GDPR guidelines.

Re: I-693 and Immunizations
 

I applied for my vaccination record with the NHS back in the UK. The email address is -

[email protected]

I got this response -

================================================== =====================
Good morning,

Thank you for your email.

Unfortunately, we are not able to action your request as our system shows that you are still registered with a General Practitioner. We are only able to action requests for unregistered patients. To request access to your GP medical records you will need to contact the surgery that you last registered with.

If you have any further questions, please do contact us.

Kind regards

Access Requests Team
Primary Care Support England
Delivered on behalf of NHS England by Capita
Email: [email protected]
Customer Support Centre: 0333 014 2884
Address: Primary Care Support England, 3 Caxton Road, Fulwood, Preston, PR2 9ZZ
Website: www.pcse.england.nhs.uk

================================================== =====================

I contacted my GP and they had no record of my vaccination either.

With no vaccination record for either my wife or I, I booked the I693 appointment at Passport Health at Charlotte. We went to the appointment today, we were asked a question about alcohol and whether we had both had Chickenpox (affirmative answer).

We were both given a Tetanus, The MMR jab, had blood drawn and gave urine samples. That was it and I can pick up the sealed dociument and a copy for us early next week.

$1294 - Bargain :o

Re: I-693 and Immunizations
 

$1294 for both of you I hope!
That's why we went back to our own Dr here to get the titers/jabs done - it's completely free with health insurance. Our GC medicals cost us $250 each.

Re: I-693 and Immunizations
 

The $1294 was in total for both of us.

Something like $399 for the visit + testing fees + vaccinations bought it up to $647 each. Had it not been for Covd-19, I would have done what you did.

Re: I-693 and Immunizations
 

I agree with the above, when I went to get my medical done by an approved civil surgeon, he advised me that the lack of documentation for a few immunizations would be an issue. They did not accept any insurance. He offered to provide the immunizations at a substantial charge, but advised me given I had good insurance coverage that he'd happily write a script for the vaccinations and to go have it done at my local CVS minute clinic, then drop by my records. Total cost for them ended up being $0 vs $500 or so out of pocket. (Plus the $300 or so for the exam, if I recall)

Re: I-693 and Immunizations
 

The other half and I asked our family doctor practice for any immunization history record. One of us has none, the other has 6 recorded vaccines.

I don’t know what it will look like when we get mine here in the US. I looked up what is used as the detail behind I-693 for vaccines. I found the CDC document, “Vaccine Requirements According to Applicant Age”

So for anyone 18-64 years of age you need:

Tetanus/Diptheria (Td) or Tetanus/Diptheria/Pertussis (Tdap)

plus

MMR (measles, mumps, rubella)

plus

Varicella (chickenpox)

plus (if in season)

Influenza


Walmart’s Pharmacy is great value and the pharmacist printed me a docket to show these are now “done” so no need to worry about the historical records now.

Onto the next part… 3 tests:

Blood test for QuantiFERON-TB (IGRA - interferon gamma release assay) which has CPT Code 86480

Blood test for Syphilis - serologic with CPT Code 86592

Urine lab test for Gonorrhea - CPT Code 87491


The first two (bloods) are likely seen as preventative 1 time a year tests covered by insurance. The urine test is not.

I’ve seen advice on sites saying get your vaccines done and do the same for these tests ahead of your medical exam to save time/cost. I can see it may be a cost saver.

Did you do the blood and urine test before your medical and get a results print to take with you to the US CIS medical exam? How did you organize it? I tried Quest Diagnostics today. I got an appointment for us next week but they won’t let me order the tests using my insurance.

I also went to Care Now which is a PPO in network for my insurance. It seems like my insurance will cost us a copay each of ~$70 and then they will bill the insurer and we “should” only be asked to pay for the Gonorrhea test. Probably around $200 each total.

Incidentally, for people looking at this thread in the future… I noticed most places want to lump Chlamydia (CPT code 87591) in with the Gonorrhea test, and it is not necessary for I-693.

if anyone has any additional advice/costs info, please share!


ps… The MMR vaccine stings when they give it. Thankfully the pharmacist warned me before it. He said the varicella would sting too, but it was mild in comparison. The tetanus, and previously flu, and the Covid vaccine were a walk in the park compared to that MMR thing!!

Re: I-693 and Immunizations
 

This is the document Civil Surgeons are provided with for this work.

https://www.cdc.gov/immigrantrefugee...licant-Age.pdf