Birth Certificate Related

[kd2008]

Be careful about when you get your vaccination shots and do your TB test.

http://www.cdc.gov/vaccines/recs/vac...-guide-508.pdf

Goto page 14, Note 52:

Note 52:Measles vaccination may temporarily suppress tuberculin reactivity. MMR vaccine may be given after, or on the same day as, TB testing. If MMR has been given recently, postpone the TB test until 4-6 weeks after administration of MMR. If giving MMR simultaneously with tuberculin skin test, use the Mantoux test, not multiple puncture tests, because the latter, if results are positive, require confirmation (and confirmation would then have to be postponed 4-6 weeks).

Don't be penny wise pound foolish to skimp a few bucks out your pocket and get the vaccination reimbursed through insurance. The civil surgeon in my town said they won't file and deal with insurance claim. If I get the shots done with my primary physician then they are not responsible if the medical report they write is incomplete etc.

If your PD is long ways away from being current, then I guess this is not an issue.

[28thJune2007]

All you need is proof that vaccination is given to you. Even if you have it from India, It would work. I am talking from personal experience. I just got my form I 693 done.

I have one question for the Guru's or anyone else who may have noticed this:

I have varicella history. MY doctor asked me the age when I had it. In the form he put VH but also a date in the date received column as (01/01/1988, 1988 is birth year plus the age I had varicella). When I asked the assistant she said the system automatically generate this date. Did anyone else also had the same experience. I thought they just need to put VH.

[soggadu]

Here's my plan of action. I have verified from a friend that this will work. I am all set with part 1 for myself and family.

1) Go to your primary physician (covered by your company/personal insurance) and tell him/her to do a blood test to check the titers for the MMR, etc. Based on the blood report,if the doctor finds that you really need the vaccines, you can take the vaccine in his/her office. This is COVERED by insurance since he/her is primary physician and NOT the civil surgeon. So no need to go to county hospital etc for cheap vaccines. Get a note from doctor that you have been given these vaccines on that particular date. Also, keep a copy of blood report. Once you get these you are set, there is no time limit/expiration for these reports.

2) When you are ready to apply for 485, call the civil surgeon office to book an appt. Let them know that you have proof of vaccinations. Your bill from the civil surgeon will be considerably reduced since you already have the proof that you have all required vaccinations. If the surgeon insists that you need to do another blood report for titers,etc or if he insists on giving you vaccines again then he is a crook. Better avoid.

thank you hopeful bhai...can you please tell in detail what i need to ask my primary physician ( check the titers for the MMR, etc? ) is this question ok? or anything else needed? please spoon feed me on this one...

[28thJune2007]

1988 is my Year of birth + Age I got Varicella

[Monica12]

All you need is proof that vaccination is given to you. Even if you have it from India, It would work. I am talking from personal experience. I just got my form I 693 done.

I have one question for the Guru's or anyone else who may have noticed this:

I have varicella history. MY doctor asked me the age when I had it. In the form he put VH but also a date in the date received column as (01/01/1988, 1988 is birth year plus the age I had varicella). When I asked the assistant she said the system automatically generate this date. Did anyone else also had the same experience. I thought they just need to put VH.

Yes, I agree with this.. If your vaccination records are from India..it will work. I remember submitting some records from my Doc in India

[nishant2200]

I just called up a civil surgeon office, told them I don't have any vaccination records and they told me that:
- once you setup appointment, the first day they will do physical exam (damn I remember those from school days... ouch), TB skin test, and blood work. The blood work will include finding out what vaccines I might need.
- After two days, I go back to office, they see the TB results on my skin, as well as they get the blood work results. The doctor further can proceed on what I need to do based on these.

He quoted me 250 dollars, plus additional for X-ray or vaccinations. How much for that, they said, once you are into this, you can talk with doctor.

She was asking if I could come on this wednesday, and I had to regretfully tell her, not yet

[gchopeful123]

Hey Soggadu,
Based on the information I have, for our age category we need the MMR, TDAP and Varicella titers. If you have these within your blood, you dont need a vaccine. If not, then you need to take the vaccine. I am sure abt these 3, not sure if more are required recently. Maybe someone who has done their immigration medical with the civil surgeon recently mention if more are needed.

EDIT: Did some googling and found this: http://www.cdc.gov/immigrantrefugeeh...tructions.html
Particularly, look at the example : "For example, if the applicant is 35 years of age, then he or she is required to receive tetanus and diphtheria toxoids vaccine (Td) or diphtheria and tetanus toxoids and acellular pertussis antigen vaccine (Tdap), MMR, and varicella (if no history of varicella disease)."

Also -
"The civil surgeon may refer the applicant to another health-care provider to have the required vaccinations administered. In such a case, the civil surgeon must not complete the form until the applicant returns with a written record from the referral health-care provider that notes the vaccines administered and the dates of administration."

The table on this site is very useful for undertstanding what is applicable for our age category:

http://www.drmones.com/miamiimmigrationdoctor.html

thank you hopeful bhai...can you please tell in detail what i need to ask my primary physician ( check the titers for the MMR, etc? ) is this question ok? or anything else needed? please spoon feed me on this one...

Here's my plan of action. I have verified from a friend that this will work. I am all set with part 1 for myself and family.

1) Go to your primary physician (covered by your company/personal insurance) and tell him/her to do a blood test to check the titers for the MMR, etc. Based on the blood report,if the doctor finds that you really need the vaccines, you can take the vaccine in his/her office. This is COVERED by insurance since he/her is primary physician and NOT the civil surgeon. So no need to go to county hospital etc for cheap vaccines. Get a note from doctor that you have been given these vaccines on that particular date. Also, keep a copy of blood report. Once you get these you are set, there is no time limit/expiration for these reports.

2) When you are ready to apply for 485, call the civil surgeon office to book an appt. Let them know that you have proof of vaccinations. Your bill from the civil surgeon will be considerably reduced since you already have the proof that you have all required vaccinations. If the surgeon insists that you need to do another blood report for titers,etc or if he insists on giving you vaccines again then he is a crook. Better avoid.

[gchopeful123]

Hey Nishant,

Based on what KD2008 mentioned here, it is better to get the vaccinations done by primary physician well in advance instead of waiting till the last moment.

Be careful about when you get your vaccination shots and do your TB test.

http://www.cdc.gov/vaccines/recs/vac...-guide-508.pdf

Goto page 14, Note 52:

Note 52:Measles vaccination may temporarily suppress tuberculin reactivity. MMR vaccine may be given after, or on the same day as, TB testing. If MMR has been given recently, postpone the TB test until 4-6 weeks after administration of MMR. If giving MMR simultaneously with tuberculin skin test, use the Mantoux test, not multiple puncture tests, because the latter, if results are positive, require confirmation (and confirmation would then have to be postponed 4-6 weeks).
Don't be penny wise pound foolish to skimp a few bucks out your pocket and get the vaccination reimbursed through insurance. The civil surgeon in my town said they won't file and deal with insurance claim. If I get the shots done with my primary physician then they are not responsible if the medical report they write is incomplete etc.

If your PD is long ways away from being current, then I guess this is not an issue.

I just called up a civil surgeon office, told them I don't have any vaccination records and they told me that:
- once you setup appointment, the first day they will do physical exam (damn I remember those from school days... ouch), TB skin test, and blood work. The blood work will include finding out what vaccines I might need.
- After two days, I go back to office, they see the TB results on my skin, as well as they get the blood work results. The doctor further can proceed on what I need to do based on these.

He quoted me 250 dollars, plus additional for X-ray or vaccinations. How much for that, they said, once you are into this, you can talk with doctor.

She was asking if I could come on this wednesday, and I had to regretfully tell her, not yet

[soggadu]

I just called up a civil surgeon office, told them I don't have any vaccination records and they told me that:
- once you setup appointment, the first day they will do physical exam (damn I remember those from school days... ouch), TB skin test, and blood work. The blood work will include finding out what vaccines I might need.
- After two days, I go back to office, they see the TB results on my skin, as well as they get the blood work results. The doctor further can proceed on what I need to do based on these.

He quoted me 250 dollars, plus additional for X-ray or vaccinations. How much for that, they said, once you are into this, you can talk with doctor.

She was asking if I could come on this wednesday, and I had to regretfully tell her, not yet

I just read the last line and was thinking yaaa why not..... :-):-)

on a serious note, why don't we follow what hopeful bhai have suggested and go through primary doc..... Would be free right...

hey N.... amour pd is in n for NOVEMBER right?..

[gchopeful123]

Yes - it is free. Fully covered by insurance with the primary physician (Disclaimer: Check with your insurance first. I had confirmed with them before going to the clinic). Also, have a look at my previous 2 posts above, made some edits/updates.

I just read the last line and was thinking yaaa why not..... :-):-)

on a serious note, why don't we follow what hopeful bhai have suggested and go through primary doc..... Would be free right...

hey N.... amour pd is in n for NOVEMBER right?..

I just called up a civil surgeon office, told them I don't have any vaccination records and they told me that:
- once you setup appointment, the first day they will do physical exam (damn I remember those from school days... ouch), TB skin test, and blood work. The blood work will include finding out what vaccines I might need.
- After two days, I go back to office, they see the TB results on my skin, as well as they get the blood work results. The doctor further can proceed on what I need to do based on these.

He quoted me 250 dollars, plus additional for X-ray or vaccinations. How much for that, they said, once you are into this, you can talk with doctor.

She was asking if I could come on this wednesday, and I had to regretfully tell her, not yet

[soggadu]

moderators can you please collect the posts of gchopeful and create a new thread for it.... Very useful information to get vaccines from your primary physician....

[nishant2200]

Sounds very reasonable, although I would say then that we should ask the primary care physician also to do the blood work first to find out which vaccines we really need. I am thinking that it might be bad for health if we take double vaccine at this age. Also the civil surgeon may know certain caveats about the timing of the vaccines which the primary care physician would not, I am just throwing out my nervous theories here, since the dates may go back after a month, and you really need to do everything in the one month your dates are current.

Jonty Rhodes, and other physicians in the house, guys, let us know your thoughts or input.

Hey Nishant,

Based on what KD2008 mentioned here, it is better to get the vaccinations done by primary physician well in advance instead of waiting till the last moment.

[makmohan]

Refer to the following link for details.
http://www.uscis.gov/portal/site/usc...0045f3d6a1RCRD
The exam results are valid for a year only but the vaccination record should really be valid forever.

Mohan pyaare... imho, you need to get vaccines just once unlike flu shots and maintain the records. When u r ready for 485, submit it to your doc... also the doc will know from your initial blood work... so no tensions...hey good luck in school...ek din tum jaroor collector banoogeeeeeeee.....

Thanks very much, Teddy and Suggadu. As always you are very helpful!

[gchopeful123]

Agreed. I had meant that - get vaccinations done from PP only if you need them based on blood report (refer Part 1 from my original post on this topic). In any case, since the day I have completed Part 1, I am very relaxed. One more item checked off. My PD is Sep 2007, so never know when my day would come to file. The lesser things to worry about, the better. In fact, I would suggest everyone with PD 2007 date to get started on this. Not sure abt other states, luckily in NJ, most primary physicians are available on weekends

Not sure what you mean by caveats though. All they need is a proof that you are immune/had vaccines for MMR,Tdap, Varicella. This can be from any date/location (records from your childhood in home country, recently adminstered in US,etc). Once you provide the proof, the civil surgeon has to accept them.

Sounds very reasonable, although I would say then that we should ask the primary care physician also to do the blood work first to find out which vaccines we really need. I am thinking that it might be bad for health if we take double vaccine at this age. Also the civil surgeon may know certain caveats about the timing of the vaccines which the primary care physician would not, I am just throwing out my nervous theories here, since the dates may go back after a month, and you really need to do everything in the one month your dates are current.

Jonty Rhodes, and other physicians in the house, guys, let us know your thoughts or input.

Hey Nishant,

Based on what KD2008 mentioned here, it is better to get the vaccinations done by primary physician well in advance instead of waiting till the last moment.

[nishant2200]

This part is confusing. Teddy's link says the exam is valid for 12 months. So can someone just get it done and get the sealed envelope right now, and apply 4 months later when he gets current.

Sounds very reasonable, although I would say then that we should ask the primary care physician also to do the blood work first to find out which vaccines we really need. I am thinking that it might be bad for health if we take double vaccine at this age. Also the civil surgeon may know certain caveats about the timing of the vaccines which the primary care physician would not, I am just throwing out my nervous theories here, since the dates may go back after a month, and you really need to do everything in the one month your dates are current.

Jonty Rhodes, and other physicians in the house, guys, let us know your thoughts or input.

[gchopeful123]

Let's not confuse the 12-month validity with the vaccination validity. There is no expiration for the vaccinations adminstered. The 12-month expiration applies only for the civil surgeon report.

But to answer your question, yes - you are very much entitled to do that. The civil surgeon in my area provides appointments immediately so it's not much of an issue for me. But yes, if your civil surgeon does not provide immediate appts, it would be prudent to get this done before hand, as long as you are reasonably sure that your dates would be current within the next year.

This part is confusing. Teddy's link says the exam is valid for 12 months. So can someone just get it done and get the sealed envelope right now, and apply 4 months later when he gets current.

Sounds very reasonable, although I would say then that we should ask the primary care physician also to do the blood work first to find out which vaccines we really need. I am thinking that it might be bad for health if we take double vaccine at this age. Also the civil surgeon may know certain caveats about the timing of the vaccines which the primary care physician would not, I am just throwing out my nervous theories here, since the dates may go back after a month, and you really need to do everything in the one month your dates are current.

[Monica12]

umm.. another thought...make the appointment with Civil surgeon if it's hard to get one and you can always cancel it later if dates don't become current..he is not going to charge you

[Monica12]

Hey Soggadu,
Based on the information I have, for our age category we need the MMR, TDAP and Varicella titers. If you have these within your blood, you dont need a vaccine. If not, then you need to take the vaccine. I am sure abt these 3, not sure if more are required recently. Maybe someone who has done their immigration medical with the civil surgeon recently mention if more are needed.

EDIT: Did some googling and found this: http://www.cdc.gov/immigrantrefugeeh...tructions.html
Particularly, look at the example : "For example, if the applicant is 35 years of age, then he or she is required to receive tetanus and diphtheria toxoids vaccine (Td) or diphtheria and tetanus toxoids and acellular pertussis antigen vaccine (Tdap), MMR, and varicella (if no history of varicella disease)."

Also -
"The civil surgeon may refer the applicant to another health-care provider to have the required vaccinations administered. In such a case, the civil surgeon must not complete the form until the applicant returns with a written record from the referral health-care provider that notes the vaccines administered and the dates of administration."

The table on this site is very useful for undertstanding what is applicable for our age category:

http://www.drmones.com/miamiimmigrationdoctor.html

Tetanus is good to get even if you are less than 35 yrs old ( just in case you are walking bare-feet and get an old nail in your foot LOL!)...when I had submitted mine I was much younger than 35, still got it then I wonder now if the doc had asked me to get it ( I am %*&% scared of shots, so he probably did).

Check with the civil surgeon before making the appointment if he will give you all the req vaccinations. In most cases, they do and dont think there will be a need to go to another doc for them.

The only time there will be a need to go to another office is if one tests positive for TB skin test (PPD). In this case, an x-ray will be needed to rule out TB. This happens to lots of Indians, as in India it's very common to get exposed to someone who has TB at some some points in our lives. So, dont panic if you wake up with a huge red rash on your arm after the TB skin test . It's just tuberculin working it's magic

Also, tetanus shots are valid for 5 yrs , I think.

[chikitsak]

Tetanus shot has to be within the last 10 hears. Some people are allergic to PPD antigen and they can get a TB spot test which is a blood test. If any of these are positive then you need to get a Chest Xray and "start" Anti-tuberculosis treatment if the chest X ray has any blemishes. Also a Blood test for syphilis is done.

If you are not sure of your vaccination or do not have the record, blood test can be done to determine whether you need the vaccine or not..... alternatively you can just get the vaccine. Of course all this is much cheaper if you can get this done through your PCP in prep for the civil surgeon. All except the Syphilis test and the TB spot test.

[rinku1112]

Guys,

I just want to share my experience with Immigration Physicals as I see some discussion about which vaccines to take. I went to the closest civil surgeon listed on USCIS website after recent VB was out.

Basically they asked me to get the following done:

1) Tetanus immunization. - $48
2) MMR immunization. - $80
3) TB skin test. - $20
4) Blood work to determine there is no Syphilis. - $12
5) Physical exam. - $140

All other vaccines (polio, rotavirus, etc...) except Varicella vaccine are not needed for a typical EB immigrant age group and not needed. In case (3) is positive then a chest x-ray is needed, and probably some other tests that cost more... but I don't have this experience to comment.

Note: If you had Chicken Pox (most Indian kids do) in childhood then mention this as a verbal confirmation will eliminate requirement for taking Varicella vaccine, else this will be administered as well - cost is $41. All costs are per person.

The CS office did not accept insurance but my employer foot the bill for us. No harm in checking with your employer if they will foot the above cost. The prices above may vary by state/region in US (I am in south), but still cost of $1000/$2000 as some mentioned earlier on this thread for this sounds too much. Also in most cases your employer will foot this bill.



Cheers

[Monica12]

Tetanus shot has to be within the last 10 hears. Some people are allergic to PPD antigen and they can get a TB spot test which is a blood test. If any of these are positive then you need to get a Chest Xray and "start" Anti-tuberculosis treatment if the chest X ray has any blemishes. Also a Blood test for syphilis is done.

If you are not sure of your vaccination or do not have the record, blood test can be done to determine whether you need the vaccine or not..... alternatively you can just get the vaccine. Of course all this is much cheaper if you can get this done through your PCP in prep for the civil surgeon. All except the Syphilis test and the TB spot test.

For general purposes, tetanus is valid for 10 yrs but for immigration purposes, it's 5 yrs ( unless this rule changed in the last many yrs)

[Monica12]

Rinku, chikitsak..great info!

[GCDespo]

Nishant, Did you try your school for any records?

This weekend I went for physical and they chared 235 $ for the examiniation fee and DDP. All the vaccinations records from my earlier check up are used.So no additional fee charged for the vaccinations

Passed the TB test and got the paper work today.

[soggadu]

Nishant, Did you try your school for any records?

This weekend I went for physical and they chared 235 $ for the examiniation fee and DDP. All the vaccinations records from my earlier check up are used.So no additional fee charged for the vaccinations

Passed the TB test and got the paper work today.

despo bhai...please tell me how I can get records from my us university...

[nishant2200]

No one understood on phone. The university is like 40 miles away drive with heck lot traffic. I will just let the doctor do the bloodwork to find what vaccines needed.

Nishant, Did you try your school for any records?

This weekend I went for physical and they chared 235 $ for the examiniation fee and DDP. All the vaccinations records from my earlier check up are used.So no additional fee charged for the vaccinations

Passed the TB test and got the paper work today.