International Adoption: Health Guidance and the Immigration Process

For Parents: Overseas Medical Exam and Vaccinations for Your Adopted Child

Medical Exam

The medical examination process for your adopted child begins overseas with a visit to a panel physician. A panel physician is a Department of State-designated medical doctor who performs medical exams overseas for immigrants (including international adoptees), refugees, and migrants coming into the United States. Panel physicians, who are located in many countries in the world, must refer to CDC guidelines (technical instructions) on medical exams. Panel physicians are trained in the technical instructions that CDC provides.

The purpose of the overseas medical exam is to identify applicants, including adoptees, with Class A conditions. Children with these conditions must be treated or get a waiver before they can get a visa to come to the United States.

The visa medical exam differs from a normal physical that you may be used to. The visa medical exam includes:

  • a physical exam
  • a series of vaccines*
  • a screening for tuberculosis/TB (skin test/chest x-ray examination)
  • a blood test for syphilis (not routinely done for children under 15 unless there is reason to suspect infection)

*Some adopted children can receive an affidavit to have their vaccinations delayed until after they arrive in the United States. Children who receive an affidavit must receive the required vaccines once they arrive in the United States. For more information, please see the affidavit Cdc-pdf[PDF – 1 page]External.

Once the medical exam is completed, the panel physician will give you a sealed packet containing the medical exam forms. When you arrive in the United States, give the sealed packet to the Customs and Border Protection (CBP) officer. The CBP officer is an immigration official who will process your paperwork when you first enter the United States. During the medical exam, you should ask for an extra copy of the medical exam forms and give them to your child’s medical provider in the United States.

Children should also receive a medical exam once they enter the United States. For more information, please see Finding a Medical Provider in the United States.


Vaccinations are an important part of the overseas medical examination. The Immigration and Nationality Act requires that all immigrant visa applicants, including adopted children, show proof of having received certain vaccinations named in the law, as well as others recommended by the Advisory Committee on Immunization Practices, before they may be granted an immigrant visa. Vaccination requirements depend on the age of your child. The age-appropriate vaccinations your child may require can be found in the vaccination schedules for children.