Recent changes to United States immigration law now require immigrant visa applicants toobtain certain vaccinations (listed below) prior to the issuance of an immigrant visa. Panelphysicians who conduct medical examinations of immigrant visa applicants are nowrequired to verify that immigrant visa applicants have met the new vaccinationrequirement, or that it is medically inappropriate for the visa applicant to receive one ormore of the listed vaccinations:

-- mumps
-- measles
-- rubella
-- polio
-- tetanus and diphtheria toxoids
-- pertussis
-- influenzae type b (Hib)
-- hepatitis B
-- varicella
-- pneumococcal and
-- influenza.

In order to assist the panel physician, and to avoid delays in the processing of an immigrantvisa, all immigrant visa applicants should have their vaccination records available forthe panel physician's review at the time of the immigrant medical examination. Visaapplicants should consult with their regular health care provider to obtain a copy of theirimmunization record, if one is available. If you do not have a vaccination record, thepanel physician will work with you to determine which vaccinations you may need to meetthe requirement. Certain waivers of the vaccination requirement are available upon therecommendation of the panel physician.

Only a physician can determine which of the listed vaccinations are medically appropriate for you, given your age, medical history and current medical