The immigration blood test is not a general health panel. It screens for three specific conditions that USCIS considers relevant to public health admissibility: tuberculosis, syphilis, and gonorrhea. Each test has its own age requirement, its own methodology, and its own set of possible outcomes. Understanding what gets drawn, why, and what happens next removes most of the uncertainty from the process.
If you are in the Tampa Bay area, your immigration health exam in Tampa at Medical Exams of Tampa includes all required blood tests as part of the appointment. The QuantiFERON-TB Gold draw is included in the base exam fee.
Which blood tests are required and for whom?
Three blood tests are part of the immigration medical examination, each with a different age threshold:
- Tuberculosis (QuantiFERON-TB Gold or T-SPOT): required for all applicants age 2 and older
- Syphilis (RPR): required for all applicants age 15 and older
- Gonorrhea: required for all applicants age 15 and older
Children under 2 are not tested for TB by blood draw. Children under 15 are not tested for syphilis or gonorrhea. These thresholds are set by CDC Technical Instructions and applied uniformly by every civil surgeon in the country.
The tuberculosis blood test: QuantiFERON-TB Gold explained
Since October 2018, USCIS no longer accepts the tuberculin skin test (TST) as a TB screening method for immigration purposes. The only accepted method is an interferon-gamma release assay (IGRA), either the QuantiFERON-TB Gold or the T-SPOT.TB blood test. Both work by measuring the immune system’s response to TB proteins in a blood sample drawn at the civil surgeon’s office.
The shift away from the skin test was deliberate. Many foreign-born applicants received the BCG vaccine as children, a TB immunization common outside the United States. The BCG vaccine frequently causes false positive results on the tuberculin skin test, which led to unnecessary follow-up chest X-rays and delays. The blood-based IGRA tests are not affected by prior BCG vaccination, making them far more reliable for this population.
The blood draw itself takes a few minutes. Results typically return within 24 to 72 hours, which is why most civil surgeon offices complete the blood draw at a first visit and schedule the physician sign-off for a second appointment once all results are in.
What happens if the TB blood test comes back positive
A positive QuantiFERON result does not mean you have active tuberculosis and does not automatically make you inadmissible. It means your immune system has responded to TB proteins, which can indicate either active disease or latent TB infection.
The next step after a positive blood test is a chest X-ray. The X-ray determines whether there is evidence of active pulmonary tuberculosis. Two outcomes are possible:
Positive blood test, normal chest X-ray: this indicates latent TB infection. Latent TB means the bacteria are present in the body but inactive. Most people with latent TB have no symptoms and are not contagious. This is classified as a Class B condition on Form I-693. It does not make you inadmissible, but the civil surgeon must report the finding to the local health department. You are not required to complete treatment before your application is approved, though treatment is strongly recommended.
Positive blood test, abnormal chest X-ray: this may indicate active tuberculosis, which is a Class A condition and a ground of inadmissibility. Active TB requires referral to a health department and completion of treatment before the civil surgeon can certify you. Once treatment is documented and complete, the civil surgeon can clear the condition and finalize Form I-693.
The syphilis test: why you cannot use a recent result from another doctor
The civil surgeon screens for syphilis using a rapid plasma reagin (RPR) test, which detects syphilis antibodies in the blood. One important rule that catches many applicants off guard: the civil surgeon cannot use RPR results from any other provider, no matter how recent. Even if you had a syphilis test done at your primary care doctor last week, the civil surgeon must order and receive their own result. This is a CDC requirement, not a clinic policy.
A reactive RPR result triggers a confirmatory test. If syphilis is confirmed and active, it is a Class A condition requiring treatment before Form I-693 can be completed. Treated syphilis with documented cure does not affect admissibility.
The gonorrhea test
Gonorrhea testing is required for all applicants 15 and older. Like the syphilis test, it must be ordered by the civil surgeon directly and cannot be replaced by results from another provider. A positive result indicates active infection, which is a Class A condition. Treatment clears the condition and the civil surgeon can proceed once it is documented.
Do you need to fast before the blood draw?
No fasting is required before the immigration blood draw. The tests screen for infectious disease markers, not metabolic values like glucose or cholesterol. You can eat and drink normally before your appointment. There are no restrictions on medications either, unless the civil surgeon advises otherwise based on a specific finding during the physical exam.
What a Class A vs Class B finding means for your application
The civil surgeon classifies findings from the blood tests into two categories that USCIS uses to determine admissibility.
A Class A condition (active TB, untreated syphilis, active gonorrhea) makes you inadmissible. Your application cannot be approved until the condition is treated and the civil surgeon documents the resolution on Form I-693. This does not mean your application is denied permanently. It means it is paused until treatment is complete.
A Class B condition (latent TB, past syphilis with documented treatment, other findings that are not immediately disqualifying) is noted on the form but does not block approval. USCIS may recommend follow-up care after admission, but the application proceeds.
Book your immigration blood tests in Tampa
At Medical Exams of Tampa, the QuantiFERON-TB Gold blood draw is included in the base exam fee of $270 for adults and $220 for children. Syphilis and gonorrhea tests for applicants 15 and older are included in the same appointment. The office processes results promptly and contacts you as soon as Form I-693 is ready to be sealed.
To schedule your exam, call 813-249-0001 or book your immigration exam with a civil surgeon in Tampa online.
