In order for refugees to be eligible for a green card/permanent residence they must first complete all required immunizations. At their health screening they will be given immunization records book.
These appointments will be made with their County Public Health office and the initial appointment will be scheduled by their caseworker. Future immunizations can take place with their primary care physician, but their last Civil Surgeon appointment must again be with the Public Health office around their 12th month in the country. From the appointment, they will leave with a sealed envelope for USCIS (US Citizenship and Immigration Services). Once finished they can schedule an appointment for the green card application.