US .Vaccination card size can vary ,please check measurements before purchasing. The maximum Suitable Vaccination card size is 4" L x 3" W. If you think the card holder(Another Card Size 4 1/4X3 1/2 )doesn’t fit, just flip it over and slide the top underneath and it seals closed. Suitable occasion: Multi Purpose Use and Reuse for a Health Record Keeper or for Special or Promotional Events, Conventions, Concerts, Festivals, Retreats, Family & School Reunions, Store Tags, Fundraisers, Field Trips, PTA, Transit Bus, VIP Pass and More. [Design]: Dual-use hanging slot/holes design, the middle slot for lanyard, keychain or retractable carabiner reel clip, the both side holes for the cord/strap/string/thread. Strong and Flexible plastic material. The badge holders will not leave trace, folded and refolded many time. The hanging Slot/holes will not break, distorted many time. [Material]: Durable PVC (poly vinyl chloride) material, wear-resistant and corrosion-resistant properties. WATERPROOF, SEALABLE Clear card pouch is made of flexible,Resealable zipper keeps contents safe and dry. CDC Vaccination Card is not included