International adoption: Immunization considerations
- Mary Allen Staat, MD, MPH
Mary Allen Staat, MD, MPH
- Professor of Pediatrics
- Cincinnati Children's Hospital Medical Center; University of Cincinnati
Each year thousands of children immigrate to the United States through international adoption. Internationally adopted children are at increased risk for common infectious diseases such as tuberculosis, intestinal parasites, skin infections, and infestations because they come from resource-poor countries where these conditions are common. Assuring that these children are protected against vaccine-preventable diseases often can be challenging. Many internationally adopted children have poor documentation of immunizations from their birth country or may not have had the opportunity to have received the vaccines routinely given in the United States.
Immunization of internationally adopted children and their close contacts will be discussed here. Infectious diseases in international adoptees and general issues related to adoption are discussed separately. (See "International adoption: Infectious disease aspects" and "Adoption".)
IMMUNIZATIONS FOR INTERNATIONAL ADOPTEES
Immunizations in the country of origin — Routine immunization schedules vary from country to country and are available for specific countries through the World Health Organization. Most children arrive to the United States with documentation of some immunizations from their birth country. Children often receive some immunizations during the exit evaluation in their country of origin.
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- Department of Health and Human Services. Criteria for Vaccination Requirements for U.S. Immigration Purposes. http://www.gpo.gov/fdsys/pkg/FR-2009-11-13/pdf/E9-27317.pdf (Accessed on May 21, 2013).
- Centers for Disease Control and Prevention. Notice of revised vacination criteria for U.S. immigration http://www.cdc.gov/immigrantrefugeehealth/laws-regs/vaccination-immigration/revised-vaccination-criteria-immigration.html (Accessed on May 21, 2013).
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- Sokal EM, Van Collie O, Buts JP. Horizontal transmission of hepatitis B from children to adoptive parents. Arch Dis Child 1995; 72:191.
- Centers for Disease Control and Prevention (CDC). Pertussis in an infant adopted from Russia--May 2002. MMWR Morb Mortal Wkly Rep 2002; 51:394.
- Centers for Disease Control and Prevention (CDC). Measles outbreak among internationally adopted children arriving in the United States, February-March 2001. MMWR Morb Mortal Wkly Rep 2002; 51:1115.
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- Centers for Disease Control and Prevention (CDC). Measles among adults associated with adoption of children in China--California, Missouri, and Washington, July-August 2006. MMWR Morb Mortal Wkly Rep 2007; 56:144.
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- Centers for Disease Control and Prevention (CDC), Advisory Committee on Immunization Practices. Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for use of hepatitis A vaccine in close contacts of newly arriving international adoptees. MMWR Morb Mortal Wkly Rep 2009; 58:1006.
- Centers for Disease Control and Prevention. Hepatitis A. In: Health Information for International Travel 2018: The Yellow Book. Available at http://wwwnc.cdc.gov/travel/page/yellowbook-home (Accessed on May 17, 2017).
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- IMMUNIZATIONS FOR INTERNATIONAL ADOPTEES
- Immunizations in the country of origin
- Immunization after adoption
- - Valid immunization record
- - Unknown or uncertain immunization
- Serologic testing
- IMMUNIZATIONS FOR FAMILY MEMBERS AND CONTACTS
- Routine immunizations
- Hepatitis A vaccine
- Hepatitis B vaccine
- Additional immunizations for travel
- SUMMARY AND RECOMMENDATIONS