Internationally adopted children: What vaccines should they receive?

Department of Pediatrics, Hospital Carlos III, Madrid, Spain.
Vaccine (Impact Factor: 3.62). 10/2008; 26(46):5784-90. DOI: 10.1016/j.vaccine.2008.08.029
Source: PubMed


It is of paramount importance to know the vaccination status in internationally adopted children, so that they can be correctly immunized. This study ascertains the seroprotection rate for vaccine-preventable diseases and the validity of the immunization cards in 637 adopted children. The absence of the immunization card (13% of children) correlated with a poor global vaccine protection. Children with immunization records (87%) had a better global seroprotection but the information obtained from the card did not accurately predict seroprotection for each particular antigen. The best variable to predict the status of seroprotection was the country of origin. The highest rate of protection was found in children from Eastern Europe and, in descending order, India, Latin America, China and Africa. General recommendations for immunization of internationally adopted children are difficult to establish. Actions for vaccination have to be mainly implemented on the basis of the existence of the immunization card and of the country of origin.

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Available from: Mj J Cilleruelo, Aug 21, 2014
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    • "If there are concerns about whether vaccines were administered properly or were immunogenic, repeat administration of immunizations is recommended. The lack of definitive recommendations for immunization decisions in internationally adopted children is likely due to the varied results from previously published studies [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15]. The interpretation and comparison of results from these studies may differ due to differences in laboratory methods and definitions of protection . "
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    ABSTRACT: Definitive immunization guidelines for internationally adopted children are lacking. We examined whether these children had serologic evidence of protection against vaccine-preventable diseases. For children with ≥3 vaccine doses, overall protection was high for diphtheria (85%), tetanus (95%), polio (93%), hepatitis B (77%), and Hib (67%). For children ≥12 months of age with ≥1 dose of measles, mumps, or rubella vaccines, 95%, 72%, and 94% were immune, respectively. Children without immunization documentation had lower immunity. Serologic testing was useful in verifying the immunization status in internationally adopted children with and without documentation of immunizations.
    Vaccine 10/2010; 28(50):7947-55. DOI:10.1016/j.vaccine.2010.09.069 · 3.62 Impact Factor
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    • "Differences between our results and Cilleruelo's for tetanus and polio may exist because children (especially younger children) may still have had protection from prior vaccinations and age cutoffs for defining up-to-date were different. In our analysis, children with an adequate number of prior doses who had reached the minimum recommended age for a subsequent vaccination were considered UTD-V until they exceeded the maximum recommended age, whereas Cilleruelo used a younger age cutoff [15]. In Cilleruelo's study, it is possible that younger children defined as not up-todate were still protected by prior doses, which would explain the lack of association. "
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    ABSTRACT: To determine which factors are predictive of protective antibody against vaccine-preventable diseases in internationally adopted children, we evaluated 562 children with serologic testing for at least one vaccine antigen before receiving a US vaccination. Vaccination status was defined as the number-of-doses recorded and as the presence of an up-to-date and valid record according to the American Academy of Pediatrics and the Advisory Committee on Immunization Practices guidelines. The number-of-doses recorded was the best predictor of protective antibody. These findings suggest that other options for immunization verification guidelines for internationally adopted children should be considered by policy makers.
    Vaccine 10/2010; 29(1):95-103. DOI:10.1016/j.vaccine.2010.09.098 · 3.62 Impact Factor
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    ABSTRACT: Objetivo: evaluar el estado vacunal de los niños inmigrantes recién llegados. Material y métodos: estudio descriptivo observacional transversal. Población: inmigrantes entre 6 meses y 15 años. Variables: registro de vacunaciones, tipo y número de dosis de vacunas administradas, características sociodemográficas del niño y los padres, adoptado (sí/no). El estado vacunal se valoró según el Expanded Program on Immunizatión OMS (EPI-1974) y el �Protocolo de Atención a Niños Inmigrantes� (PANI). Resultados: trajeron registro de vacunaciones un 62,1% (intervalo de confianza [IC] del 95%: 59,3%-65,0%). Bien vacunado según EPI-1974, 54,1% (IC 95%: 50%-57,9%). Encontramos significación estadística (p < 0,001) entre procedencia y las variables: traer registro, saber leer y escribir y estar vacunado correctamente según el EPI. Bien vacunados según el PANI: difteria 94% (IC 95%: 91,9%-95,6%); tétanos, 93,2% (IC 95%: 91,1%-95,0%); tos ferina, 93,2% (IC 95%: 91,1%-95,0%); polio, 92,9% (IC 95%: 90,8%-94,7%); sarampión, 41,6% (IC 95%: 37,6%-43,3%); rubeola, 27,2% (IC 95%: 24,0%-30,7%); parotiditis, 20,73% (IC 95%: 17,8%-23,9%); hepatitis B, 48,37% (IC 95%: 44,6%-52,1%); hepatitis A, 1,69% (IC 95%: 0,9%-2,9%); meningitis, C 7,75% (IC 95%: 5,9%-9,9%); Haemophilus influenzae tipo b, 19,18% (IC 95%: 16,3%-22,3%); y BCG, 81% (IC 95%: 78,5%-83,1%). Conclusiones: muchos niños inmigrantes no aportan registro de vacunas. Entre los que sí lo aportan hay una alta cobertura en difteria, tétanos y tos ferina. Según este estudio, el resto de vacunas sistemáticas recomendadas en esta población ha de complementarse.
    Pediatria de Atencion Primaria 06/2010; 12(46). DOI:10.4321/S1139-76322010000300006
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