Vaccine records of internationally adopted children may not reflect protection against disease

VaccineCHICAGO – Children adopted from countries such as Russia, China and Guatemala may not be protected against polio, measles or other diseases despite records indicating they have been immunized, according to a report in the May issue of Archives of Pediatrics & Adolescent Medicine, a theme issue on vaccines.

U.S. families have adopted almost 250,000 foreign-born children in the last 15 years, according to background information in the article. Many of these children were living in orphanages or other institutional settings with few resources and are likely to have incomplete immunization records or none at all. When valid written records do exist, the American Academy of Pediatrics Committee on Infectious Disease advises that they could be considered as evidence of previous vaccination. However, there are reasons to suspect that these records may not accurately reflect immunity, including "documentation inaccuracies, lack of vaccine potency and impaired immune response, possibly due to stress or malnutrition."

Emaculate Verla-Tebit, Ph.D., and colleagues at Case Western Reserve University School of Medicine, Cleveland, obtained data from 465 children who visited the International Adoption Clinic at Rainbow Babies and Children’s Hospital between 2001 and 2006 and who presented for care within 180 days of arrival to the United States. Most of the adopted children came from Russia (41.7 percent), China (20.9 percent) or Guatemala (15.7 percent). Immunization records were available for 397 (85.4 percent) of adoptees (average age 19.4 months). Blood samples were obtained and tested for evidence of immunity against diphtheria, tetanus, measles, hepatitis B and polio.

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