Immunizations for an International Adoption

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Immunizations for families going abroad for an inter-country adoption

Immunizations
for Families going abroad
for an International Adoption

As an adoption medicine specialist and as a pediatric infectious diseases physician who counsels families regularly regarding international travel, I am sharing my current recommendations for vaccines for families traveling abroad to adopt children. Hepatitis B
Children adopted from abroad are at risk for Hepatitis B infection. Children adopted from China have a Hepatitis B carriage rate of about 5%. This means that in spite of negative testing in China, 5 % of children adopted from China will test positive for Hepatitis B surface antigen when they arrive in the U.S. Children adopted from eastern Europe, Russia, Southeast Asia, and Central America also are at risk for Hepatitis B carriage and the carriage rate varies from country to country. Family members are at risk for in- household transmission of Hepatitis B infection from exposure to the blood of those individuals who are Hepatitis B carriers, unless they are fully immunized against Hepatitis B. There is a universal Hepatitis B vaccination program in the U.S. for young infants since 1991 so if families have biological children, these children are already protected.
The Hepatitis B vaccine is a 3 vaccine series. The first two immunizations are separated by an interval of at least one month and the third vaccine is usually administered six months from the date of the first vaccine.

Hepatitis A
This is a very common infection when traveling abroad. The infection is acquired from food and water. The vaccine is a two vaccine series. One vaccine is given preferably one month before travel and then a booster is given 6-12 months later. This vaccine is licensed for all individuals over the age of 2 years and provides life-long immunity.

Tetanus/Diphtheria
You never know when you are going to step on a rusty nail while you are abroad. You don't want to be in the position of needing a "tetanus shot" in a foreign country. You should have a booster every ten years.

Measles Booster
Measles is still a problem all over the world. According to data from the Centers for Disease Control and Prevention (CDC) as of July 24, 1998, an estimated 36.5 million cases of measles with one million deaths are reported each year worldwide. For those adults born after 1957, I recommend a measles booster. If you were born in or before 1957, you probably had measles as a child and are subsequently protected. If you have concerns regarding immunity, there is a blood test for measles antibodies, but it is less expensive to just have the booster if you have any doubts about your immunity to measles.

Influenza Vaccine
If you have lung or heart disease, "flu" vaccine is recommended during the influenza season (November through April). This vaccine is given once starting in November and only protects the individual for that season. The effectiveness of the vaccine is about 70-80 %.

Polio Vaccine
Most of us in the United States have had the complete polio vaccine series as children and the World Health Organization's Extended Immunization Program has been working diligently to meet their goal of world eradication of polio by the year 2000. There are occasional outbreaks of polio in third world countries, but they are usually associated with war-torn regions and more inaccessible areas. If you cannot confirm that you had polio vaccines as a child, then I would recommend one polio booster in the form of the injectable inactivated polio vaccine. This obviates the possibility of vaccine associated paralytic polio (vapp) infection that is a very low, but real risk with the oral preparation of polio vaccine.

Other Vaccines (Cholera and Typhoid)
Many people consult physicians who advise cholera and typhoid vaccines. I would not recommend these vaccines generally across the board when traveling abroad unless there are specific regional reports regarding outbreaks of typhoid and cholera. This information can be obtained through the CDC via their International Traveler's Hotline (404) 332-4559. There is also a Fax Information Service for international travel and immunization through the CDC (404) 332-4565. Remember that the advice from the CDC should be utilized along with a travel medicine specialist consultation so that your individual travel needs can be tailored for you by the physician.