Internationally adopted children: What vaccines should they receive?

Factors associated with protective antibody levels to vaccine preventable diseases in internationally adopted children

“…Similar to our findings, other studies have reported lower levels of protection in Chinese children [11,15-17]. However, the results of previous studies compared to our study varied with respect to age [10,13,15,17], institutionalization [9,10,15,16], and nutritional status [10,13,15,16]. Given these differences, we felt it was important to adjust for these factors in multivariable analyses.…”

“…While several studies have examined whether internationally adopted children have documentation of immunizations [5-8] and protective antibody levels to vaccine preventable diseases [9-19], only two studies have comprehensively examined factors associated with protection through multivariable analyses [15,16]. The results of these studies varied and the reasons for these differences are not entirely clear.…”

Serologic testing to verify the immune status of internationally adopted children against vaccine preventable diseases

“…For tetanus, they reported a lower proportion protected (87%) compared to ours (95%) which may be due to the different definitions of protection that were used (>0.50 IU/mL compared to ours >0.10 IU/mL). Similar to our data, two previous studies [11,12] detected an increase in protective antibody with additional number of doses for diphtheria and tetanus.…”

“…For children with ≥3 doses of vaccine, we found the proportion protected in our study was slightly higher (77%) compared to Saiman (69%) [15]. Without regard to number of doses, our population had lower rates of protection (60%) compared to the children in the Cilleruelo study (76%) that took place during similar time periods as ours [11]. In the Verla-Tebit study, 94% of children with ≥2 doses of vaccine were protected [12].…”

“…The countries evaluated, ages of children studied and laboratory methods used may account for some of the differences seen between studies. Some studies presented data for children with ≥3 doses, without indicating how many additional doses were given [5–7,9,11,12]. In order to make direct comparisons with the existing literature, we have presented our data by the specific number of doses as well as by ≥3 doses of vaccine for diphtheria, tetanus, polio, and HBV and ≥1 dose for measles, mumps, rubella, and varicella.…”