Schulte Joann M, Maloney Susan, Aronson Jane, San Gabriel Pablo, Zhou Juyan, Saiman Lisa
Division of HIV/AIDS-Surveillance and Epidemiology, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Pediatrics. 2002 Feb;109(2):E22. doi: 10.1542/peds.109.2.e22.
Increasing numbers of families in the United States are adopting children who were born in other countries. Appropriate immunization of internationally adopted children provides a challenge to pediatricians who must evaluate documentation of vaccines administered overseas and fulfill the recommended US childhood immunization schedule. The acceptability of vaccinations received outside the United States was addressed by the Advisory Committee on Immunization Practices in 1994, but few population-based studies assessing these vaccinations have been reported.
We performed a retrospective cohort study of 504 children who were adopted from other countries and evaluated in 1997 and 1998. Our goal was to determine the acceptability of overseas vaccinations for meeting US immunization requirements. We assessed immunization records for both valid documentation of receipt of vaccine and comparability with the recommended US schedule. We also determined the number of children who were up to date (UTD) for diphtheria-tetanus-pertussis, polio, hepatitis B, and measles-mumps-rubella vaccines under the US schedule.
The children's mean age at initial US evaluation was 19 months; 71% were girls, and most (88%) had resided in orphanages. They were adopted from 16 countries, most frequently from China (48%) and Russia (31%). Thirty-five percent (178) of children had overseas immunization records, 167 (94%) of which were considered valid. Most children with valid records (112 [67%] of 167) were UTD for 1 or more vaccine series under the US schedule.
The majority (65%) of internationally adopted children had no written records of overseas immunizations. Among the 178 children with documented overseas immunizations, 167 (94%) had valid records and some vaccine doses that were acceptable and UTD under the US schedule. Additional research and more specific guidance in the most cost-effective approaches to evaluation of overseas vaccinations are needed to ensure appropriate state-side vaccination and to improve the health of these children and their communities.
在美国，越来越多的家庭收养出生在其他国家的儿童。对国际收养儿童进行适当的免疫接种给儿科医生带来了挑战，他们必须评估在海外接种疫苗的记录，并完成美国推荐的儿童免疫接种计划。免疫实践咨询委员会在1994年讨论了在美国境外接种疫苗的可接受性，但很少有基于人群的研究评估这些接种情况。
我们对1997年和1998年从其他国家收养并接受评估的504名儿童进行了一项回顾性队列研究。我们的目标是确定海外接种疫苗对于满足美国免疫要求的可接受性。我们评估了免疫记录，以确定疫苗接种的有效记录以及与美国推荐计划的可比性。我们还确定了按照美国计划，白喉-破伤风-百日咳、脊髓灰质炎、乙型肝炎和麻疹-腮腺炎-风疹疫苗接种最新（UTD）的儿童数量。
这些儿童在美国初次评估时的平均年龄为19个月；71%为女孩，大多数（88%）曾居住在孤儿院。他们来自16个国家，最常见的是中国（48%）和俄罗斯（31%）。35%（178名）儿童有海外免疫记录，其中167份（94%）被认为有效。大多数有有效记录的儿童（167名中的112名[67%]）按照美国计划，1种或多种疫苗系列接种最新。
大多数（65%）国际收养儿童没有海外免疫接种的书面记录。在178名有海外免疫接种记录的儿童中，167名（94%）有有效记录，并且一些疫苗剂量按照美国计划是可接受的且接种最新。需要进行更多研究，并就评估海外接种疫苗的最具成本效益的方法提供更具体的指导，以确保在美国本土进行适当的疫苗接种，并改善这些儿童及其社区的健康状况。
