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Predictive value of immunization records and risk factors for immunization failure in internationally adopted children.
Arch Pediatr Adolesc Med. 2009 May; 163(5):473-9.AP

Abstract

OBJECTIVES

To measure the predictive value of immunization records for protective immunity and identify risk factors for immunization failure.

DESIGN

Prospective cross-sectional study, 2001-2006.

SETTING

International Adoption Clinic, Rainbow Babies and Children's Hospital, Cleveland, Ohio.

PARTICIPANTS

A total of 465 international adoptees presenting within 180 days of arrival. Main Exposure Immunization records of vaccines given.

OUTCOME MEASURES

Protective immunity to polio, hepatitis B, tetanus, diphtheria, and measles.

RESULTS

Vaccination records were available for 397 (85.4%) adoptees (mean age, 19.4 months; 65.2% girls). Most children came from Russia (41.7%), China (20.9%), and Guatemala (15.7%). Acute or chronic malnutrition was present in 5.5% and 15.4% of adoptees, respectively. Preadoptive settings were institutional (52%), community-based (14%), or both (34%). Of adoptees with 3 or more tetanus (n = 203) or 3 or more diphtheria (n = 205) vaccinations, 87.2% and 94.6% had protective immunity, respectively. Of adoptees with 3 or more polio vaccinations (n = 216), protective immunity was present in 58.3%, 82.4%, and 51.9% for polio types 1, 2, and 3, respectively. Of adoptees with 2 or more hepatitis B vaccinations (n = 170), 94.1% had protective immunity. A total of 80.8% of adoptees with measles vaccination (n = 99) had protective immunity. Children from China were less likely to have protective immunity than children from Russia (odds ratio, 0.34; 95% confidence interval, 0.17-0.66). Nutritional status had no predictive effect.

CONCLUSIONS

The predictive value of immunization records in international adoptees is limited and varies between birth countries. Immunization records should not be accepted as evidence of protective immunity. Parents should be well informed and supported to choose between revaccination or vaccination, based on serologic testing.

Authors+Show Affiliations

Division of Global Child Health, Department of Pediatrics, Case Western Reserve University, Cleveland, OH 44106-7292, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

19414695

Citation

Verla-Tebit, Emaculate, et al. "Predictive Value of Immunization Records and Risk Factors for Immunization Failure in Internationally Adopted Children." Archives of Pediatrics & Adolescent Medicine, vol. 163, no. 5, 2009, pp. 473-9.
Verla-Tebit E, Zhu X, Holsinger E, et al. Predictive value of immunization records and risk factors for immunization failure in internationally adopted children. Arch Pediatr Adolesc Med. 2009;163(5):473-9.
Verla-Tebit, E., Zhu, X., Holsinger, E., & Mandalakas, A. M. (2009). Predictive value of immunization records and risk factors for immunization failure in internationally adopted children. Archives of Pediatrics & Adolescent Medicine, 163(5), 473-9. https://doi.org/10.1001/archpediatrics.2009.26
Verla-Tebit E, et al. Predictive Value of Immunization Records and Risk Factors for Immunization Failure in Internationally Adopted Children. Arch Pediatr Adolesc Med. 2009;163(5):473-9. PubMed PMID: 19414695.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictive value of immunization records and risk factors for immunization failure in internationally adopted children. AU - Verla-Tebit,Emaculate, AU - Zhu,Xiaobei, AU - Holsinger,Eva, AU - Mandalakas,Anna Maria, PY - 2009/5/6/entrez PY - 2009/5/6/pubmed PY - 2009/5/27/medline SP - 473 EP - 9 JF - Archives of pediatrics & adolescent medicine JO - Arch Pediatr Adolesc Med VL - 163 IS - 5 N2 - OBJECTIVES: To measure the predictive value of immunization records for protective immunity and identify risk factors for immunization failure. DESIGN: Prospective cross-sectional study, 2001-2006. SETTING: International Adoption Clinic, Rainbow Babies and Children's Hospital, Cleveland, Ohio. PARTICIPANTS: A total of 465 international adoptees presenting within 180 days of arrival. Main Exposure Immunization records of vaccines given. OUTCOME MEASURES: Protective immunity to polio, hepatitis B, tetanus, diphtheria, and measles. RESULTS: Vaccination records were available for 397 (85.4%) adoptees (mean age, 19.4 months; 65.2% girls). Most children came from Russia (41.7%), China (20.9%), and Guatemala (15.7%). Acute or chronic malnutrition was present in 5.5% and 15.4% of adoptees, respectively. Preadoptive settings were institutional (52%), community-based (14%), or both (34%). Of adoptees with 3 or more tetanus (n = 203) or 3 or more diphtheria (n = 205) vaccinations, 87.2% and 94.6% had protective immunity, respectively. Of adoptees with 3 or more polio vaccinations (n = 216), protective immunity was present in 58.3%, 82.4%, and 51.9% for polio types 1, 2, and 3, respectively. Of adoptees with 2 or more hepatitis B vaccinations (n = 170), 94.1% had protective immunity. A total of 80.8% of adoptees with measles vaccination (n = 99) had protective immunity. Children from China were less likely to have protective immunity than children from Russia (odds ratio, 0.34; 95% confidence interval, 0.17-0.66). Nutritional status had no predictive effect. CONCLUSIONS: The predictive value of immunization records in international adoptees is limited and varies between birth countries. Immunization records should not be accepted as evidence of protective immunity. Parents should be well informed and supported to choose between revaccination or vaccination, based on serologic testing. SN - 1538-3628 UR - https://www.unboundmedicine.com/medline/citation/19414695/Predictive_value_of_immunization_records_and_risk_factors_for_immunization_failure_in_internationally_adopted_children_ L2 - https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/archpediatrics.2009.26 DB - PRIME DP - Unbound Medicine ER -