Evaluation and Administration of Immunization Status of Adopted Children
| • Infectious diseases (for updates on infectious disease screening, please consult the AAP Red Book17) |
| ○ Hepatitis B |
| • Test for HBsAb; if negative, give age-appropriate immunization |
| ○ Diphtheria, pertussis, and tetanus toxoids |
| • Immunize as appropriate for age. Serologic testing for antitoxoid antibodies 4 wk after dose 1 if severe local reaction. |
| • If previously received ≥3 doses, serologic testing for antitoxoid antibody to diphtheria and tetanus toxins before administrating additional doses or administer a single dose of diphtheria and tetanus-containing vaccine, followed by serologic testing 1 mo later for antitoxoid antibody. |
| ○ Haemophilus influenza type b (Hib) |
| • Age-appropriate immunization |
| • If >12 mo of age, serologic testing for Hib immunoglobulin G (IgG) is available |
| ○ Pertussis |
| • There is no serologic test routinely available, but may use antibodies to diphtheria or tetanus as a marker that vaccine was previously given. |
| ○ Poliovirus |
| • Immunize with inactivated poliovirus vaccine (IPV) per routine schedule |
| • An alternative to vaccination would be to perform serologic testing for neutralizing antibody to poliovirus types 1, 2, and 3 or give a single dose of IPV, followed by serologic testing. |
| ○ Measles-Mumps-Rubella (MMR) |
| • Immunize with MMR or obtain measles antibody concentration. If positive, give MMR vaccine to protect against mumps and rubella. |
| • An alternative would be to perform serologic testing for IgG antibody to vaccine viruses, indicated by the immunization record. |
| ○ Varicella |
| • Give age-appropriate immunization if there is not a reliable history of previous disease or serologic evidence of disease by varicella antibody. |
| ○ Pneumococcal |
| • Give age-appropriate immunization. |
| • If >12 mo of age, serologic testing for IgG for serotypes 7-14 |
| • Infectious diseases (for updates on infectious disease screening, please consult the AAP Red Book17) |
| ○ Hepatitis B |
| • Test for HBsAb; if negative, give age-appropriate immunization |
| ○ Diphtheria, pertussis, and tetanus toxoids |
| • Immunize as appropriate for age. Serologic testing for antitoxoid antibodies 4 wk after dose 1 if severe local reaction. |
| • If previously received ≥3 doses, serologic testing for antitoxoid antibody to diphtheria and tetanus toxins before administrating additional doses or administer a single dose of diphtheria and tetanus-containing vaccine, followed by serologic testing 1 mo later for antitoxoid antibody. |
| ○ Haemophilus influenza type b (Hib) |
| • Age-appropriate immunization |
| • If >12 mo of age, serologic testing for Hib immunoglobulin G (IgG) is available |
| ○ Pertussis |
| • There is no serologic test routinely available, but may use antibodies to diphtheria or tetanus as a marker that vaccine was previously given. |
| ○ Poliovirus |
| • Immunize with inactivated poliovirus vaccine (IPV) per routine schedule |
| • An alternative to vaccination would be to perform serologic testing for neutralizing antibody to poliovirus types 1, 2, and 3 or give a single dose of IPV, followed by serologic testing. |
| ○ Measles-Mumps-Rubella (MMR) |
| • Immunize with MMR or obtain measles antibody concentration. If positive, give MMR vaccine to protect against mumps and rubella. |
| • An alternative would be to perform serologic testing for IgG antibody to vaccine viruses, indicated by the immunization record. |
| ○ Varicella |
| • Give age-appropriate immunization if there is not a reliable history of previous disease or serologic evidence of disease by varicella antibody. |
| ○ Pneumococcal |
| • Give age-appropriate immunization. |
| • If >12 mo of age, serologic testing for IgG for serotypes 7-14 |