Vaccines for adopted or immigrant children

What records are acceptable?

The CDC says only written documentation should be accepted as evidence of previous vaccination. Vaccines given outside the U.S. generally can be accepted as valid if the vaccines, dates, intervals between doses and ages match U.S. recommendations. A record that does not meet those conditions may not count.

When are doses repeated?

When there is no record, or it is questionable, the CDC describes two approaches: repeat the vaccinations, or use blood tests to decide which are needed. Examples from the CDC's table:

• DTaP: children under 7 can be revaccinated without regard to recorded doses; with 3 or more recorded doses, testing for diphtheria and tetanus antibody is a reasonable option.
• Polio: the simplest approach is to revaccinate people under 18 with IPV on the U.S. schedule.
• MMR: the simplest approach is to revaccinate with 1 or 2 doses; blood tests are an alternative, and measles-containing doses given before the first birthday are not counted.
• Hepatitis B: with no known vaccination, an age-appropriate series is given. The CDC also says children from regions where hepatitis B is common should be tested for HBsAg regardless of vaccination status.
• Hib: not recommended routinely for people aged 5 and older.

What is different for adopted children?

The CDC notes that birth countries often use different schedules, and that data are inconclusive about how well an internationally adopted child's record reflects protection. It also advises making sure household contacts are adequately vaccinated. Your practitioner will decide what to accept, repeat or test.

How does this relate to the planner?

The planner is built for healthy children with dose records you can document. It does not judge foreign records. Review who should not use this tool, then decide with your clinician what to enter under "Already had some shots?" Once the clinician has set which doses count, the planner can lay out the rest. If records are simply lost, see how to find vaccine records.

Common questions

Do vaccines given in another country count in the U.S.?

They generally can, if the schedule is similar to the U.S. schedule in vaccines, ages and intervals, and if there is written documentation. The CDC also says clinicians have a limited ability to determine whether a person is protected based on country of origin alone, so a clinician reviews each record.

Is repeating vaccines safe?

The CDC says repeating vaccinations is an acceptable option that usually is safe. Excess tetanus-containing doses can increase local reactions, which is one reason clinicians sometimes use blood tests to decide what is needed.

Our adopted child has a record that lists many doses. Is that enough?

Not necessarily. The CDC notes that adopted children's birth countries often have different schedules, and that data are inconclusive on how well an internationally adopted child's record reflects protection. Ask your practitioner whether to accept the record, repeat doses or check antibody levels.

Can I use the planner for my child?

Only with your practitioner's agreement. The planner assumes a healthy child and dose records you can document, and it cannot judge a foreign record. Read who should not use this tool first.