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