Immigrants and Refugees - New Zealand Immunisation Schedule

Immunisation
Immigrants and Refugees

Note: The following is an extract from page 66 of the Immunisation Handbook 2006.

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Immigrant and refugee children

Adults and children who enter New Zealand as refugees or immigrants require assessment in regard to their vaccination requirements.

Assess the immunisation status of the presenting child and determine which catch-up vaccinations the child should receive. Children who have been previously immunised in a non-industrialised country may have received BCG, three doses of DTwP and OPV in the fi rst six months of life, and a dose of measles vaccine between 9 and 15 months of age. However, they are unlikely to have received Hib or MMR vaccine, unless they have come from an industrialised country. Increasing numbers of countries have hepatitis B vaccine included in their national childhood immunisation schedule.

If a refugee or immigrant child has no valid documentation of vaccination, an age appropriate catch-up programme should be commenced (see Appendix 2).

If there is a valid record of vaccination, the history of prior doses should be taken into account when planning a vaccination catch-up that complies with the New Zealand programme.

Tuberculosis is an important public health problem for refugees. Figures from the United States (US) show that approximately 1–2 percent of refugees are suffering from active tuberculosis on arrival, and about half have positive tuberculin skin tests. The number who have received BCG immunisation is unknown. It is important that all refugee children be skin tested with the Mantoux tuberculin test at the time of the first visit and, if negative, tested again three months later to identify recently acquired infection. Previous BCG immunisation should be considered when interpreting Mantoux results. A chest X-ray is recommended if the Mantoux is > 10 mm following BCG, or > 5 mm without a previous history of BCG.

In New Zealand the policy is to provide BCG vaccination to newborns at increased risk of tuberculosis (see section 1.3 and chapter 12 for more details on the neonatal BCG eligibility criteria).

The prevalence of chronic hepatitis B infection in refugees from eastern Asia is estimated to be 10–15 percent. If a member of the family is found to have chronic hepatitis B infection, it is recommended all the family be screened and immunisation offered to all susceptibles. If no one in the family is a carrier, all children under 16 years of age should be offered immunisation against hepatitis B.

For details of immunisation schedules of other countries, contact your local immunisation co-ordinator/facilitator, medical officer of health or IMAC.

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Page last updated: 13 June 2008