Immigrants and refugees
Immunisation for immigrant and refugee children, as covered in the Immunisation Handbook 2011.
Note: The following information is an extract from page 23 of the Immunisation Handbook 2011.
Immigrant and refugee children
Adults and children who enter New Zealand as refugees or immigrants will need an assessment of their documented vaccination status and an appropriate catch-up programme will need to be determined. Information on eligibility for funded vaccines can be found in the eligibility for publicly funded health and disability services section.
Children who have been previously immunised in a developing country may have received BCG, three doses of DTwP and OPV in the first 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, pneumococcal or MMR vaccine. Increasing numbers of countries have hepatitis B vaccine included in their national childhood immunisation schedule.
If a refugee or immigrant has no valid documentation of vaccination, an age appropriate catch-up programme is recommended (see Appendix 2, page 379 (PDF, 412 KB) for children and adolescents, and Section 1.5, page 20 (PDF, 160 KB) for adult immunisation). If there is a documented record of vaccination, the history of prior doses should be taken into account when planning a catch-up programme that complies with the Schedule.
Tuberculosis
Tuberculosis is an important public health problem for refugees and immigrants. Figures from the United States 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. During the 10-year period 1995 to 2004, country of birth was recorded for 89.3 percent of the 3772 tuberculosis cases reported New Zealand. Of these cases, 64.6 percent (2174 cases) were born overseas. There was a significant increasing trend in the number of cases in overseas-born people during this period.
It is important that all refugee children with suspected tuberculosis be appropriately investigated. If they are negative but are known to have been recently exposed, they should be tested again three months later to identify recently acquired infection. Previous BCG immunisation should be considered when interpreting Mantoux results (see Chapter 14 (PDF 408 KB).
In New Zealand the policy is to offer BCG vaccination to infants at increased risk of tuberculosis. Refer to Chapter 14 (PDF 408 KB) for the neonatal BCG eligibility criteria.
Hepatitis B
The prevalence of chronic hepatitis B infection in refugees from eastern Asia is estimated to be 10–15 percent. If a member of a family is found to have chronic hepatitis B infection, it is recommended that all the family be screened and immunisation offered to all those who are non-immune. Even if no-one in the family is a carrier, it is recommended that all children aged less than 16 years be vaccinated against hepatitis B.
Varicella
People who have grown up in the tropics are less likely to have had chickenpox and may be non immune adults. Because adult chickenpox can be severe, if there is no history of chickenpox and serology is negative, varicella vaccine should be offered (although it is currently not funded).
Details of immunisation schedules of other countries can be found at the WHO website (see Appendix 11, page 433 (PDF, 412 KB) or by contacting the Immunisation Advisory Centre (IMAC)
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Page last updated: 15 August 2011
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