Can immunization records from orphanages be relied upon, given that vaccinations in third-world nations often are not on par with accepted standards?
To revaccinate or not is a very heated and emotional decision that all adoptive parents need to face with the help of their general pediatrician. While obviously, the safest and the most accurate way is to just revaccinate every child regardless of immunization records, this method unfortunately does not sit well with many parents; I feel that each case needs to be evaluated on an individual basis.
There are many reasons why physicians in the U.S.A do not want to accept the immunization records for internationally adopted children. In this article I will try to elaborate on these concerns, and explain my personal style to vaccinations.
Other reasons: why these children may not mount an immune response is as follows:
Much of this information presented comes from experience with children adopted many years ago in the eighties to early nineties. Since then, orphanages have changed for the better. In the times that we live in now, most people care about children and try to advocate for them. Orphanages especially in the Eastern European countries are now better staffed, supplied, and health care is now available. Granted it is not at the level that we have here in the U.S.A, it has greatly improved improved. Shortfalls do exist however. If the child lives in the main city of a particular country, funding is available, but if they live somewhere on the outskirts, you could be sure that healthcare is limited and may even be nonexistent.
My personal approach to vaccinations is as follows:
While the revaccination decision can be pretty emotional for parents because of extra shots, realistically even in children who got some vaccines overseas, they did not get a lot of them. Vaccines generally encountered on the medical record are only the Hepatitis B, DTP and Polio. Many times they do not even have the complete series; I would need to give them booster vaccines anyway. I rarely ever see the HIB, MMR, Chickenpox or the new Prevnar vaccines.
The revaccination controversy does certainly exist; I feel that it is somewhat over publicized. Vaccines are good things to have. They prevent many of the deadly childhood illness that many young doctors today here in the U.S.A, may never have seen.
There are many people out there that have many personal stories related to the side effects of vaccinations. Some of these people are advocates against mass vaccination in the U.S.A. I respect their decisions and all that I can do as a physician is try to educate them. I never try to forcefully impose a doctor’s belief and the standard of care on them. It is really good for their general health that most everyone around them is already vaccinated.
I know that today, because of mass vaccination in the U.S.A, our children rarely die from these illness that may have affected them if they were to remain in the orphanages, such as Polio, Pertusis, HIB Meningitis just to name a few.
The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it - only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made. This Web site does not constitute a physician-patient relationship.
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© George Rogu, M.D.
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