Abstract
Control of vaccine preventable diseases (VPDs) is a challenge for healthcare systems. Different studies highlighted the suboptimal immunization of internationally adopted children (IAC). To evaluate the immunization status against measles, mumps, rubella (MMR), and varicella (V) in a large cohort of IAC, data at first screening visit of all IAC (<18 years) consecutively referred to Meyer Children’s University Hospital (Florence, Italy) from 2009 to 2018 were collected and analyzed. In total, 1927 children (median age: 5.99 years, interquartile range: 3.33–8.21) were enrolled. More than half of IAC were unprotected against MMR-V. The reliability of the vaccination documentation of the country of origin was poor, since more than a quarter of the IAC serologically tested were not protected against MMR-V, despite the vaccination documentation attesting previous vaccination. This was significantly more pronounced in children aged 15–18 years and in those originating from Africa. High rate of discordant serological results/documentation brings up questions regarding the optimal management of IACs, and suggests a rapid, careful, and complete assessment of immunization status timely after IAC’s arrival. Serological testing of IAC of all ages followed by vaccination of seronegative children should be provided.
Highlights
The control of vaccine preventable diseases (VPDs), such as measles or varicella, is a priority for healthcare systems
43.8% was included for mumps, whereas only 32.7% of the population was included in the study for varicella immunization status
In the current study we analyzed the measles-mumps-rubella-varicella (MMRV) vaccination status and serological data available in a large population of internationally adopted children (IAC) referred to a single center in Tuscany (Italy) over a 10-year period
Summary
The control of vaccine preventable diseases (VPDs), such as measles or varicella, is a priority for healthcare systems. Outbreaks have been reported worldwide in recent years due to insufficient immunization coverage among the general population [1]. Recent epidemiological data on VPDs in the European Union and European Economic Area (EU/EEA) demonstrate ongoing transmission in the context of insufficient vaccine coverage [1]. Measles continues to be a threat in EU/EEA countries. 2019, 10,958 cases were reported in adults and children by the European Centre for Disease. Prevention and Control [2,3]. The highest numbers were described in France, Bulgaria, Italy, Poland, and Lithuania [4]. Never reached the elimination status (interruption for at least 36 months)
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