Refugee Immunization Requirements: A Quick Quiz

As the tragedies began to unfold in Ukraine in the early months of 2022, the US agreed to admit up to 100 000 refugees from the war-torn country. Refugees, unlike immigrants, are not required to have any vaccines prior to arrival in the US. Routine vaccine requirements vary among countries. For example, Haemophilus influenzae type b (Hib) vaccines are not routinely given to children in the Ukraine, so many child refugees will need that vaccine after arrival in the US.

Scenario: A family comes to your office from Ukraine under refugee status. The parents are in their mid-thirties, and they have 3 children aged 3 months, 17 months, and 61 months. The parents have vaccine records for the children but not for themselves. The parents tell you through an interpreter that they have received all their vaccines. Refresh your memory on refugee immunization requirements with the 2 questions below based on this scenario.

1. The 17-month-old can receive his 4th DTaP shot. Mom tells you he developed a fever to 105 with his DTP shot at 6 months of age—Ukraine still uses the whole-cell pertussis (wP) vaccine. She asks if the DTaP is safer, and you tell her the US has used a more purified form of pertussis vaccine that is much less likely to cause high fevers since 1996. Which of the following is NOT true?