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Incomplete Immunity and Missed Vaccination Opportunities in East African Immigrants Settling in Australia

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Abstract

Background: Immigrants and refugees are at particular risk of incomplete immunisation and may be unaware of their vaccination status. There is a paucity of data on the immunisation status of adult immigrants from African countries. Aims: To review the immunisation status of adult immigrants from East Africa, and to identify missed opportunities for vaccination. Methods: A community survey was conducted using self-reported vaccination status, Mantoux skin tests, and serological testing for immunity to hepatitis B, tetanus, diphtheria and measles. Results: Proven inadequate immunity against at least one of tetanus (67%), hepatitis B (41%), diphtheria (34%) or measles (3%) was found among 100/126 (81%) participants despite a median of seven visits to vaccine providers since immigration. A positive Mantoux test occurred in 17% of participants. Conclusions: Pre- and post-arrival health assessments are currently failing to address vaccination needs in recently arrived East African adult immigrants. Immigrants should have their immunisation status assessed, with opportunistic vaccination provided wherever possible.

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References

  1. Barnett ED, Christiansen D, Figueira M. Seroprevalence of Measles, Rubella and Varicella in refugees. CID 2002;35:403–8.

    Article  Google Scholar 

  2. Smith R. Vaccines and medicines for the world’s poorest. BMJ 2000;320:952–3.

    Article  PubMed  CAS  Google Scholar 

  3. Hanjeet K, Lye MS, Sinnian M, Schnur A. Evaluation of cold chain monitoring in Kelantan, Malaysia. Bull WHO 1996;74:391–7.

    PubMed  CAS  Google Scholar 

  4. Jacobs DH, Tovar JM, Hung OL, Kim M, Ye P, Chiang WK, Goldfrank LR. Behavioral risk factor and preventive health care practice survey of immigrants in the emergency department. Acad Emerg Med 2002;9(6):599–608.

    Article  PubMed  Google Scholar 

  5. Sheridan E, Aitken C, Jeffries D, Hird M, Thayalasekaran P. Congenital rubella syndrome: a risk in immigrant populations. Lancet 2002;359(9307):674–5.

    Article  PubMed  CAS  Google Scholar 

  6. Sharan S, Sharma S, Billson FA. Congenital rubella cataract: a timely reminder in the new millennium? Clin Experiment Ophthalmol 2006;34(1):83–4.

    Article  PubMed  Google Scholar 

  7. Dentinger CM, Heinrich NL, Bell BP, Fox LM, Katz DJ, Culver DH, Shapiro CN. A prevalence study of hepatitis A virus infection in a migrant community: is hepatitis A vaccine indicated? J Pediatr 2001;138(5):705–9.

    Article  PubMed  CAS  Google Scholar 

  8. Tawk HM, Vickery K, Bisset L, Selby W, Cossart YE. Infection in endoscopy study group. The impact of hepatitis B vaccination in a Western country: recall of vaccination and serological status in Australian adults. Vaccine 2006;24(8):1095–106.

    Article  PubMed  Google Scholar 

  9. Gjorup IE, Skinhoj P, Bottiger B, Plesner AM. Changing epidemiology of HBV infection in Danish children. J Infect 2003;47(3):231–5.

    Article  PubMed  CAS  Google Scholar 

  10. Coughlan S, Connell J, Cohen B, Jin L, Hall WW. Suboptimal measles–mumps–rubella vaccination coverage facilitates an imported measles outbreak in Ireland. Clin Infect Dis 2002;35(1):84–6. Epub 2002 Jun 6.

    Article  PubMed  Google Scholar 

  11. Centers for Disease Control and Prevention (CDC). Rubella and congenital rubella syndrome—United States, January 1, 1991–May 7, 1994. MMWR Morb Mortal Wkly Rep 1994 Jun 3;43(21):391, 397–401.

  12. Kjersem H, Jepsen S. Varicella among immigrants from the tropics, a health problem. Scand J Soc Med 1990;18(3):171–4.

    PubMed  CAS  Google Scholar 

  13. Department of Immigration & Multicultural Affairs Settlement Database. http://www.settlement.immi.gov.au/settlement/enterSelectReport.do Accessed June 22nd, 2007.

  14. Agadjanian V, Prata N. Civil war and child health: regional and ethnic dimensions of child immunization and malnutrition in Angola. Soc Sci Med 2003;56(12):2515–27.

    Article  PubMed  Google Scholar 

  15. Skull SA, Ngeow JY, Biggs BA, Street A, Ebeling PR. Vitamin D deficiency is common and unrecognized among recently arrived adult immigrants from The Horn of Africa. Intern Med J 2003;33(1–2):47–51.

    Article  PubMed  CAS  Google Scholar 

  16. Intercooled Stata for Windows 98/95/NT [program]. 7.0 version. TX, USA: College Station; 2000.

  17. Gidding HF, Backhouse JL, Burgess MA, Gilbert GL. Immunity to diphtheria and tetanus in Australia: a national serosurvey. MJA 2005;183(6):301–4.

    PubMed  Google Scholar 

  18. Tiong ACD, Patel MS, Gardiner J, Ryan R, Linton KS, Walker KA, Scopel J, Biggs B-A. Health issues in newly arrived African refugees attending general practice clinics in Melbourne. MJA 2006;185(11–12):602–6.

    PubMed  Google Scholar 

  19. Talan DA, Abrahamian FM, Moran GJ, Mower WR, Alagappan K, Tiffany BR, Pollack CV Jr, Steele MT, Dunbar LM, Bajani MD, Weyant RS, Ostroff SM. Tetanus immunity and physician compliance with tetanus prophylaxis practices among emergency department patients presenting with wounds. Ann Emerg Med 2004;43(3):305–14.

    Article  PubMed  Google Scholar 

  20. Ogilvie EL, Veit F, Crofts N, Thompson SC. Hepatitis infection among adolescents resident in Melbourne Juvenile Justice centre: risk factors and challenges. J Adolesc Health 1999;25(1):46–51.

    Article  PubMed  CAS  Google Scholar 

  21. Thompson SC, Goudey RE, Breschkin AM, Carnie J, Catton M. Exposure to hepatitis B and C of tattooists in Victoria in 1984. J Viral Hepat 1997;4(2):135–8.

    PubMed  CAS  Google Scholar 

  22. Kelly HA, Riddell MA, Lambert SB, Leydon JA, Catton MG. Measles immunity among young adults in Victoria. Commun Dis Intell 2001;25(3):129–32.

    PubMed  CAS  Google Scholar 

  23. Lifson AR, Thai D, Hang K. Lack of immunization documentation in Minnesota refugees: challenges for refugee preventive health care. J Immigr Health 2001;3(1):47–52.

    Article  PubMed  CAS  Google Scholar 

  24. St Sauver JL, Jacobson RM, Vierkant RA, Jacobsen SJ, Green EM, Poland GA. Association of parental vaccination reports with measles, mumps, and rubella protective antibody levels: comparison of Somali immigrant, Hispanic migrant, and US children in Rochester, Minn. Mayo Clin Proc 2002;77(3):241–5.

    Article  Google Scholar 

  25. Shin DH, Yu HS, Park JH, Shin JH, Kim SJ. Recently occurring adult tetanus in Korea: emphasis on immunization and awareness of tetanus. J Korean Med Sci 2003;18(1):11–6.

    PubMed  Google Scholar 

  26. Centres for Disease Control and Prevention. Increase in African immigrants and refugees with tuberculosis—Seattle-King County, Washington, 1998–2001. Morb Mortal Wkly Rep 2002;51(39):882–3.

    Google Scholar 

  27. Trends in Tuberculosis—United States, 2005. MMWR March 23, 2006;55(No. 11).

  28. Centers for Disease Control and Prevention. Guidelines for the investigation of contacts of persons with infectious tuberculosis and Guidelines for using the QuantiFERON®-TB Gold test for detecting Mycobacterium tuberculosis infection, United States. Morb Mortal Wkly Rep 2005;54(No. RR-15). http://www.cdc.gov/mmwr/pdf/rr/rr5415.pdf (PDF).

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Acknowledgments

Funding support for this work was provided by the Victorian Infectious Diseases Service, RMH and the University of Melbourne Department of Medicine. The authors wish to thank the following persons for their invaluable input: the study participants; staff from the Western Region and Banyule Community Health Services; the advisory committee and community workers, Sagal Mohammed, Munira Mahmoud, Malyun Ahmed, Kinfe Abera Kahhsay and Abdulrahman Mohammed; Sheik Issa Musse from the Islamic Call Society; and the many other community members who provided advice and assistance.

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Authors and Affiliations

  1. Clinical Epidemiology and Biostatistics Unit, Department of Paediatrics, Royal Children’s Hospital, The University of Melbourne, Parkville, VIC, 3052, Australia

    Susan A. Skull

  2. Menzies School of Health Research, P.O. Box 41096, Casuarina, NT, Australia

    Susan A. Skull

  3. Department of Medicine (RMH/WH), The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, 3050, Australia

    Joanne Y. Y. Ngeow & Beverley-Ann Biggs

  4. Microbiological Diagnostic Unit, Public Health Laboratory, Microbiology & Immunology Department, The University of Melbourne, Parkville, VIC, 3010, Australia

    Geoff Hogg

  5. Centre for Clinical Research Excellence in Infectious Diseases (CCREID), The Royal Melbourne Hospital, Parkville, VIC, 3050, Australia

    Beverley-Ann Biggs

Authors
  1. Susan A. Skull
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  2. Joanne Y. Y. Ngeow
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  3. Geoff Hogg
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  4. Beverley-Ann Biggs
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Correspondence to Beverley-Ann Biggs.

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Skull, S.A., Ngeow, J.Y.Y., Hogg, G. et al. Incomplete Immunity and Missed Vaccination Opportunities in East African Immigrants Settling in Australia. J Immigrant Minority Health 10, 263–268 (2008). https://doi.org/10.1007/s10903-007-9071-9

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  • DOI: https://doi.org/10.1007/s10903-007-9071-9

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