Table 2.

Vaccinations recommended by different Western countries for newly arrived Internationally Adopted Children (IAC).

	Refers to	Year	Country Protocol:	DTaP/IPV/Hib/HBV	MMR-V	Men	PCV	BCG	HPV	Rotavirus
RECOMMENDED VACCINE FOR	IAC + Imm.	2013	ITALY	Vaccinate all IAC using age appropriate vaccination and follow the national schedule
	IAC + Imm.	2016	IRELAND	Three doses for IAC from four months to <18 years of age 1	12months-18 years of age: Two doses 2	One dose +/- a booster	4–12 months two doses two months apart;IAC 1 yr-2 yrs: one dose. NO if IAC >2 years of age	One dose (All IAC from four months-15 yrs of age); one dose high risk 15–18 yrs	Guidelines 2015: vaccinate all females 12–13 years old	Not reported in this guidance
	IAC	2004	UNITED KINDOM	IAC from two months of age up to 12 months with 6-in-1 vaccine 2	>13-15 months: Two doses 2	Three, two, or one dose depending on IAC age	IAC>2 years only if splenic dysfunction is known	Vaccine IAC <14 years	Not reported in this guidance	Not reported in this guidance
	IAC + Migrants	2014	FRANCE	No Hib if older than five years of age. HBV IAC < 11 years of age: Three doses, 11–15 yrs 2/3 dose schedule	Two doses 3	MenC IAC: 12–24 months: One dose + one booster	Two doses +/- a booster Depending on IAC age	Vaccinate IAC older than three months with Tuberculin skin test -	Not reported in this guidance	Not reported in this guidance
	IAC	2008	SPAIN	No Hib if older than five years of age	Vaccinate IAC >12 months old	Vaccinate IAC with age appropriate schedule 4	<6 years of age	Not reported in this guidance	Not reported in this guidance	Not reported in this guidance
	IAC + Migrants	2018	CANADA	Vaccinate all IAC with missing or uncertain vaccination records	Two doses: First dose 12–15 months of Age; a booster at 18 months or anytime later.5	Vaccinate all IAC with missing or uncertain vaccination records	Vaccinate all IAC with missing or uncertain vaccination records	Vaccine children living in very specific geographic areas	Vaccinate all IAC with missing or uncertain vaccination records	Vaccinate all IAC with missing or uncertain vaccination records
	IAC	2019	US AAP	Immunize following AAP catch-up schedule			=	=	=	=
	IAC	2019	US CDC	Immunize following ACIP schedule6			=	=	=	=
	Migrants	2018	ECDC	Offer DTaP/IPV/Hib vaccine to all migrants without documentation records; HBV: Offer to all migrants from intermediate to high prevalence countries who do not have evidence of vaccination or immunity	Vaccinate all IAC without documentation records.	Not reported in this guidance	Not reported in this guidance	Not reported in this guidance	Not reported in this guidance	Not reported in this guidance

Note: IAC: Internationally adopted children; Imm.: Immigrants; UK: United Kingdom; HBsAg: Hepatitis B surface antigen; HBsAb: Hepatitis B surface antibody; HBcAb: Hepatitis B core antibody; T: Tetanus; D: Diphtheria; DTaP Diphtheria-Tetanus-acellular-Pertussis; Hib: Type B Haemophilus Influenzae; IPV inactivated poliovirus; MMR-V: Measles-mumps-rubella-varicella vaccine; R: Rubella, V: Varicella; Me: Measles; Mu: Mumps; HAV: Hepatitis A; PCV: Pneumococcal conjugate vaccine; Men: meningococcal vaccine; BCG: Bacille Calmette Guerin; yrs: Years. ¹ IRELAND: Vaccinate IAC from four months to <10 years with 6-in-1 vaccine three doses two months apart for IAC from four months to <10 years of age; vaccinate with Tdap/IPV IAC from 10 years to <18 years of age: Three doses two months apart. ² UK: Vaccinate IAC from two months of age up to their first birthday with 6-in-1 vaccine: Three doses one month apart; use DTaP/IPV/Hib three doses one month apart for IAC from one to 10 years of age. ² IRELAND schedule depending on age: 12 months–4 yrs: First dose, 4–5 yrs second dose. IAC from 4 to <18 years of age: Two doses MMR at one-month intervals. Offer varicella vaccine to girls of childbearing age and some immunocompromised children, e.g., those with HIV infection. ² UK: One dose of MMR vaccine is recommended in IAC 13–15 months and a booster at 3–5 years; IAC at 1–5 years: First dose on arrival and second dose either three months later or with pre-school booster, as appropriate; IAC >5 years: Two doses separated by three months; varicella NOT specified. ³ France: Vaccinate all IAC between two years and 16 years of age, with MMR vaccine (two doses one month apart). Vaccinate adolescent IAC (12–16 years of age) with varicella vaccine: Two doses, one month apart. ⁴ SPAIN Men: the Spanish protocol recommend vaccinate IAC following the National schedule⁵ Canada: The first dose of a combination MMR or MMRV vaccine is given between 12 and 15 months of age, with a booster at 18 months or anytime later, though typically before school entry. Vaccinate against varicella following age-appropriate schedule for all IAC. ⁶ CDC immunization should be given according to the current ACIP schedule for catch-up vaccination and if there is uncertainty regarding immunization status or validity of the immunization records, the child should be immunized according to the ACIP schedule. UK MenC: Depending on age: MenC: IAC< 5 months: Three doses; 5–12 months: Two doses; 1–5 years: Single dose; > 5 years: Single dose. PCV FRANCE: IAC from 2–6 months old two doses and a booster (2,4,11 months); IAC 7–11 months old: Two doses two months apart and a booster after one year; IAC 12–23 months old two doses two months apart. BCG IRELAND: One dose of BCG vaccine should be given to low risk children from four months up to 15 years of age and high-risk children and adults up to 35 years of age. BCG UK recommends providing BCG vaccination to IAC aged <14 year.