CDC Refugee Provider Guidelines
CDC Guidelines for pre-departure and post-arrival medical screening and treatment of U.S.-bound refugees
I-693 Assistance for the Green Card Application

Immunization Guidelines & Resources

U.S. Bound Refugee Immunization Schedules
for overseas immigrations

School Vaccine Requirements, Forms and Other Resources 

Evaluating and Updating Immunizations
​​during the Domestic Medical Examination for Newly Arrived Refugees

Includes information on evaluating vaccine records, serology, immunization schedules, administration, and more.  

Immunization Schedule for Persons 0-18 Years
​includes catch-up schedule - 2020 

Immunization Schedule for Adults
2020

Assessment of Poliovirus Vaccination Status
​and Children Who Received Poliovirus Vaccine Outside of the United States

Immunization Resources
Foreign Language Terms - aids to translating foreign immunization records
Quick Chart of Vaccine-Preventable Disease Terms in multiple languages
Technical Instructions for Vaccination for Civil Surgeons
Requirements for routine vaccination of adjustment of status applicants who are not fully vaccinated or lack documentation
CDPHE's Stay Current with Vaccines during Covid-19 Postcards and Flyers in 12 Languages
Department of Health and Human Services news update: "Ineffective DTaP Vaccines Manufactured and Distributed in China"

Technical Tips

TECHNICAL TIP #1
Initial Vaccines

Refugee screening sites provide at least initial vaccinations. Please do no vaccinate newly arriving refugees unless you are a state-designated screening site. If you do vaccinate, particularly with live viral vaccines, this will negatively impact other important aspects of screening including screening for TB.

Technical Tip #2
Confirming and Recording Titer & Ciis

CIIS has the capacity to record titer information for the following vaccines. Check CIIS for immunity status against specific vaccine preventable diseases. If immune, do not vaccinate against these diseases and assure immunity is noted in patient’s record.
  • H. influenzae type b (Hib)
  • Hepatitis A
  • Hepatitis B
  • Poliovirus
  • Tetanus
  • Varicella
Lab confirmed immunity is entered as a precaution/contradiction. For further details on how to add titer in CIIS, see below.
STEP 1: When patient is selected, click on the “precautions/ contraindications” box
STEP 2: When patient is selected, click on the “precautions/ contraindications” box
STEP 3: Using the drop-down menu, select the appropriate option for a lab- confirmed immunity. The effective date should be the date the lab test was performed. No expiration date is needed. Complete transaction by clicking the “create” button. 

Technical Tip #3
HIV & Live, Attenuated Vaccinations

People with HIV benefit greatly from receiving vaccines against other vaccine-preventable diseases; however, strong consideration should be given to not vaccinate with live viral vaccines unless HIV status is known. HIV testing is done at all 4 refugee screening sites. In general, people with HIV should not get live, attenuated vaccines unless the benefit outweighs the risk. Vaccines work best when an HIV-infected persons' CD4 count is above 200 copies/mm3. Decisions to vaccinate patients with HIV should be done in consultation with an expert in HIV care. Live, attenuated vaccines are contraindicated for patients with AIDS.
Recommended Immunization Schedules for persons affected with HIV:

Technical Tip #4
Refugees & Hepatitis B

Between 2009 and 2013, rates of Hepatitis B infections among refugees arriving in Colorado were between 3% - 4% (CDPHE). The CDC recommends that all refugees from intermediate and high endemicity countries (Hepatitis B virus surface antigen prevalence > 2%) should undergo Hepatitis B testing. Refugees who are chronically infected with Hepatitis B should receive further evaluation and monitoring. Refugees who are not immune and are not chronically infected should be offered vaccination.

Last Updated on December 20, 2020

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