Date printed: 24/10/2018
Children and adults entering Australia as migrants or refugees, or seeking asylum should (but do not always) have their vaccination status assessed1 and should (but do not always) receive appropriate catch-up vaccination. Migrants from resource-poor settings — especially refugees or people seeking asylum — may be incompletely vaccinated according to the Australian schedule and may have incomplete records of vaccination.2-4
Vaccination is a priority in refugee health care, and all age groups should receive catch-up vaccination. Catch-up schedules depend on primary care services in most states and territories.
See Infographic. Vaccination for migrants, refugees and people seeking asylum.
People with documentation of vaccination
Refugees and people seeking asylum may have been vaccinated as part of their visa application process or while in Australian immigration detention. Documentation, such as the Departure Health Check or Australian immigration detention health records, may provide information about whether refugees and people seeking asylum received any vaccines.5
If a person has a record of vaccination from overseas, consider any previous doses when planning a catch-up vaccination schedule.
Check the dosing intervals — some doses may be invalid because the interval between doses was too short. This is often the case with oral poliomyelitis vaccines and tetanus vaccines.
Also check all vaccination records before vaccination, because people may have visited multiple immunisation providers after they arrived in Australia.
People without documentation of vaccination
If a migrant, refugee or person seeking asylum has no valid documentation of vaccination, they should start a catch-up schedule. See Catch-up vaccination and the fact sheet Free catch-up vaccines for refugees and humanitarian entrants aged 20 years and over.
Adult migrants, refugees and people seeking asylum may need vaccination, especially with MMR (measles-mumps-rubella) vaccine. This is particularly important for women of child-bearing age to protect against rubella (see Pre-vaccination serological testing). Some refugees may have received a dose of MMR as part of their pre-departure screening, but may need another dose on arrival in Australia. 1
If a child is ≥12 months of age, they can receive their 1st doses of the following vaccines at the same visit:
- DTPa (diphtheria-tetanus-acellular pertussis)
- hepatitis B
- IPV (inactivated poliovirus)
- MMR
- MenC (meningococcal C)
- 13vPCV (13-valent pneumococcal conjugate)
- Hib (Haemophilus influenzae type b)
For details, see Catch-up vaccination.
Live attenuated viral vaccines
People may have received live attenuated viral vaccines as part of pre-departure screening. These may include measles-containing vaccines or yellow fever vaccine (especially people arriving from central and northern Africa).
Allow at least 4 weeks before giving any other live attenuated viral vaccines. Also note that live attenuated viral vaccines may interfere with tuberculin skin test reactions (see Tuberculosis).
Pre-vaccination serological testing
Serological testing before vaccination is not routinely recommended. However, it may be needed for:
- migrants, refugees and people seeking asylum from hepatitis B–endemic countries to detect current or past hepatitis B infection (also see Hepatitis B)
- female migrants, refugees and people seeking asylum of child-bearing age to identify women who are seronegative for rubella and need vaccination (see Rubella)
Reporting vaccinations to national registers
Report any vaccines that a migrant, refugee or person seeking asylum receives to the Australian Immunisation Register (AIR).
This includes any vaccinations documented before arrival in Australia and for individuals not enrolled with Medicare. People can access AIR History Statements after the AIR receives records of any documented overseas vaccination(s).
Provide people with a written record of all the vaccines they have received.
See Reporting to immunisation registers in After vaccination.
References
- Australian Government Department of Home Affairs. Fact sheet – Departure health check (DHC). (Accessed Apr 2018).
- Tiong AC, Patel MS, Gardiner J, et al. Health issues in newly arrived African refugees attending general practice clinics in Melbourne. Medical Journal of Australia 2006;185:602-6.
- Gould G, Viney K, Greenwood M, Kramer J, Corben P. A multidisciplinary primary healthcare clinic for newly arrived humanitarian entrants in regional NSW: model of service delivery and summary of preliminary findings. Australian and New Zealand Journal of Public Health 2010;34:326-9.
- Skull SA, Ngeow JY, Hogg G, Biggs BA. Incomplete immunity and missed vaccination opportunities in East African immigrants settling in Australia. Journal of Immigrant and Minority Health 2008;10:263-8.
- Australian Government Department of Health. Vaccination provider fact sheet – National Immunisation Program: Free catch-up vaccines for refugees and other humanitarian entrants aged 20 years and over (ongoing). Canberra: Australian Government Department of Health; 2017.
Definitions
- MMR
- measles-mumps-rubella
- DTPa
- diphtheria-tetanus-acellular pertussis vaccine
- IPV
- inactivated poliomyelitis vaccine
- 13vPCV
- 13-valent pneumococcal conjugate vaccine
This document was printed on: 15/11/2018. Printed content may be out of date. For up to date information, always refer to the digital version: https://immunisationhandbook.health.gov.au/vaccination-for-special-risk-groups/vaccination-for-migrants-refugees-and-people-seeking-asylum-in.
