4 Vaccinations
A systematic survey of vaccinations of refugees/migrants/asylum seekers is not easy to realise, therefore a valid evaluation of susceptibility to vaccine preventable diseases by immunization is not possible.
In reception centres and camps, where many asylum seekers live together, the probability for outbreaks of infectious diseases is increased. This population group might be difficult to reach due to migratory reasons.
Early immunization of refugees after arrival in Europe has the following objectives:
- Individual protection of the asylum seeker,
- limitation and prevention of outbreaks of vaccine-preventable infections
- and early containment of an insufficiently immunized population group, which is difficult to reach by the public health system.
If immunization records are missing, it is recommended to vaccinate according to the catch-up plan of the Austrian vaccination schedule (BMG, 2016a). Anamnestic information of refugees/migrants/asylum seekers can be accepted, if considered reliable. Immunizations that are not provided in the countries of origin should be offered as soon as possible. Information about national vaccination schedules can be obtained at the WHO vaccine-preventable diseases: monitoring system. 2016 global summary. [http://apps.who.int/immunization_monitoring/globalsummary/schedules] Immunization centres of the Austrian provinces can be found here. [https://www.gesundheit.gv.at/Portal.Node/ghp/public/content/impfungen-beratung-impfstellen-bundeslaender.html]
The italic notation in the tables marks vaccinations that are recommended by the National Immunization Committee, but are not funded. For people accommodated in refugee camps influenza immunization is suggested in winter season, but the subsidy has not been resolved, yet.
For children older than six years the appropriate vaccine divergent from the routine immunization plan often is not available. Or like in the case of the diphtheria, pertussis, tetanus and polio vaccine, licence for basic immunization does not exist. In this context it might be inevitable to dispose vaccinations “off label”.
The boxes that are highlighted in grey are recommended by the Austrian national vaccination body of the Federal Ministry of Health and Women, however, they are not financed by public authorities.
Recommendation for vaccine catching up for children up to 6 years
| Diphterie (DIP) Tetanus (TET) ev. Pertussis (PEA) Poliomyelitis (IPV) | 3 Dosen | 1. Diphterie-Tetanus-Poliomyelitis-Pertussis z.B.: als Tetra-vac
2. Dosis nach 2 Monaten, 3. Dosis nach 12 Monaten |
| Masern Mumps (MMR) Röteln | 2 Dosen | mindestens 4 Wochen Abstand |
| Hepatitis A (HAV) | 2 Kinderdosen | im Abstand von 6-12 Monaten |
| Hepatitis B (HBV) | 3 Dosen | 2. Dosis nach 4 Wochen, 3. Dosis nach 6 Monaten |
Recommendation for vaccine catching up for children and youth from 7 to 18 years
| Diphterie (DIP) Tetanus (TET) Pertussis (PEA) Poliomyelitis (IPV) | 3 Dosen | z.B.: als Tetravac
2. Dosis nach 2 Monaten, 3. Dosis nach 12 Monaten trotz Zulassung nur für Kinder bis 12 Jahren bzw. als Auffrischungsimpfung auch Boostrix Polio – oder Repevax |
|
| Masern Mumps (MMR) Röteln | 2 Dosen | mindestens 4 Wochen Abstand | |
| Hepatitis A (HAV) | 2 Dosen | im Abstand von 6-12 Monaten | |
| Hepatitis B (HBV) | 3 Dosen | 2. Dosis nach 4 Wochen, 3. Dosis nach 6 Monaten | |
| Varizellen (VZ)
bei negativer Varizellenanamnese |
2 Dosen | im Mindestintervall von 6 Wochen | |
| Meningokokken konjugiert MEC/MEC4
Meningokokken B |
1 Dosis
2 Dosen im Abstand von 6 Monaten |
||
Concept for the early immunization of refugees/asylum seekers for Austria (Robert Koch-Institute, 2015)
- The STIKO recommends starting vaccinating asylum seekers as soon as possible, preferentially within the first days after arrival in a reception centre.
- Adults with documented primary immunization against tetanus, diphtheria, pertussis and polio, require a single booster injection, if the last vaccination was carried out more than ten years ago. Children from five years onwards need a booster, if the last tetravalent vaccination lies more than five years in the past.
- Initially a single measles, mumps and rubella (MMR) immunization, that is acknowledged, is adequate. Children shall get a second shot of MMR or MMR-V (plus varicella) in the course.
- If inoculants are not sufficiently available, children are to be vaccinated preferably.
- In the course of an outbreak of a vaccine-preventable disease the particular vaccination is to be administered as a priority.
- In camps it should be considered to offer additional influenza immunization to every resident, according to the Austrian vaccination schedule (BMG, 2016a). However, a decision on funding in Austria has not been taken, yet.
- The completion of the primary immunization should be carried out according the National vaccination schedule.