title: Australian population cohort study of newly arrived refugee children:  how effective is predeparture measles and rubella vaccination?
abstract: BACKGROUND
  Predeparture medical screening and measles-mumps-rubella vaccination are routinely given to refugee children before departure from most transit countries en route to Australia.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the effectiveness of this single measles-mumps-rubella vaccine and the reliability of its documentation. This is important in determining refugees' susceptibility to measles and rubella and the risk to the nonvaccinated community.
  
  
  METHODS
  We analyzed measles and rubella serology in a comprehensively screened population of newly arrived refugees. We reviewed seropositivity rates based on age, sex, country of departure and vaccine documentation.
  
  
  RESULTS
  Of 164 children screened, 139 (84.8%) were immune to rubella; 143 (87.7%) to measles and 119 (73.0%) to both. There was no significant difference in immunity among those of different ages or those departing different continents. Immunity rates among those with documented measles-mumps-rubella tended to be higher: 91.1% for rubella, 89.1% for measles and 80.0% for both diseases, but this did not reach significance at the 5% level. There was a significant difference between males (65.9%) and females (81.3%) immune to both diseases (P = 0.042).
  
  
  CONCLUSIONS
  This cohort demonstrated similar measles and rubella seropositivity rates to those of the Australian population, but lower rates than population seroconversion studies, which have been estimated at 95%. Males were less likely to be immune. Rates in those with documented vaccination approximated seroconversion studies. This confirms the appropriateness of current guidelines which suggest that immunization is not required in the face of documented prior vaccination, but is required without such documentation.
authors.affiliation: Department of Community Child Health, Sydney Children’s Hospitals Network, Corner of Barker and Avoca St, Randwick 2031, Australia. karen.zwi@SESIAHS.HEALTH.NSW.GOV.AU
authors.forename: Paul Robert
authors.initials: PR
authors.lastname: Joshua
authors.forename: Mitchell M
authors.initials: MM
authors.lastname: Smith
authors.forename: Alaric Sek Kai
authors.initials: AS
authors.lastname: Koh
authors.forename: Lisa Anne
authors.initials: LA
authors.lastname: Woodland
authors.forename: Karen
authors.initials: K
authors.lastname: Zwi
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage* / Q000276:immunology; D012036:Refugees / Q000706:statistics & numerical data*; D012409:Rubella / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control
chemical_list: D022542:Measles-Mumps-Rubella Vaccine