Extended Family Members of Adopted Children May Need Hepatitis A Vaccine

by Pam Connell | More from this Blogger

27 Apr 2009 02:23 AM

If you are beginning an international adoption, you've probably thought quite a bit about the health of your potential child. In a home study, you have had to address questions about your own health. A few of us might think 6 months ahead to plan for a trip to our child's country. Even if we do begin a vaccination schedule for ourselves, we likely wouldn't think of having our parents or other close relatives, neighbors and babysitters vaccinated. I know I didn't.

But that needs to change. In a sobering case, a 51-year-old adoptive grandmother was hospitalized earlier this spring for Hepatitis A, a liver virus. It seems that she received the virus from her newly-adopted grandchild.

The Advisory Committee on Immunization Practices, which makes recommendations to the U.S. Centers for Disease Control in Atlanta, voted to recommend that "all close contacts of children coming from countries where Hepatitis A is relatively common" be vaccinated against Hepatitis A. These countries include Guatemala, China, Russia, and Ethiopia, which are currently countries accounting for the majority of international adoptions by U.S. families.

Don't panic. Hepatitis, like HIV, is not spread through sneezing skin contact. It is spread through blood, and-unlike HIV-through feces. Therefore anyone who might pitch in to change a diaper or assist a child with toileting or "accident" cleanup, or dealing with a cut or bloody nose, etc., should use gloves, and preferably should be immunized. (Here is a blog describing how one foster mother followed precautions for a one-year-old who might have been exposed to Hepatitis C.)

The Committee specifically makes this recommendation for those who may be in that close contact with the child during the first 60 days of their arrival in the U.S. I personally would rather do this for the first six months, but check with your child's doctor. There are doctors experienced in international adoption and common conditions children from different countries may have. One thing to note is that unlike many adults with hepatitis, children may not show the jaundice that makes doctors and parents suspect hepatitis. Of course, parents who travel to pick up their new arrival need to be immunized as well. Grandparents, babysitters or other close contacts should ideally receive the first dose of the vaccine about two weeks before the child's arrival.

Experts stated that internationally adopted children are believed to account only for an estimated 100 to 1000 of the 32,000 Hepatitis A cases generally found in the United States each year.

Hepatitis B is also common in other parts of the world, including some Asian countries. Note that some vaccines-like the hepatitis B series, need more than one vaccine and there must be a waiting period in between-such as three shots each given two months apart, for example. You will want to start this process early in your adoption process. Make it the first thing you do while you are waiting, perhaps right after you've submitted all the paperwork for immigration, agency application and homestudy. The hepatitis A vaccine is now recommended for all children in the U.S., and the hepatitis B vaccine is required in most states. But adults are likely to lack these protections since the vaccines were not available when we were children.

My husband and I received the hepatitis B series of shots nine years ago, while we were preparing to go to Korea to pick up our first daughter. Our son had received this series in infancy. I confess I never really thought about non-traveling family members, and I don't recall any discussion of Hepatitis A or C. But changes like this are what make it more important to have a knowledgeable doctor, preferably with experience in international adoption.

Please see these related blogs: Vaccinations in Adopted Children and Families

What Is An Adoption Doctor and Why Would I Need One?

Learn more about Pam Connell

Pam Connell is a mother of three by both birth and adoption. She has worked in education, child care, social services, ministry and journalism.

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