Clinical management of immigrants' immunization histories: a focus on Soviet health records and BCG

Increasing numbers of immigrants from the former Soviet Union are settling in the United States each year, making it imperative for clinicians to know how to find and interpret immigrant children's immunization records. Records show that these children have usually received immunizations against tetanus, diphtheria, pertussis, poliomyelitis, measles, mumps and tuberculosis (BCG). They are occasionally vaccinated against influenza, smallpox and tularemia, but never against rubella, hepatitis B or H. influenzae meningitis. The Soviet immunization schedule differs significantly from the U.S. schedule only in BCG vaccine and polio immunization. Contrary to widespread belief in the United States, BCG vaccination does not necessarily render a child's tuberculin skin test positive, and it certainly does not confer total immunity to tuberculosis. MMR vaccination is essential for all Soviet immigrant children. A single update of all the other immunizations may be a wise approach when handling Soviet children's immunizations.