Adopting a Child from Another Country (Intercountry Adoption)
CDC recommends making sure you are up to date with your COVID-19 vaccines before travel, which includes additional doses for individuals who are immunocompromised or booster doses when eligible. Follow all requirements and recommendations at each location during travel, and take steps to protect yourself and others. If you are traveling internationally, check the COVID-19 Travel Health Notice for your destination and visit the International Travel webpage for requirements and recommendations.
Each year, parents in the United States adopt more than 5,000 children from all over the world. Adopting a child from another country is can be a wonderful and exciting event for families. The health of both the child and their parents and family is one of many issues that needs to be addressed during the adoption process.
If you are adopting a child from another country,
- Consider a preadoption medical review with a pediatrician who is familiar with the health issues of children adopted from other countries to review the available medical history and vaccination record for the child,
- Plan for safe travel overseas for both you and your child, and
- Arrange for your child to have a medical exam with a pediatrician specializing in adoption health soon after you return home.
Before Your Trip
To understand more about possible health concerns for your child, you should consider a preadoption medical review with a pediatrician who is familiar with the health issues of children adopted internationally to review the available medical history and vaccination record for the child. You should not rely on only the required overseas medical examination (see below) in the immigrant visa process to detect all possible disabilities and illnesses.
At least one month before you go abroad to unite with your child, schedule a visit with a travel medicine specialist or your doctor to discuss disease risks, vaccinations, medications, and advice for your destination. General guidance for traveling internationally with children also applies to your child who you are bringing home to the United States.
People in the United States who will have close contact with your child (including extended family and caregivers) should be up to date on routine vaccines, as well as have immunity to hepatitis A and B. They should also have a Tdap booster to prevent pertussis (whooping cough) and, depending on the child’s country of origin, a booster of polio vaccine. It is important for everyone who has contact with your child to be fully vaccinated, even if they do not live in the same home; illnesses have been spread from children adopted from other countries to grandparents, aunts, uncles, cousins, and other caregivers in the United States.
During Your Trip: The Overseas Medical Exam
At least 4–6 weeks before you depart to unite with your child, schedule a visit with a travel medicine specialist to discuss disease risks in the destination country and what you can do to avoid them. Your travel medicine specialist may recommend vaccines to protect against diseases in that country. Your travel medicine specialist can also give you advice on travel safety, food and water precautions, and preventing travelers’ diarrhea. General guidance for traveling internationally with children also applies to the adopted child you are bringing home.
People at home who will have close contact with your child (including extended family and caregivers) should be up-to-date on routine vaccines, as well as being vaccinated against hepatitis A and B. They should also have a booster of the vaccine that prevents pertussis (whooping cough) and, depending on the child’s country of origin, a booster of polio vaccine. It is important for everyone who has contact with the child to be vaccinated, even if they do not live in the same home; there have been cases of illnesses spread from internationally adopted children to grandparents, aunts, uncles, cousins, and other caregivers.
The Overseas Medical Exam
Children who are being adopted overseas by US citizens must have a medical exam in their country of origin, performed by a doctor specially designated by the US Department of State. This exam is designed to detect certain serious illnesses, such as tuberculosis, and should not be relied on to detect all possible health conditions. Additional information about the overseas medical exam is available from the Department of State: http://adoption.state.gov/adoption_process/how_to_adopt/health.php.
After Your Trip: The Follow-Up Medical Exam in the United States
Within two weeks of arrival in the United States, your child should have another medical exam to assess his or her general health and screen for other infections, such as intestinal parasites, which are common in internationally adopted children. In some circumstances, screening for developmental delays can be considered.