Updated December 04, 2014.
Your child has had all or most of his vaccines, but you can't find his vaccine records. Your doctor can't find them either. What do you do? Does he need to start getting shots all over again?
Unfortunately, this happens much more often than you would think.
Families move, doctors retire, and records get lost.
If this happens to you, before you go any further, there are a few things you can do to locate your child's shot records:
If a child's shot record is truly lost, the Advisory Committee on Immunization Practices (ACIP) recommends that the child "should be considered susceptible and should be started on the age-appropriate vaccination schedule."
Since most kids and parents likely don't look forward to extra shots, the ACIP does offer one other option: "Serologic testing for immunity is an alternative to vaccination for certain antigens." That means that blood tests can be done to try and prove that your child did already get all of his shots.
Going this route, a child could be tested for:
These tests are also sometimes done for internationally adopted children who may have received some vaccines in their home country before being adopted.
There aren't any tests for the Haemophilus influenzae type b (Hib) or pertussis vaccines. Fortunately, you only need one dose of Hib after age 15 months, and you don't get it at all once you are five years old. So, if your school age child had positive results for all of the above tests, he might not need to repeat the MMR, hepatitis A, hepatitis B, IPV, or Varivax vaccines.
With the test results, your pediatrician can write a letter stating that your child is immune to the appropriate vaccine-preventable diseases and doesn't need to repeat the vaccines.
Your child may still need a pertussis shot (DTaP vs Tdap) and any vaccines for which the tests show he doesn't have proven immunity, though.
What about Prevnar? Although it may not be widely available, there is a Streptococcus pneumoniae IgG antibody 7 serotypes test that could help to verify that your child had Prevnar. Like Hib, Prevnar is mainly for infants, toddlers, and preschoolers, and isn't required for older kids in school. Therefore, verifying this vaccine isn't usually as important as the others.
Keep in mind that there are a few downsides do doing these tests instead of simply repeating the vaccines. For one, there is the cost of the tests, which may not be covered by insurance. Also, you may need a new letter each time your child changes schools, goes to a new camp, goes off to college, etc.
To help avoid being in the situation where your child's shot record could be lost, it can be helpful to:
Hurricane Katrina should have been a wake-up call that important records can get destroyed. In addition to losing records in your home, with such a wide-scale disaster, records at your doctor's office will likely be lost, too. Fortunately, Louisiana already had a statewide immunization tracking system. So, even with so much being lost in the floods, immunization records remained intact.
Sources:
General Recommendations on Immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. December 1, 2006 / Vol. 55 / No. RR-15
The Success of an Immunization Information System in the Wake of Hurricane Katrina. PEDIATRICS Vol. 119 No. 6 June 2007, pp. 1213-1217
Your child has had all or most of his vaccines, but you can't find his vaccine records. Your doctor can't find them either. What do you do? Does he need to start getting shots all over again?
Unfortunately, this happens much more often than you would think.
Families move, doctors retire, and records get lost.
If this happens to you, before you go any further, there are a few things you can do to locate your child's shot records:
- Contact previous day care centers, schools, camps, or anyone else that you may have given a copy of his shot record to, and see if they still have a copy.
- If your previous doctor moved or retired, contact your local medical society or state medical board to see where old records may be stored. Doctors are supposed to store old records for a certain amount of time, but just how long varies from state to state.
- If your pediatrician is still in practice, try his office again to see if they can find them. Although medical records are sometimes misplaced, it is usually possible to find them if office staff keep looking.
- Find out if your state has an immunization registry and, if so, if your child has any vaccine records in it. Many pediatricians are not routinely recording all of a child's vaccines with a computerized statewide immunization registry.
Lost Shot Records
If a child's shot record is truly lost, the Advisory Committee on Immunization Practices (ACIP) recommends that the child "should be considered susceptible and should be started on the age-appropriate vaccination schedule."
Since most kids and parents likely don't look forward to extra shots, the ACIP does offer one other option: "Serologic testing for immunity is an alternative to vaccination for certain antigens." That means that blood tests can be done to try and prove that your child did already get all of his shots.
Going this route, a child could be tested for:
- measles - measles antibody (IgG)
- mumps - mumps antibody (IgG)
- rubella - rubella immune status enzyme immunoassay (EIA) test (IgG)
- hepatitis A - hepatitis A total antibody test (IgG)
- hepatitis B - quantitative hepatitis B surface antibody test
- diphtheria - diphtheria antitoxoid antibody
- tetanus - tetanus antitoxoid antibody
- poliovirus types 1, 2, and 3 - poliovirus antibody test
- varicella (chicken pox) - varicella-zoster virus antibody immunity screen
These tests are also sometimes done for internationally adopted children who may have received some vaccines in their home country before being adopted.
There aren't any tests for the Haemophilus influenzae type b (Hib) or pertussis vaccines. Fortunately, you only need one dose of Hib after age 15 months, and you don't get it at all once you are five years old. So, if your school age child had positive results for all of the above tests, he might not need to repeat the MMR, hepatitis A, hepatitis B, IPV, or Varivax vaccines.
With the test results, your pediatrician can write a letter stating that your child is immune to the appropriate vaccine-preventable diseases and doesn't need to repeat the vaccines.
Your child may still need a pertussis shot (DTaP vs Tdap) and any vaccines for which the tests show he doesn't have proven immunity, though.
What about Prevnar? Although it may not be widely available, there is a Streptococcus pneumoniae IgG antibody 7 serotypes test that could help to verify that your child had Prevnar. Like Hib, Prevnar is mainly for infants, toddlers, and preschoolers, and isn't required for older kids in school. Therefore, verifying this vaccine isn't usually as important as the others.
Keep in mind that there are a few downsides do doing these tests instead of simply repeating the vaccines. For one, there is the cost of the tests, which may not be covered by insurance. Also, you may need a new letter each time your child changes schools, goes to a new camp, goes off to college, etc.
Avoiding Lost Shot Records
To help avoid being in the situation where your child's shot record could be lost, it can be helpful to:
- encourage your doctor to participate in a immunization registry program
- have your own copy of your child's shot record updated each time your child gets vaccines at your pediatrician's office
- make a copy of your child's vaccine record and keep it in a secure place, such as a home safe that offers fire protection and which is water-resistant
- keep a second copy of your child's vaccine record in a second place outside your home, such as a safe deposit box or a family member's home
Hurricane Katrina should have been a wake-up call that important records can get destroyed. In addition to losing records in your home, with such a wide-scale disaster, records at your doctor's office will likely be lost, too. Fortunately, Louisiana already had a statewide immunization tracking system. So, even with so much being lost in the floods, immunization records remained intact.
Sources:
General Recommendations on Immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. December 1, 2006 / Vol. 55 / No. RR-15
The Success of an Immunization Information System in the Wake of Hurricane Katrina. PEDIATRICS Vol. 119 No. 6 June 2007, pp. 1213-1217