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Refugees are one of the few groups of immigrants to the United States who are not required to have any vaccinations prior to arrival. Refugees are infrequently up-to-date with age appropriate vaccinations, although vaccination in accordance with the Advisory Committee on Immunization Practices (ACIP) is mandated prior to both entrance into school and application for permanent resident status. A combination of vaccination records and laboratory testing of immunity is used to determine need for vaccinations. This chapter reviews recommendations for vaccination of both adult and child refugees. [ABSTRACT FROM AUTHOR]