Only 59% of refugees complete hepatitis B vaccination within one year of arrival

Refugees receive an overseas medical examination before departure, but vaccination series are frequently incomplete because of supply shortages at panel sites, short notice before travel, and the impossibility of completing multi-dose series (like hepatitis B, which requires 3 doses over 6 months) before departure. Upon arrival, refugees are supposed to receive a domestic medical screening within 30-90 days, but the handoff between overseas records and U.S. primary care is fragmented. So what? Research shows that only 59% of eligible refugees completed the three-dose hepatitis B vaccine series within one year of resettlement, and 8% of MMR-eligible refugees received zero doses within a year. So what? Incomplete vaccination leaves refugees vulnerable to preventable diseases, and because refugees are often housed in dense, multi-family housing and work in close-contact environments like meatpacking plants, warehouses, and food service, outbreaks can spread quickly. So what? A single outbreak in a refugee community triggers public health emergencies, workplace shutdowns, and media coverage that fuels anti-refugee sentiment, undermining political support for resettlement broadly. So what? Preventable disease outbreaks become ammunition for policy advocates seeking to reduce refugee admissions, threatening the entire program. The structural reason this persists is that there is no integrated health record system between overseas panel physicians and U.S. domestic providers; vaccination records arrive as scanned paper documents in the Electronic Disease Notification (EDN) system, and local clinics must manually reconcile them with U.S. immunization schedules.