Author Archive


Georgia Paxton, Gillian Singleton


  • Provide catch-up immunisation so people from refugee-like backgrounds are immunised equivalent to an Australian-born person of the same age.
  • Written records are considered reliable evidence of vaccination status.
  • In the absence of written immunisation documentation, full catch-up immunisation is recommended.
  • Routine serology against a range of vaccine preventable diseases (VPD) is not recommended to guide catch-up immunisation. Serology for hepatitis B infection and immunity is part of initial health screening. Offer testing for:
    • varicella serology (if ≥14 years if there is no history of natural infection)
    • rubella serology (in women of childbearing age).
  • Do not presume other providers are completing immunisation catch-up – be opportunistic – immunisation is the responsibility of all health providers.

Identifying patients from refugee backgrounds

Key points

Identification of people from refugee backgrounds, including people seeking asylum, is important so that healthcare providers can tailor their approach.

There are a number of indicators that a person may be from a refugee background. These include:

  • country of birth
  • year of arrival in Australia
  • need for interpreter
  • preferred language
  • visa type
  • referral source.


If a person speaks a language other than English and comes from a country that has a history of conflict and human rights violations, e.g. Afghanistan, Iraq, Sri Lanka, Iran or Burma (Myanmar), they are likely to be from a refugee background. A country of asylum or transit such as Pakistan, Malaysia, Thailand or Egypt can also suggest a refugee background. Country of birth is not necessarily an indication of ethnicity or religious background.

People from refugee backgrounds can also be identified by their visa number, which indicates the category of Australia’s Humanitarian program under which they arrived. This includes entrants with the following visa subclasses:

Offshore – Refugee

  • Refugee Visa (Subclass 200)
  • In-country Special Humanitarian Visa (Subclass 201)
  • Emergency Rescue Visa (Subclass 203)
  • Woman at Risk Visa (Subclass 204)

Offshore – Special Humanitarian Program

  • Global Special Humanitarian Visa (Subclass 202)

Onshore Protection Program

  • (permanent) Protection Visa (Subclass 866)
  • Temporary Protection Visa (TPV) (Subclass 785)
  • Safe Haven Enterprise Visa (SHEV) (Subclass 790)

People seeking asylum

People seeking asylum who arrive in Australia and subsequently apply for protection as refugees have different visa types and eligibility for services.

Those arriving with valid entry documentation (e.g. a student or visitor visa) are permitted to reside in the community while their application is considered and are provided with a Bridging Visa after their original visa expires.

  • Bridging Visa A (Subclass 010)
  • Bridging Visa C (Subclass 030)
  • Bridging Visa E (Subclass 050 & 051)

People seeking asylum who hold a Bridging Visa E may have arrived without valid documentation prior to 2014. Those who arrived after this date were subject to transfer to Nauru and Manus. Also, some people who were transferred to Australia from regional processing centres for medical care will also hold a Bridging Visa E.

Visas are subject to change. For the most up-to-date information about visa types, see the Australian Government Department of Home Affairs:

See Asylum seekers.

Practice tip: Record country of birth, need for an interpreter, preferred language, date of arrival and visa number, in patient files to support care, particularly for people with special or complex needs.

People from refugee backgrounds may be referred by settlement and asylum seeker support services, refugee health nurses and services and/or specialised services for survivors of torture and trauma.


People who have been in Australia for some time may not identify as refugees and may find questions about visa number details intrusive.

In some circumstances people from a refugee background may have a permanent or temporary visa (e.g. orphan, spouse, student, some people seeking asylum) that does not entitle them to Medicare, yet they may be unable to pay for healthcare services. These circumstances may require further advice and advocacy with local health and welfare agencies, and refugee and asylum seeker health services.

Hepatitis C

Jennifer Maclachlan, Benjamin Cowie, David Isaacs, Joshua S Davis


  • Offer testing for hepatitis C (HCV) to people if they have:
    • risk factors for HCV (see text)
    • lived in a country with a high prevalence (>3%) of HCV (see table 5.1)
    • an uncertain history of travel or risk factors.
  • Initial testing is with anti-HCV test (HCV Ab). If this is positive, request an HCV RNA test.
  • If positive, refer to a doctor accredited to treat HCV for further assessment.

Produced by

in consultation with

                  Refugee Health Network of Australia

Endorsed by

Funded by

The Australian Refugee Health Practice Guide was produced with funds from the Australian Government Department of Health.


The information set out in the Australian Refugee Health Practice Guide (“the Guide”) is current at the date of first publication and is intended for use as a guide of a general nature only and may or may not be relevant to particular patients or circumstances. Nor is the Guide exhaustive of the subject matter. Persons implementing any recommendations contained in the Guide must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular circumstances when so doing. The statements or opinions that are expressed in the Guide reflect the views of the contributing authors and do not necessarily represent the views of the editors or Foundation House. Compliance with any recommendations cannot of itself guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional and the premises from which the health professional operates.

Whilst the information is directed to health professionals possessing appropriate qualifications and skills in ascertaining and discharging their professional (including legal) duties, it is not to be regarded as clinical advice and, in particular, is no substitute for a full examination and consideration of medical history in reaching a diagnosis and treatment based on accepted clinical practices.

Accordingly, Foundation House and its employees and agents shall have no liability (including without limitation liability by reason of negligence) to any users of the information contained in the Guide for any loss or damage (consequential or otherwise), cost or expense incurred or arising by reason of any person using or relying on the information contained in the Guide and whether caused by reason of any error, negligent act, omission or misrepresentation in the information. Although every effort has been made to ensure that drug doses and other information are presented accurately in the Guide, the ultimate responsibility rests with the prescribing clinician. For detailed prescribing information or instructions on the use of any product described herein, please consult the prescribing information issued by the manufacturer.