Background: Immigrants and refugees are at particular risk of incomplete immunisation and may be unaware of their vaccination status. There is a paucity of data on the immunisation status of adult immigrants from African countries. Aims: To review the immunisation status of adult immigrants from East Africa, and to identify missed opportunities for vaccination. Methods: A community survey was conducted using self-reported vaccination status, Mantoux skin tests, and serological testing for immunity to hepatitis B, tetanus, diphtheria and measles. Results: Proven inadequate immunity against at least one of tetanus (67%), hepatitis B (41%), diphtheria (34%) or measles (3%) was found among 100/126 (81%) participants despite a median of seven visits to vaccine providers since immigration. A positive Mantoux test occurred in 17% of participants. Conclusions: Pre- and post-arrival health assessments are currently failing to address vaccination needs in recently arrived East African adult immigrants. Immigrants should have their immunisation status assessed, with opportunistic vaccination provided wherever possible.