Challenges in the equitable access to COVID-19 vaccines for migrant populations in Europe

Armocida, Benedetta; Formenti, Beatrice; Missoni, Eduardo; D’Apice, Clelia; Marchese, Valentina; Calvi, Marzia; Castelli, Francesco; Ussai, Silvia

doi:10.1016/j.lanepe.2021.100147

Cited by 38 publications

(43 citation statements)

References 6 publications

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“…32 Vaccine implementation strategies will need to be adapted to meet the individual needs of refugees considering the multiple barriers they face when accessing the vaccines. 33 The…”

Section: Urgent Need For Community Engagement Strategiesmentioning

confidence: 99%

Factors influencing refugees’ willingness to accept COVID‐19 vaccines in Greater Sydney: a qualitative study

Mahimbo

Kang²,

Sestakova

et al. 2022

Australian and New Zealand Journal of Public Health

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Objectives: Achieving high vaccination coverage is a critical strategy to reducing the spread of COVID‐19 infection. This study, undertaken before the Delta variant outbreak, aimed to understand potential drivers and barriers influencing COVID‐19 vaccine uptake for refugees. Methods: Four focus group interviews were conducted with 37 refugees from four language groups (Arabic, Dari, Dinka and Karen). Data were analysed thematically. Results: Willingness to accept COVID‐19 vaccines was associated with participants’ perceptions of disease severity, and benefits such as increased immunity against COVID‐19 disease and prevention of the spread of the disease. Cues for increasing individual willingness to get vaccinated included obtaining information from trusted sources and community engagement. By contrast, information gaps on vaccines compounded by misinformation on social media contributed to a reluctance to be vaccinated. Conclusion: As this study was conducted before the Delta variant outbreak, participants’ stance on COVID‐19 vaccines may have changed. However, addressing vaccine literacy needs for this group remains an on‐going priority. Health promotion initiatives must be tailored to the different socio‐cultural contexts of each community. Implications for public health: Engagement with refugee populations is critical for optimising access and uptake of vaccines to protect health, prevent death and ensure that control of the pandemic is equitable. This may also provide valuable public health lessons for other marginalised populations.

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“…32 Vaccine implementation strategies will need to be adapted to meet the individual needs of refugees considering the multiple barriers they face when accessing the vaccines. 33 The…”

Section: Urgent Need For Community Engagement Strategiesmentioning

confidence: 99%

Factors influencing refugees’ willingness to accept COVID‐19 vaccines in Greater Sydney: a qualitative study

Mahimbo

Kang²,

Sestakova

et al. 2022

Australian and New Zealand Journal of Public Health

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“…Undocumented migrants and other socially disadvantaged populations have faced significant hurdles to get vaccinated, including digital, transportation and health system navigation barriers. The European Centre for Disease Prevention and Control (ECDC) and the Council of Europe have called for tailored vaccination programmes for undocumented migrants that are free from immigration control enforcement activities,32 but only a few national immunisation plans explicitly include provisions for undocumented migrants, or address potential barriers, such as language proficiency or identification requirements 33 34. In addition, the willingness and hesitancy of individuals, including undocumented migrants, to get immunised depends on a variety of factors, such as self-perceived risks and severity of illness; confidence in the safety and effectiveness of the vaccine; trust in medical, governmental, or pharmaceutical institutions; and behavioural and social processes (eg, awareness, information, education, social norms, networks and media).…”

Section: Introductionmentioning

confidence: 99%

COVID-19 vaccine hesitancy among undocumented migrants during the early phase of the vaccination campaign: a multicentric cross-sectional study

et al. 2022

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Study objectivesThe marginalisation of undocumented migrants raises concerns about equitable access to COVID-19 vaccination. This study aims to describe migrants’ hesitancy about the COVID-19 vaccination during the early phase of the vaccination campaign.SettingThis multicentric cross-sectional survey was conducted in health facilities providing care to undocumented migrants in the USA, Switzerland, Italy and France in February–May 2021.ParticipantsEligibility criteria included age >16 years, being of foreign origin and living without valid residency permit in the country of recruitment. A convenience sample of minimum 100 patients per study site was targeted.Primary and secondary outcome measuresData were collected using an anonymous structured questionnaire. The main outcomes were perceived access to the local COVID-19 vaccination programme and demand for vaccination.ResultsAltogether, 812 undocumented migrants participated (54.3% Geneva, 17.5% Baltimore, 15.5% Milano and 12.7% Paris). Most (60.9%) were women. The median age was 39 years (interquartile range 1). Participants originated from the Americas (55.9%), Africa (12.7%), Western Pacific (11.2%) Eastern Mediterranean (7.9%), Europe (7.6%) and South-East Asia (4.7%). Overall, 14.1% and 26.2% of participants, respectively, reported prior COVID-19 infection and fear of developing severe COVID-19 infection. Risk factors for severe infection were frequently reported (29.5%). Self-perceived accessibility of COVID-19 vaccination was high (86.4%), yet demand was low (41.1%) correlating with age, comorbidity and views on vaccination which were better for vaccination in general (77.3%) than vaccination against COVID-19 (56.5%). Participants mainly searched for information about vaccination in the traditional and social media.ConclusionsWe found a mismatch between perceived accessibility and demand for the COVID-19 vaccination. Public health interventions using different communication modes should build on trust about vaccination in general to tackle undocumented migrants’ hesitancy for COVID-19 vaccination with a specific attention to men, younger migrants and those at low clinical risk of severe infection.

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“…This could directly affect low vaccination rates among this population segment for the reasons mentioned above. However, several structural barriers impede the homeless and the undocumented population from accessing COVID-19 vaccines [ 17 ]. The vaccination plan in 2021 was prepared in agreement with the Regional Health Authority of Lazio and allowed patients without direct access to the INHS to receive immunisation.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, the Italian vaccination strategy consists of each region setting up its vaccination criteria and booking systems according to their agenda settings and priorities. Besides being highly inequitable in mode and scope, until recently, none of the regional booking systems allowed access to vaccines to people without an Italian social security number [ 17 ]. This includes foreigners (e.g., tourists, migrants), undocumented people, and people without proof of residence.…”

Section: Introductionmentioning

confidence: 99%

Unequal Access to Testing and Vaccination Services for the Homeless and Undocumented Population During COVID-19 Pandemic

Morrone

Buonomini

Sannella

et al. 2022

Int J Public Health

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Objectives: To furnish a model to ensure access and use of healthcare services to the undocumented and homeless population.Methods: Between March 2020 and October 2021, public and third sector actors in Rome implemented an accessible COVID-19 screening service and vaccination program targeting the homeless and undocumented population.Results: 95.6% of the patients tested negative to both rapid and molecular tests. 0.9% tested positive to both. 0.7% were false negatives, while 2.8% were false positives. None of the participants refused the diagnostic treatment. From July to October 2021, 1384 people received a complete cycle of the COVID-19 vaccine through the program. 632 (45.6%) also agreed to perform the antibodies testing before inoculation. 318 (50.31%) of these were positive at the time of vaccination.Conclusion: We present a cost-effective model for reducing structural barriers to access diagnostic and preventive services for the homeless and undocumented population that can be applied to different public health settings.

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Challenges in the equitable access to COVID-19 vaccines for migrant populations in Europe

Cited by 38 publications

References 6 publications

Factors influencing refugees’ willingness to accept COVID‐19 vaccines in Greater Sydney: a qualitative study

Factors influencing refugees’ willingness to accept COVID‐19 vaccines in Greater Sydney: a qualitative study

COVID-19 vaccine hesitancy among undocumented migrants during the early phase of the vaccination campaign: a multicentric cross-sectional study

Unequal Access to Testing and Vaccination Services for the Homeless and Undocumented Population During COVID-19 Pandemic

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