Differences in Influenza Vaccination Coverage between Adult Immigrants and Italian Citizens at Risk for Influenza-Related Complications: A Cross-Sectional Study

Fabiani, Massimo; Riccardo, Flavia; Napoli, Anteo Di; Gargiulo, Lidia; Declich, Silvia; Petrelli, Alessio

doi:10.1371/journal.pone.0166517

Cited by 27 publications

(28 citation statements)

References 18 publications

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“…Our study showed a reduced level of vaccination against flu among migrants, particularly in Italy. This difference was more apparent among non- EU citizens and this result is in line with previous findings from Spain [ 35 ] and Italy [ 36 ].…”

Section: Discussionsupporting

confidence: 93%

Migrant’s access to preventive health services in five EU countries

Rosano¹,

Dauvrin

Buttiġieġ

et al. 2017

BMC Health Serv Res

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BackgroundPreventive health services (PHSs) form part of primary healthcare with the aim of screening to prevent disease. Migrants show significant differences in lifestyle, health beliefs and risk factors compared with the native populations. This can have a significant impact on migrants’ access to health systems and participation in prevention programmes. Even in countries with widely accessible healthcare systems, migrants’ access to PHSs may be difficult. The aim of the study was to compare access to preventive health services between migrants and native populations in five European Union (EU) countries.MethodsInformation from Health Interview Surveys of Belgium, Italy, Malta, Portugal and Spain were used to analyse access to mammography, Pap smear tests, colorectal cancer screening and flu vaccination among migrants. The comparative risk of not accessing PHSs was calculated using a mixed-effects multilevel model, adjusting for potential confounding factors (sex, education and the presence of disability). Migrant status was defined according to citizenship, with a distinction made between EU and non-EU countries.ResultsMigrants, in particular those from non-EU countries, were found to have poorer access to PHSs. The overall risk of not reporting a screening test or a flu vaccination ranged from a minimum of 1.8 times (colorectal cancer screening), to a high of 4.4 times (flu vaccination) for migrants. The comparison among the five EU countries included in the study showed similarities, with particularly limited access recorded in Italy and in Belgium for non-EU migrants.ConclusionsThe findings of this study are in accordance with evidence from the scientific literature. Poor organization of health services, in Italy, and lack of targeted health policies in Belgium may explain these findings. PHSs should be responsive to patient diversity, probably more so than other health services. There is a need for diversity-oriented, migrant-sensitive prevention. Policies oriented to removing impediments to migrants’ access to preventive interventions are crucial, to encourage more positive action for those facing the risk of intersectional discrimination.

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Section: Discussionsupporting

confidence: 93%

Migrant’s access to preventive health services in five EU countries

Rosano¹,

Dauvrin

Buttiġieġ

et al. 2017

BMC Health Serv Res

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“…Moreover, it could also be due to unwillingness to use services for cultural, religious or other reasons [ 6 , 34 ]. This is why providing culturally sensitive information, training health professionals in culturally competent service delivery, and engaging key individuals from the migrant community to promote immunization could be important to meet health needs of immigrants and overcome informal barriers to immunization [ 34 – 38 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of rubella immunization rates in immigrant and Italian women of childbearing age: Results from the Italian behavioral surveillance system PASSI (2011-2015)

et al. 2017

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BackgroundInternational migration rapidly increased in the last decade, raising a renewed attention to its impact on public health. We evaluated differences in rubella immunization rate (RIR) between immigrant and Italian women of childbearing age and tried to identify the driving factors causing them.MethodsWe analyzed data from the Italian behavioral surveillance system PASSI collected in 2011–2015 in a nationally representative sample of residents in Italy. The analysis was performed using log-binomial models to compare RIR between 41,094 Italian women and 3140 regular immigrant women of childbearing age (18–49 years), stratifying the latter by area of origin and length-of-stay in Italy (recent: ≤ 5-years; mid-term: 6-10-years; long-term: > 10-years).ResultsImmigrant women showed a RIR of 36.0% compared to 60.2% among Italian women (RIR-ratio = 0.60, 95% confidence interval (CI): 0.57–0.63). Adjusting for demographic characteristics (i.e., sex, age and area of residence), socio-economic factors (i.e., education, occupation, family composition and economic status) and an indicator of the presence of at least one health-risk behavior (i.e., physical inactivity, current cigarette smoking, excessive alcohol consumption and excess weight) did not significantly change this difference (RIR-ratio = 0.56, 95% CI: 0.53–0.59). Recent immigrants (RIR-ratio = 0.47, 95% CI: 0.42–0.53) and immigrants from high migratory pressure countries (HMPC) in sub-Saharan Africa (RIR-ratio = 0.41, 95% CI: 0.31–0.56) and Asia (RIR-ratio = 0.42, 95% CI: 0.33–0.53) showed the greatest differences in RIR compared with Italian women.ConclusionsDifferences in RIR between immigrant and Italian women were not explained by different demographic, socioeconomic and health-risk behaviors characteristics. As entitlement to free-of-charge immunization in Italy is universal, regardless of migration status, other informal barriers (e.g., cultural and barriers to information access) might explain lower RIRs in immigrant women, especially recent immigrants and those from HMPC in sub-Saharan Africa and Asia. Further investigations are needed to identify obstacles and appropriate promotion and access-enabling strategies for rubella immunization.

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“…Migrants do not specifically represent a risk of spreading influenza to receiving countries [25]. Nonetheless, migrants are more susceptible to influenza in part due to lower levels of vaccine coverage [26, 27]. Infection may be transmitted by droplet, aerosol, or contact [28].…”

Section: Viral Infectionsmentioning

confidence: 99%

Pulmonary Diseases in Refugees and Migrants in Europe

et al. 2018

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More than 2 million people fleeing conflict, persecution, and poverty applied for asylum between 2015 and 2016 in the European Union. Due to this, medical practitioners in recipient countries may be facing a broader spectrum of conditions and unusual presentations not previously encountered, including a wide range of infections with pulmonary involvement. Tuberculosis is known to be more common in migrants and has been covered broadly in other publications. The scope of this review was to provide an overview of exotic infections with pulmonary involvement that could be encountered in refugees and migrants and to briefly describe their epidemiology, diagnosis, and management. As refugees and migrants travel from numerous countries and continents, it is important to be aware of the various organisms that might cause disease according to the country of origin. Some of these diseases are very rare and geographically restricted to certain regions, while others have a more cosmopolitan distribution. Also, the spectrum of severity of these infections can vary from very benign to severe and even life-threatening. We will also describe infectious and noninfectious complications that can be associated with HIV infection as some migrants might originate from high HIV prevalence countries in sub-Saharan Africa. As the diagnosis and treatment of these diseases can be challenging in certain situations, patients with suspected infection might require referral to specialized centers with experience in their management. Additionally, a brief description of noncommunicable pulmonary diseases will be provided.

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Differences in Influenza Vaccination Coverage between Adult Immigrants and Italian Citizens at Risk for Influenza-Related Complications: A Cross-Sectional Study

Cited by 27 publications

References 18 publications

Migrant’s access to preventive health services in five EU countries

Migrant’s access to preventive health services in five EU countries

Comparison of rubella immunization rates in immigrant and Italian women of childbearing age: Results from the Italian behavioral surveillance system PASSI (2011-2015)

Pulmonary Diseases in Refugees and Migrants in Europe

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