Estimating COVID-19 vaccine uptake and its drivers among migrants, homeless and precariously housed people in France

Abstract

Background Migrants, people experiencing homelessness (PEH), or precariously housed (PH) are at high risk for COVID-19 infection, hospitalization, and death from COVID-19. However, while data on COVID-19 vaccine uptake in these populations are available in the USA, Canada, and Denmark, we are lacking, to the best of our knowledge, data from France. Methods In late 2021, we carried out a cross-sectional survey to determine COVID-19 vaccine coverage in PEH/PH residing in Ile-de-France and Marseille, France, and to explore its drivers. Participants aged over 18 years were interviewed face-to-face where they slept the previous night, in their preferred language, and then stratified for analysis into three housing groups (Streets, Accommodated, and Precariously Housed). Standardized vaccination rates were computed and compared to the French population. Multilevel univariate and multivariable logistic regression models were built. Results We find that 76.2% (95% confidence interval [CI] 74.3–78.1) of the 3690 participants received at least one COVID-19 vaccine dose while 91.1% of the French population did so. Vaccine uptake varies by stratum, with the highest uptake (85.6%; reference) in PH, followed by Accommodated (75.4%; adjusted odds-ratio = 0.79; 95% CI 0.51–1.09 vs. PH) and lowest in Streets (42.0%; AOR = 0.38; 95%CI 0.25–0.57 vs. PH). Use for vaccine certificate, age, socioeconomic factors, and vaccine hesitancy is associated with vaccination coverage. Conclusions In France, PEH/PH, and especially the most excluded, are less likely than the general population to receive COVID-19 vaccines. While vaccine mandate has proved an effective strategy, targeted outreach, on-site vaccinations, and sensitization activities are strategies enhancing vaccine uptake that can easily be replicated in future campaigns and other settings.

Sociodemographic disparities affect COVID‐19 vaccine uptake in non‐elderly adults with increased risk of severe COVID‐19

“…The second study investigated vaccination coverage after one dose and found a negative effect in the group with chronic diseases [10]. In France, similar findings among socially vulnerable groups in Paris and Marseille have been described [29].…”

“…The second study investigated vaccination coverage after one dose and found a negative effect in the group with chronic diseases [10]. In France, similar findings among socially vulnerable groups in Paris and Marseille have been described [29]. In the Swedish setting, socioeconomic differences regarding vaccination coverage, without linkage to medical diagnosis, have been previously reported [8, 9].…”

A Mobile-Based Preventive Intervention for Young, Arabic-Speaking Asylum Seekers During the COVID-19 Pandemic in Germany: Design and Implementation

“…With regard to COVID-19, a qualitative interview study with recently arrived migrants and refugees in the United Kingdom reported that 72% of participants were hesitant to uptake a COVID-19 vaccine before the start of large-scale vaccination campaigns [ 43 ]. A recent French study reported a significantly lower COVID-19 vaccination rate among precariously housed and collectively accommodated migrants than among the general French population [ 44 ].…”

Morbidity and mortality in a prospective cohort of people who were homeless during the COVID-19 pandemic

“…Nevertheless, the most critical point is targeting effective prevention strategies including COVID-19 vaccination efforts among people experiencing homelessness. In France, COVID-19 vaccination strategy targeting people who are homeless was implemented in May 2021, including management of vaccination centers for marginalized population, sensitization, mobile vaccination teams, and physical accompaniment to vaccination centers ( 54 ).…”