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Abstract

Background

Migrants within the European Union and European Economic Area (EU/EEA) may be underimmunised and lack documentation on previous vaccinations. We investigated approaches to vaccination in recently arrived adult and child migrants, and guideline availability and implementation. : Between March and May 2017, a national vaccination expert from every EU/EEA country and Switzerland completed an electronic questionnaire. We used descriptive analyses to calculate percentages, and framework analysis to synthesise free-text responses. : We approached 32 countries (response rate 100%). Although 28 experts reported vaccination guidance at national level, specific guidelines for recently arrived migrants were only available in six countries and not consistently implemented. Twenty-three countries administered vaccinations during on-arrival health checks. Most experts recommended multiple vaccination opportunities be made available: at point of entry (n = 13) or at holding level (reception centres, migrant camps, detention centres) (n = 21). In 30 countries, child migrants without evidence of previous vaccination were re-vaccinated according to the national schedule. Diphtheria-pertussis-tetanus and polio vaccinations were given to migrant children in all countries, measles-mumps-rubella (MMR) in 31 countries, hepatitis B vaccination in 25. Low levels of catch-up vaccination were reported in adult migrants, with only 13 countries offering MMR and 10 countries charging fees. : Existing guidance is often not migrant-specific and may not be applied in practice; clarification is needed on which vaccines should be given. Strategies are needed specifically for catch-up vaccination in adult migrants. Vaccinations should be offered in multiple settings, free of charge, with sufficient guidance and training provided to front-line healthcare professionals.

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/content/10.2807/1560-7917.ES.2018.23.41.1700772
2018-10-11
2018-10-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.41.1700772
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References

  1. Andre FE, Booy R, Bock HL, Clemens J, Datta SK, John TJ, et al. Vaccination greatly reduces disease, disability, death and inequity worldwide. Bull World Health Organ. 2008;86(2):140-6.  https://doi.org/10.2471/BLT.07.040089  PMID: 18297169 
  2. World Health Organization (WHO). European Immunization Week. Geneva: WHO; 2014. Available from: http://www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/european-immunization-week
  3. Finnegan G. European Commission launches Health Award for NGOs promoting vaccines. News and social media. Immunize Europe Forum. Copenhagen: World Health Organization Regional Office for Europe; 2017. Available from: http://www.immunize-europe.org/topic/236-european-commission-launches-health-award-for-ngos-promoting-vaccines/
  4. World Health Organization Regional Office for Europe (WHO/Europe). European Vaccine Action Plan 2015-2020. Copenhagen: WHO/Europe; 2014. Available from: http://www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/publications/2014/european-vaccine-action-plan-20152020-2014
  5. Mipatrini D, Stefanelli P, Severoni S, Rezza G. Vaccinations in migrants and refugees: a challenge for European health systems. A systematic review of current scientific evidence. Pathog Glob Health. 2017;111(2):59-68.  https://doi.org/10.1080/20477724.2017.1281374  PMID: 28165878 
  6. Vaidya V, Hanumante N, Joshi A, Mahajan S. Immunization status of underfive children in migrants from periurban areas of pune. Natl J Community Med.2013;4(3):457-60.
  7. Nakken CS, Skovdal M, Nellums LB, Friedland JS, Hargreaves S, Norredam M. Vaccination status and needs of asylum-seeking children in Denmark: a retrospective data analysis. Public Health. 2018;158:110-6.  https://doi.org/10.1016/j.puhe.2018.02.018  PMID: 29653865 
  8. United Nations High Commissioner of Refugees (UNHCR). Forced displacement in 2015. Geneva: UNHCR; 2016. Available from: http://www.unhcr.org/statistics/unhcrstats/576408cd7/unhcr-global-trends-2015.html
  9. World Health Organization (WHO). WHO-UNICEF estimates of BCG coverage. Geneva: WHO. [Accessed: 24 Jun 2017]. Available from: http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tswucoveragebcg.html
  10. Prymula R, Shaw J, Chlibek R, Urbancikova I, Prymulova K. Vaccination in newly arrived immigrants to the European Union. Vaccine. 2018;36(36):5385-90.  https://doi.org/10.1016/j.vaccine.2017.05.079  PMID: 28602605 
  11. Pavlopoulou ID, Tanaka M, Dikalioti S, Samoli E, Nisianakis P, Boleti OD, et al. Clinical and laboratory evaluation of new immigrant and refugee children arriving in Greece. BMC Pediatr. 2017;17(1):132.  https://doi.org/10.1186/s12887-017-0888-7  PMID: 28549451 
  12. Williams GA, Bacci S, Shadwick R, Tillmann T, Rechel B, Noori T, et al. Measles among migrants in the European Union and the European Economic Area. Scand J Public Health. 2016;44(1):6-13.  https://doi.org/10.1177/1403494815610182  PMID: 26563254 
  13. Jones G, Haeghebaert S, Merlin B, Antona D, Simon N, Elmouden M, et al. Measles outbreak in a refugee settlement in Calais, France: January to February 2016. Euro Surveill. 2016;21(11):30167.  https://doi.org/10.2807/1560-7917.ES.2016.21.11.30167  PMID: 27020578 
  14. Marin M, Patel M, Oberste S, Pallansch MA. Guidance for assessment of poliovirus vaccination status and vaccination of children who have received poliovirus vaccine outside the United States. MMWR Morb Mortal Wkly Rep. 2017;66(1):23-5.  https://doi.org/10.15585/mmwr.mm6601a6  PMID: 28081056 
  15. Asgary R, Segar N. Barriers to health care access among refugee asylum seekers. J Health Care Poor Underserved. 2011;22(2):506-22.  https://doi.org/10.1353/hpu.2011.0047  PMID: 21551930 
  16. Hunter-Adams J, Rother H-A. A Qualitative study of language barriers between South African health care providers and cross-border migrants. BMC Health Serv Res. 2017;17(1):97.  https://doi.org/10.1186/s12913-017-2042-5  PMID: 28143514 
  17. Hargreaves S, Friedland JS, Gothard P, Saxena S, Millington H, Eliahoo J, et al. Impact on and use of health services by international migrants: questionnaire survey of inner city London A&E attenders. BMC Health Serv Res. 2006;6(1):153.  https://doi.org/10.1186/1472-6963-6-153  PMID: 17134491 
  18. Médecins du monde (MDM). [Doctors of the World International Network]. International Network 2016 Observatory Report: Access to healthcare for people facing multiple vulnerabilities in health in 31 cities in 12 countries. Paris: MDM; 2016. Available from: https://mdmeuroblog.files.wordpress.com/2016/11/observatory-report2016_en-mdm-international.pdf
  19. Hui C, Dunn J, Morton R, Staub LP, Tran A, Hargreaves S, et al. Interventions to improve vaccination uptake and cost effectiveness of vaccination strategies in newly arrived migrants in the EU/EEA: a systematic review. Int J Environ Res Public Health. 2018;15(10):2065.  https://doi.org/10.3390/ijerph15102065  PMID: 30241320 
  20. Executive Agency for Health and Consumers (EAHC). Recommendations of the PROMOVAX Consortium on Migrant Immunizations. Luxembourg: EAHC. [Accessed: June 2017]. Available from: http://www.promovax.eu/pdfs/Recommendation.pdf
  21. European Centre for Disease Prevention and Control (ECDC). Vaccine scheduler. Stockholm: ECDC. [Accessed: 24 Jun 2017]. Available from: http://vaccine-schedule.ecdc.europa.eu/Pages/Scheduler.aspx
  22. Kärki T, Napoli C, Riccardo F, Fabiani M, Dente MG, Carballo M, et al. Screening for infectious diseases among newly arrived migrants in EU/EEA countries--varying practices but consensus on the utility of screening. Int J Environ Res Public Health. 2014;11(10):11004-14.  https://doi.org/10.3390/ijerph111011004  PMID: 25337945 
  23. Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13(1):117.  https://doi.org/10.1186/1471-2288-13-117  PMID: 24047204 
  24. O’Flanagan D, Cotter S, Mereckiene J, VENICE II Consortium. Vaccination coverage assessment in EU/EEA, 2011. Rome: Vaccine European New Integrated Collaboration Effort (VENICE) III project. [Accessed: 24 Jun 2017]. Available from: http://venice.cineca.org/Final_Vaccination_Coverage_Assesment_Survey_2011_1.pdf
  25. Snider CJ, Diop OM, Burns CC, Tangermann RH, Wassilak SGF. Surveillance systems to track progress toward polio eradication--worldwide, 2014-2015. MMWR Morb Mortal Wkly Rep. 2016;65(13):346-51.  https://doi.org/10.15585/mmwr.mm6513a3  PMID: 27054558 
  26. Kennedy J. Why have the majority of recent polio cases occurred in countries affected by Islamist militancy? A historical comparative analysis of the political determinants of polio in Nigeria, Somalia, Pakistan, Afghanistan and Syria. Med Confl Surviv. 2016;32(4):295-316.  https://doi.org/10.1080/13623699.2017.1294338  PMID: 28266226 
  27. Pottie K, Greenaway C, Feightner J, Welch V, Swinkels H, Rashid M, et al. coauthors of the Canadian Collaboration for Immigrant and Refugee Health. Evidence-based clinical guidelines for immigrants and refugees. CMAJ. 2011;183(12):E824-925.  https://doi.org/10.1503/cmaj.090313  PMID: 20530168 
  28. United States Department of Health and Human Services (HHS). The National Vaccine Program Office national adult immunization plan. Washington D.C.: HHS. [Accessed: 24 May 2017]. Available from: https://www.hhs.gov/sites/default/files/nvpo/national-adult-immunization-plan/naip.pdf
  29. De Vito E, Parente P, de Waure C, Poscia A, Ricciardi W. A review of evidence on equitable delivery, access and utilization of immunization services for migrants and refugees in the WHO European Region. Health Evidence Network Synthesis Report 53. Copenhagen: World Health Organization Regional Office for Europe; 2017. Available from: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0097602/pdf/PubMedHealth_PMH0097602.pdf
  30. Rovný I, Mikas J, Hudecová H, Némethová D. Importance of vaccination. Diseases we can prevent thanks to the vaccination. Bratislava: Public Health Authority of the Slovak Republic, 2016. Available from: http://www.uvzsr.sk/en/index.php/documents/28-importance-of-vaccination--diseases-we-can-prevent-thanks-to-the-vaccination--new-publication-issued-in-framework-of-bca-who-in-slovakia
  31. Takla A, Wichmann O, Carrillo-Santisteve P, Cotter S, Levy-Bruhl D, Paradowska-Stankiewicz I, et al. VENICE III NITAG Survey Group. Characteristics and practices of National Immunisation Technical Advisory Groups in Europe and potential for collaboration, April 2014. Euro Surveill. 2015;20(9):21049.  https://doi.org/10.2807/1560-7917.ES2015.20.9.21049  PMID: 25764188 
  32. Hargreaves S, Nellums LB, Ramsay M, Saliba V, Majeed A, Mounier-Jack S, et al. Who is responsible for the vaccination of migrants in Europe? Lancet. 2018;391(10132):1752-4.  https://doi.org/10.1016/S0140-6736(18)30846-8  PMID: 29739550 
  33. Giambi C, Del Manso M, Dalla Zuanna T, Riccardo F, Bella A, Caporali MG, et al. CARE working group for the National Immunization Survey. National immunization strategies targeting migrants in six European countries. Vaccine. 2018;S0264-410X(18)30120-8. Epub6Feb2018. https://doi.org/10.1016/j.vaccine.2018.01.060  PMID: 29426661 
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