Determinants of Tetanus Vaccination among Adult Immigrants: Findings from the Portuguese National Health Survey 2014

Moura, Sofia; Martins, M.F.

doi:10.3390/ijerph16091619

Cited by 5 publications

(24 citation statements)

References 26 publications

(41 reference statements)

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“…A human health survey in Portugal investigated factors associated with tetanus vaccination in immigrants. Higher household income and older age were negatively associated with tetanus vaccination rates, while living in sparsely populated areas was positively associated [57]. This could be due to the fact that people in rural areas are involved in agricultural work and therefore have more contact with soil in which the tetanus-causing pathogen is usually located.…”

Section: Plos Onementioning

confidence: 99%

Canine vaccination in Germany: A survey of owner attitudes and compliance

et al. 2020

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Background Vaccination is the most important preventive measure for protection against infectious diseases in humans and companion animals. Nevertheless, scepticism about the safety and importance of vaccines is increasing in human and in veterinary medicine. Although owner attitudes towards vaccination have been investigated in cats, there are no similar studies in dogs. The goals of this study were therefore to investigate the vaccination status of dogs in Germany, to determine owner compliance with vaccination and to identify factors that play a role in owners' decisions to have their dogs vaccinated. Methods Data were collected from August 2018 to February 2019 using an online survey targeting dog owners in Germany. A total of 3,881 questionnaires were evaluated, and factors associated with the vaccination status of dogs were determined by a linear logistic regression model using Akaike information criterion. Cohen's kappa statistic was used to evaluate agreement between questionnaire and 340 vaccination passports submitted voluntarily by owners. Results A total of 46.8% (n = 1,818/3,881) of dogs were vaccinated with core vaccines according to current guidelines with the lowest vaccination rate for leptospirosis (50.1%; n = 1,941/ 3,874). Dog's age (16 weeks to 15 months) (odds ratio (OR): 3.08; 95% CI: 2.05-4.68), type (working dog) (OR: 2.06; 95% CI: 1.22-3.53) and travelling abroad within previous 36 months (OR: 1.82; 95% CI: 1.12-2.96) had the strongest 'positive' association with the vaccination status. Recommendation from a veterinarian not to vaccinate against leptospirosis had the strongest 'negative' association (OR: 0.08; 95% CI: 0.04-0.18).

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Section: Plos Onementioning

confidence: 99%

Canine vaccination in Germany: A survey of owner attitudes and compliance

et al. 2020

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“…Six (28,29,75,(79)(80)(81) out of eight studies found that under-vaccination was significantly associated with more recent migration to the host country (28,29,75,79,81) or lower acculturation with the host society (80). Other common predictors of under-vaccination included higher income (3 out of 4 studies; (41,45,85), being a refugee/asylum seeker (2/3 studies; (49, 81)), having not accessed healthcare in more than a year (2/2; (41, 45)), having no private health insurance (2/2; (41,45)) and region of residence (2/2; (28,45)). Specific familial characteristics, such as parental education level, difficulties speaking the host country language or larger family size were also associated with under-vaccination.…”

Section: Determinants Of Under-vaccination In Migrant Populationsmentioning

confidence: 99%

“…Poor HCP knowledge of migrants' entitlements to healthcare and vaccination guidelines (e.g., vaccination of individuals with incomplete/uncertain immunisation status) was highlighted, with instances of patients being wrongly refused access to primary care or not offered recommended catch-up vaccinations. (31,45,57,62) A French study of GPs found wide variation in vaccination practices for newly-arrived migrants with no vaccination record, with some GPs reluctant to revaccinate those with uncertain immunisation status due to concerns about reactogenicity. (58) There were also missed opportunities to vaccinate;…”

Section: Barriers and Facilitators To Vaccine Uptake In Migrant Populationsmentioning

confidence: 99%

“…Two studies found that migrants (adults and homeless children) who had been in contact with the healthcare system or a GP in the previous year had a significantly lower risk of being insufficiently immunised. (41,45) Similarly, regular contact with the local health services, (31) closer geographic proximity to a GP, (36) and greater integration into the local community and familiarity with health services, (61) were associated with greater engagement and vaccination uptake.…”

Section: Resource and Capacity Constraintsmentioning

confidence: 99%

“…(55) Free-of-charge vaccination, or having private health insurance, facilitated uptake. (29,33,36,45) The introduction of a cost-free HPV programme in Denmark was associated with an 11fold increase in uptake percentage among migrants. (29) Migrants with precarious immigration status said that if they could be confident there would be no associated costs, more of their community would present for COVID-19 vaccination.…”

Section: Financial Affordability: Barriers and Facilitatorsmentioning

confidence: 99%

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Defining the determinants of under-vaccination in migrant populations in Europe to improve routine and COVID-19 vaccine uptake: a systematic review

Crawshaw

Yasmin

Deal

et al. 2021

Preprint

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Diverse migrant populations in Europe are at risk of under-immunisation and have recently shown lower levels of COVID-19 vaccination intent and uptake. Understanding the determinants of vaccine uptake in migrants is critical to address immediate COVID-19 vaccination inequities, and longer-term will help improve coverage for routine vaccinations, aligning with the goals of the new Immunisation Agenda 2030. We did a systematic review following PRISMA guidelines and using a PICOS framework (PROSPERO CRD42020219214; MEDLINE, CINAHL, PsycINFO databases, 1 January 2000 – 14 September 2021) exploring barriers and facilitators to vaccine uptake and determinants of under-vaccination in migrants in the EU/EEA, UK, and Switzerland. We categorised barriers/facilitators using the ‘5As’ Determinants of Vaccine Uptake Taxonomy. 5259 data sources were screened, with 67 studies included from 16 countries, representing 366,529 migrants. Access barriers were most commonly reported (language, literacy and communication barriers; practical and legal barriers to accessing/delivering vaccination services; service barriers, including lack of specific guidelines and knowledge of healthcare professionals) for key vaccines including MMR, DTP, HPV, influenza, polio, COVID-19 vaccines. Acceptance barriers were mostly reported in Eastern European and Muslim communities for HPV, measles, and influenza vaccines. We identified 23 determinants of under-vaccination in migrants, including geographical origin (where 25/26 (96%) studies showed significance) – particularly African/Eastern European origin; recent migration; being a refugee/asylum seeker; higher income; parental education level; no healthcare contact in the past year; and lower language skills. Facilitators of migrants’ vaccine uptake included tailored vaccination messaging, community outreach and ‘nudging’ interventions. Migrants’ barriers to accessing healthcare are already well documented, and this review confirms their role in limiting vaccine uptake. These data hold immediate relevance to strengthening vaccination programmes in high-income countries, including for COVID-19. Our findings suggested that targeted, evidence-informed strategies are needed to address access and acceptance barriers to vaccination in migrants, including the development of migrant-sensitive and adaptable vaccination services and systems, unambiguous public health messaging, and coproduction of tailored interventions.

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