Measles among migrants in the European Union and the European Economic Area

Abstract

Aims: Progress towards meeting the goal of measles elimination in the EU and the European Economic Area (EEA) by 2015 is being obstructed, as some children are either not immunized on time or never immunized. One group thought to be at increased risk of measles is migrants; however, the extent to which this is the case is poorly understood, due to a lack of data. This paper addresses this evidence gap by providing an overview of the burden of measles in migrant populations in the EU/EEA. Methods: Data were collected through a comprehensive literature review, a country survey of EU/EEA member states and information from measles experts gathered at an infectious disease workshop. Results: Our results showed incomplete data on measles in migrant populations, as national surveillance systems do not systematically record migration-specific information; however, evidence from the literature review and country survey suggested that some measles outbreaks in the EU/EEA were due to sub-optimal vaccination coverage in migrant populations. Conclusions: We conclude that it is essential that routine surveillance of measles cases and measles, mumps and rubella (MMR) vaccination coverage become strengthened, to capture migrant-specific data. These data can help to inform the provision of preventive services, which may need to reach out to vulnerable migrant populations that currently face barriers in accessing routine immunization and health services.

Vaccinations in migrants and refugees: a challenge for European health systems. A systematic review of current scientific evidence

“…In Germany, foreign-born children had a three-fold higher risk of being unvaccinated, thus being more susceptible to measles. The situation is similar in Italy and Spain, with coverage rates higher among native populations than among foreign-born children [38,41]. However, Mikolajczyk reported no difference in vaccination coverage between migrant and non-migrant children [13].…”

“…A recent systematic review highlighted the lack of harmonized data on measles outbreaks and vaccination coverage among migrants in Europe [38]. Serological studies investigated the susceptibility to measles among migrants and refugees, estimating a prevalence of seronegative individuals between 6 and 13% [40,42,43].…”

“…Information on measles outbreaks was reported by Williams: [38] [39] recently reported a measles outbreak in the refugee camp of Calais, between January and February 2016; overall, 10 refugees, 2 health workers, and 1 volunteer were confirmed positive to measles. After the outbreak, a mass vaccination campaign was conducted in the camp, covering 60% of the target population.…”

“…easily accessible and centered on migrants' needs [68−71]; (3) there is often no information on the immunization status of migrants and refugees. Williams et al (2016) [38] found a lack of systematic data collection in European countries concerning cases, immunization coverage, and determinants of non-immunization for measles, mumps, and rubella (MMR). Moreover, they highlight the lack of harmonized indicators across different European countries; (4) hosting countries are facing severe economic crisis, challenging migrants' access to National Healthcare Services (NHS) and exacerbating risks of infectious diseases for migrants [72]; (5) migrants often refuse vaccination and registration by medical authorities for the fear of legal consequences; (6) the lack of coordination among public health authorities of neighboring countries may determine either duplications or lack of vaccine administration [38,73].…”

Impact of the Refugee Crisis on the Greek Healthcare System: A Long Road to Ithaca

“…It was demonstrated that diseases that can be prevented by vaccination cause flare-ups in reception and holding centers [39,42,43,44,45,46,47,48]. Outbreaks are generally more severe in refugee camps [48].…”