Migrant's access to immunization in Mediterranean Countries

Riccardo, Flavia; Dente, Maria Grazia; Kojouharova, Mira; Fabiani, Massimo; Alfonsi, Valeria; Kurchatova, Anna; Vladimirova, Nadezhda; Declich, Silvia

doi:10.1016/j.healthpol.2012.02.004

Cited by 18 publications

(26 citation statements)

References 11 publications

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“…This finding is in line with the 2009 survey mentioned above [28] that found that the predominant vaccination delivery pattern for migrants was through community-based services also targeting the general population in EU and non EU countries of the Mediterranean basin. The authors commented that, although in principle migrant populations were reported as eligible for these services, informal barriers (linguistic, cultural, etc.)…”

Section: Discussionsupporting

confidence: 90%

“…In this case, as per WHO-UNHCR-UNICEF joint recommendations [12], priority is given to vaccinations against poliomyelitis, measles and rubella, diseases targeted for elimination [43,44]. We found that only half of the surveyed countries have included adults as a target group for migrant immunization and a survey conducted in 2009 [28] found that adult migrants have more limited access to free-of charge services. This finding needs to be put in context by specifying that, in EU [45] and non-EU countries [42], immunization programmes targeting the adult resident population are also generally less consolidated, if compared to childhood immunization programmes.…”

Section: Discussionmentioning

confidence: 97%

“…Formal and/or informal barriers to services could be hindering this access. Evidence from a cross-sectional study conducted in 2009 among 22 countries bordering the Mediterranean (EU and non EU) [28] has shown that, although eligibility of migrants to immunization services offered as part of national immunization programs is almost universal, informal barriers to immunization services (e.g., language, information and cultural barriers) are a widespread issue.…”

Section: Introductionmentioning

confidence: 99%

“…The ProVacMed study [33], as the other projects mentioned above [27,28,31,32], was coordinated by the Italian Public Health Institute (Istituto Superiore di Sanità) that conducted the survey and promoted interactions among the experts of the Network.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Immunization Strategies Targeting Newly Arrived Migrants in Non-EU Countries of the Mediterranean Basin and Black Sea

Giambi

Manso

Dente

et al. 2017

IJERPH

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Background: The World Health Organization recommends that host countries ensure appropriate vaccinations to refugees, asylum seekers and migrants. However, information on vaccination strategies targeting migrants in host countries is limited. Methods: In 2015–2016 we carried out a survey among national experts from governmental bodies of 15 non-EU countries of the Mediterranean and Black Sea in order to document and share national vaccination strategies targeting newly arrived migrants. Results: Four countries reported having regulations/procedures supporting the immunization of migrants at national level, one at sub-national level and three only targeting specific population groups. Eight countries offer migrant children all the vaccinations included in their national immunization schedule; three provide only selected vaccinations, mainly measles and polio vaccines. Ten and eight countries also offer selected vaccinations to adolescents and adults respectively. Eight countries provide vaccinations at the community level; seven give priority vaccines in holding centres or at entry sites. Data on administered vaccines are recorded in immunization registries in nine countries. Conclusions: Although differing among countries, indications for immunizing migrants are in place in most of them. However, we cannot infer from our findings whether those strategies are currently functioning and whether barriers to their implementation are being faced. Further studies focusing on these aspects are needed to develop concrete and targeted recommendations for action. Since migrants are moving across countries, development of on-line registries and cooperation between countries could allow keeping track of administered vaccines in order to appropriately plan immunization series and avoid unnecessary vaccinations.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Immunization Strategies Targeting Newly Arrived Migrants in Non-EU Countries of the Mediterranean Basin and Black Sea

Giambi

Manso

Dente

et al. 2017

IJERPH

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“…Immigrants could be unaware of these services due to linguistic difficulties, be unaware they are entitled to access them free of charge, or they could be unwilling to use them for cultural, religious or other reasons [7]. The provision of culturally sensitive information in the community languages, training of professionals and services tailored to the specific needs of immigrants, and the identification and training of key individuals from the migrant community to inform and motivate immigrants to get vaccinated are among the proposed measures to overcome informal barriers to immunization [24–27]. …”

Section: Discussionmentioning

confidence: 99%

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

Fabiani

Riccardo

Napoli³

et al. 2016

PLoS ONE

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BackgroundDue to their increased vulnerability, immigrants are considered a priority group for communicable disease prevention and control in Europe. This study aims to compare influenza vaccination coverage (IVC) between regular immigrants and Italian citizens at risk for its complications and evaluate factors affecting differences.MethodsBased on data collected by the National Institute of Statistics during a population-based cross-sectional survey conducted in Italy in 2012–2013, we analysed information on 42,048 adult residents (≥ 18 years) at risk for influenza-related complications and with free access to vaccination (elderly residents ≥ 65 years and residents with specific chronic diseases). We compared IVC between 885 regular immigrants and 41,163 Italian citizens using log-binomial models and stratifying immigrants by area of origin and length of stay in Italy (recent: < 10 years; long-term: ≥ 10 years).ResultsIVC among all immigrants was 16.9% compared to 40.2% among Italian citizens (vaccination coverage ratio (VCR) = 0.42, 95% confidence interval (CI): 0.36–0.49). Adjusting for sex, age and area of residence, this difference was greatly reduced but remained statistically significant (VCR = 0.71, 95 CI: 0.61–0.81). Further adjustment for socio-economic factors (education, occupation, family composition and economic status) and a composite indicator of health-services utilization did not affect the difference (VCR = 0.78, 95% CI: 0.68–0.90). However, after adjustments, only long-term immigrants from Africa (VCR = 0.49, 95% CI: 0.28–0.85) and recent immigrants (VCR = 0.58, 95% CI: 0.43–0.78) showed a significantly different IVC compared to Italian citizens.ConclusionsDifferences in demographic characteristics, socio-economic conditions and health-services utilization explained the reduced IVC in most long-term immigrants compared to Italian citizens. By contrast, these differences did not explain the reduced IVC in long-term immigrants from Africa and recent immigrants. This suggests that IVC in these sub-groups is affected by other informal barriers (e.g., cultural and linguistic) that need to be investigated to promote effective immunization access strategies.

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Adult Vaccination Disparities Among Foreign-Born Populations in the U.S., 2012

Rodríguez-Lainz

O’Halloran

et al. 2014

American Journal of Preventive Medicine

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Background An estimated 13% foreign born persons are living in the United States. Foreign born persons are considered at higher risk of under-vaccination and exposure to several vaccine preventable diseases pre-migration or during return trips to their birth country. Information on vaccination coverage among foreign born populations is limited. Purpose To assess adult vaccination coverage disparities among foreign born populations in the United States. Methods Data from the 2012 National Health Interview Survey were analyzed in 2013. For non-influenza vaccines, we calculated the weighted proportion vaccinated. For influenza vaccination, we used the Kaplan-Meier survival analysis to assess coverage among individuals interviewed during September 2011–June 2012 and vaccinated from August 2011–May 2012. Results Overall, unadjusted vaccination coverage among U.S. born respondents was significantly higher than that of foreign born respondents: influenza, ≥18 years (40.4% versus 33.8%); PPV, 18–64 years with high-risk conditions (20.8% versus 13.7%); PPV, ≥65 years (62.6% versus 40.5%); tetanus vaccination, ≥18 years (65.0% versus 50.6%); Tdap, ≥18 years (15.5% versus 9.3%); hepatitis B, 18–49 years (37.2% versus 28.4%); shingles, ≥60 years (21.3% versus 12.0%); and HPV, females 18–26 years (38.7% versus 14.7%). Exceptions were noted for hepatitis A vaccination among travelers and hepatitis B vaccination of persons ≥18 years with diabetes. Among the foreign born, vaccination coverage was generally lower for non-U.S. citizens, recent immigrants, and those interviewed in a language other than English. Foreign born were less likely than U.S. born to be vaccinated for pneumococcal (≥65 years), tetanus (≥18 years), Tdap (≥18 years), and HPV (women 18–26 years) after adjusting for confounders. Conclusions Vaccination coverage was lower among foreign born adults than those born in the U.S. Vaccination coverage varied by immigration status, citizenship, language, and demographic characteristics. As the number of foreign born persons residing in the United States increases, it is important to consider foreign birth and immigration status when assessing vaccination disparities and planning interventions.

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Migrant's access to immunization in Mediterranean Countries

Cited by 18 publications

References 11 publications

Immunization Strategies Targeting Newly Arrived Migrants in Non-EU Countries of the Mediterranean Basin and Black Sea

Immunization Strategies Targeting Newly Arrived Migrants in Non-EU Countries of the Mediterranean Basin and Black Sea

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

Adult Vaccination Disparities Among Foreign-Born Populations in the U.S., 2012

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