Vaccination for SARS-CoV-2 of migrants and refugees, Jordan

Bellizzi, Saverio; Aidyralieva, Chinara; Alsawhala, Lora; Al-Shaikh, Ala’a; Santoro, Andrea; Profili, Maria Cristina

doi:10.2471/blt.21.285591

Cited by 16 publications

(17 citation statements)

References 1 publication

(1 reference statement)

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“…However, the testing rate in Azraq was twice the national level (98,187/100,000 persons), suggesting a lower infection rate. Testing (as well as hospitalization and vaccination) was free for refugees as they were included in the National Preparedness and Response COVID-19 plan, whose whole-of-society approach meant both Jordanians and non-Jordanians living in host communities and in camps had the same access to health services [ 16 ]. Furthermore, a positive test result did not have any implications in terms of status or access to service or livelihood supports, besides the need to isolate (as with nationals).…”

Section: Discussionmentioning

confidence: 99%

COVID-19 epidemiology and changes in health service utilization in Azraq and Zaatari refugee camps in Jordan: A retrospective cohort study

2022

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Background The effects of the Coronavirus Disease 2019 (COVID-19) pandemic in humanitarian contexts are not well understood. Specific vulnerabilities in such settings raised concerns about the ability to respond and maintain essential health services. This study describes the epidemiology of COVID-19 in Azraq and Zaatari refugee camps in Jordan (population: 37,932 and 79,034, respectively) and evaluates changes in routine health services during the COVID-19 pandemic. Methods and findings We calculate the descriptive statistics of COVID-19 cases in the United Nations High Commissioner for Refugees (UNHCR)’s linelist and adjusted odds ratios (aORs) for selected outcomes. We evaluate the changes in health services using monthly routine data from UNHCR’s health information system (HIS; January 2018 to March 2021) and apply interrupted time series analysis with a generalized additive model and negative binomial (NB) distribution, accounting for long-term trends and seasonality, reporting results as incidence rate ratios (IRRs). COVID-19 cases were first reported on September 8 and September 13, 2020 in Azraq and Zaatari camps, respectively, 6 months after the first case in Jordan. Incidence rates (IRs) were lower in camps than neighboring governorates (by 37.6% in Azraq (IRR: 0.624, 95% confidence interval [CI]: [0.584 to 0.666], p-value: <0.001) and 40.2% in Zaatari (IRR: 0.598, 95% CI: [0.570, 0.629], p-value: <0.001)) and lower than Jordan (by 59.7% in Azraq (IRR: 0.403, 95% CI: [0.378 to 0.430], p-value: <0.001) and by 63.3% in Zaatari (IRR: 0.367, 95% CI: [0.350 to 0.385], p-value: <0.001)). Characteristics of cases and risk factors for negative disease outcomes were consistent with increasing COVID-19 evidence. The following health services reported an immediate decline during the first year of COVID-19: healthcare utilization (by 32% in Azraq (IRR: 0.680, 95% CI [0.549 to 0.843], p-value < 0.001) and by 24.2% in Zaatari (IRR: 0.758, 95% CI [0.577 to 0.995], p-value = 0.046)); consultations for respiratory tract infections (RTIs; by 25.1% in Azraq (IRR: 0.749, 95% CI: [0.596 to 0.940], p-value = 0.013 and by 37.5% in Zaatari (IRR: 0.625, 95% CI: [0.461 to 0.849], p-value = 0.003)); and family planning (new and repeat family planning consultations decreased by 47.4% in Azraq (IRR: 0.526, 95% CI: [0.376 to 0.736], p-value = <0.001) and 47.6% in Zaatari (IRR: 0.524, 95% CI: [0.312 to 0.878], p-value = 0.014)). Maternal and child health services as well as noncommunicable diseases did not show major changes compared to pre–COVID-19 period. Conducting interrupted time series analyses in volatile settings such refugee camps can be challenging as it may be difficult to meet some analytical assumptions and to mitigate threats to validity. The main limitation of this study relates therefore to possible unmeasured confounding. Conclusions COVID-19 transmission was lower in camps than outside of camps. Refugees may have been affected from external transmission, rather than driving it. Various types of health services were affected differently, but disruptions appear to have been limited in the 2 camps compared to other noncamp settings. These insights into Jordan’s refugee camps during the first year of the COVID-19 pandemic set the stage for follow-up research to investigate how infection susceptibility evolved over time, as well as which mitigation strategies were more successful and accepted.

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Section: Discussionmentioning

confidence: 99%

COVID-19 epidemiology and changes in health service utilization in Azraq and Zaatari refugee camps in Jordan: A retrospective cohort study

2022

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“…Because of two factors (Jordan’s stability and its geographical location), Jordan has become an important route to safety for many refugees from nearby countries such as Palestine, Iraq, and Syria. It is estimated that, in Jordan, there are 2 million Palestinian refugees, 67,000 Iraqi refugees, 15,000 Yemeni refugees, and 6000 Sudanese refugees [ 11 ]. These numbers show the Jordanian Government’s initiative to help refugees and it is no different when it comes to Syrian refugees.…”

Section: Introductionmentioning

confidence: 99%

“…On 14 January 2021, Iraqi and Syrian refugees in camps began receiving their first doses of the COVID-19 vaccine under government guidelines [ 11 ]. Therefore, there is a certain level of accessibility when it comes to the COVID-19 vaccine for Syrian refugees.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Vaccine Acceptance among Vulnerable Groups: Syrian Refugees in Jordan

et al. 2022

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Despite the wide distribution of COVID-19 vaccines, refugees remain last in line for the intake of vaccines. Syrian refugees in Jordan reach up to 700,000 registered and almost up to 700,000 unregistered refugees. This study aims to assess the willingness of Syrian refugees in Jordan to take the COVID-19 vaccine. Participants in the Zaatari refugee camp in Jordan were invited through social media to complete the survey between January and March 2022. A total of 230 refugees participated in our study, with almost half the participants of male gender. The majority of the participants had secondary school as their highest education level and were unemployed, being below the social poverty line. Interestingly, Syrian refugees showed a high vaccine acceptance rate, as 89.6% were willing to take the vaccine. Moreover, they showed high knowledge regarding the vaccine, the disease, and the virus. Our findings highlight the importance of knowledge and awareness of the COVID-19 vaccine to increase the acceptance rate. This is very important as refugees represent a vulnerable group to infection and complications and require close attention, especially with their significant numbers in Jordon and challenges of providing adequate vaccine supplies at their camps. We hope that, with proper dissemination of knowledge and awareness and with easy accessibility to the vaccines, it will ensure high immunization to reach herd immunity in Jordan.

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“…The fourth phase showed a steady and progressive decline of the epidemiological curve with a long plateau of around 900 cases per day during the June-September 2021 time-period [7]. To note that the COVID-19 vaccination campaign in Jordan started in mid-January 2021 and targeted all individuals regardless of nationality, citizenship, and legal status [8].…”

Section: Introductionmentioning

confidence: 99%

Infection prevention and control risk factors in health workers infected with SARS-CoV-2 in Jordan: A case control study

Tarif

Ramadan²,

et al. 2022

PLoS ONE

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Background Despite under-reporting, health workers (HWs) accounted for 2 to 30% of the reported COVID-19 cases worldwide. In line with data from other countries, Jordan recorded multiple case surges among HWs. Methods Based on the standardized WHO UNITY case-control study protocol on assessing risk factors for SARS-CoV-2 infection in HWs, HWs with confirmed COVID-19 were recruited as cases from eight hospitals in Jordan. HWs exposed to COVID-19 patients in the same setting but without infection were recruited as controls. The study lasted approximately two months (from early January to early March 2021). Regression models were used to analyse exposure risk factors for SARS-CoV-2 infection in HWs; conditional logistic regressions were utilized to estimate odds ratios (ORs) adjusted for the confounding variables. Results A total of 358 (102 cases and 256 controls) participants were included in the analysis. The multivariate analysis showed that being exposed to COVID-19 patients within 1 metre for more than 15 minutes increased three-fold the odds of infection (OR 2.92, 95% CI 1.25–6.86). Following IPC standard precautions when in contact with patients was a significant protective factor. The multivariate analysis showed that suboptimal adherence to hand hygiene increased the odds of infection by three times (OR 3.18; 95% CI 1.25–8.08). Conclusion Study findings confirmed the role of hand hygiene as one of the most cost-effective measures to combat the spreading of viral infections. Future studies based on the same protocol will enable additional interpretations and confirmation of the Jordan experience.

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Vaccination for SARS-CoV-2 of migrants and refugees, Jordan

Cited by 16 publications

References 1 publication

COVID-19 epidemiology and changes in health service utilization in Azraq and Zaatari refugee camps in Jordan: A retrospective cohort study

COVID-19 epidemiology and changes in health service utilization in Azraq and Zaatari refugee camps in Jordan: A retrospective cohort study

COVID-19 Vaccine Acceptance among Vulnerable Groups: Syrian Refugees in Jordan

Infection prevention and control risk factors in health workers infected with SARS-CoV-2 in Jordan: A case control study

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