What must be done to tackle vaccine hesitancy and barriers to COVID-19 vaccination in migrants?

Crawshaw, Alison F; Deal, Anna; Rustage, Kieran; Forster, Alice S.; Campos-Matos, Inês; Vandrevala, Tushna; Würz, Andrea; Pharris, Anastasia; Suk, Jonathan E.; Kinsman, John; Deogan, Charlotte; Miller, Anna N.; Declich, Silvia; Greenaway, Chris; Noori, Teymur; Hargreaves, Sally

doi:10.1093/jtm/taab048

Cited by 114 publications

(167 citation statements)

References 8 publications

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“…Our results suggest that in precarious migrant groups, vaccine hesitancy issues could be relatively straightforward to address with clear, accessible and tailored information campaigns in a wide range of formats and languages. This should be done through existing schemes such as NHS community champions or Patient and Public Engagement groups (46) or through new collaborations with existing, trusted actors, such as charities, community groups and communities themselves, to ensure equitable uptake (14, 47).…”

Section: Discussionmentioning

confidence: 99%

“…In particular, recently arrived migrants with precarious immigration status such as undocumented migrants, asylum seekers and refugees, who are known to face many unique barriers and even exclusion from health systems, have not been well considered in research to date around the COVID-19 vaccine. Many are concerned that vulnerable groups, including precarious migrants, homeless populations, and Roma communities, as well those living in highly deprived areas, may not be reached in the COVID-19 vaccine roll-out without specific interventions to facilitate engagement with these communities in order to strengthen delivery and uptake (13, 14).…”

Section: Introductionmentioning

confidence: 99%

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Strategies and action points to ensure equitable uptake of COVID-19 vaccinations: A national qualitative interview study to explore the views of undocumented migrants, asylum seekers, and refugees

Deal

Hayward

Huda

et al. 2021

Preprint

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Introduction Early evidence confirms lower COVID-19 vaccine uptake in established ethnic minority populations, yet there has been little focus on understanding vaccine hesitancy and barriers to vaccination in migrants. Growing populations of precarious migrants (including undocumented migrants, asylum seekers and refugees) in the UK and Europe are considered to be under-immunised groups and may be excluded from health systems, yet little is known about their views on COVID-19 vaccines specifically, which are essential to identify key solutions and action points to strengthen vaccine roll-out. Methods We did an in-depth semi-structured qualitative interview study of recently arrived migrants (foreign-born, >18 years old; <10 years in the UK) to the UK with precarious immigration status between September 2020 and March 2021, seeking their input into strategies to strengthen COVID-19 vaccine delivery and uptake. We used the Three Cs model (confidence, complacency and convenience) to explore COVID-19 vaccine hesitancy, barriers and access. Data were analysed using a thematic framework approach. Data collection continued until data saturation was reached, and no novel concepts were arising. The study was approved by the University of London ethics committee (REC 2020.00630). Results We approached 20 migrant support groups nationwide, recruiting 32 migrants (mean age 37.1 years; 21 [66%] female; mean time in the UK 5.6 years [SD 3.7 years]), including refugees (n = 3), asylum seekers (n = 19), undocumented migrants (n = 8) and migrants with limited leave to remain (n = 2) from 15 different countries (5 WHO regions). 23 (72%) of 32 migrants reported being hesitant about accepting a COVID-19 vaccine and communicated concerns over vaccine content, side-effects, lack of accessible information in an appropriate language, lack of trust in the health system and low perceived need. Participants reported a range of barriers to accessing the COVID-19 vaccine and expressed concerns that their communities would be excluded from or de-prioritised in the roll-out. Undocumented migrants described fears over being charged and facing immigration checks if they present for a vaccine. All participants (n = 10) interviewed after recent government announcements that COVID-19 vaccines can be accessed without facing immigration checks remained unaware of this. Participants stated that convenience of access would be a key factor in their decision around whether to accept a vaccine and proposed alternative access points to primary care services (for example, walk-in centres in trusted places such as foodbanks, community centres and charities), alongside promoting registration with primary care for all, and working closely with communities to produce accessible information on COVID-19 vaccination. Conclusions Precarious migrants may be hesitant about accepting a COVID-19 vaccine and face multiple and unique barriers to access, requiring simple but innovative solutions to ensure equitable access and uptake. Vaccine hesitancy and low awareness around entitlement and relevant access points could be easily addressed with clear, accessible, and tailored information campaigns, co-produced and delivered by trusted sources within marginalised migrant communities. These findings have immediate relevance to the COVID-19 vaccination initiatives in the UK and in other European and high-income countries with diverse migrant populations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Strategies and action points to ensure equitable uptake of COVID-19 vaccinations: A national qualitative interview study to explore the views of undocumented migrants, asylum seekers, and refugees

Deal

Hayward

Huda

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

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“…The UN International Organisation for Migration has called on member states to include all migrants in national covid-19 vaccine distribution plans 38. Emerging data from some high income countries show low uptake of the covid-19 vaccine in migrants specifically,22 suggesting tailored and targeted strategies may be needed to ensure access to the vaccines, reduce barriers to health and vaccination systems, and tackle issues such as vaccine hesitancy and misinformation 39…”

Section: Investing In Health and Social Conditionsmentioning

confidence: 99%

Health and social needs of migrant construction workers for big sporting events

Onarheim

Phua

Babar

et al. 2021

BMJ

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“…Although calls are being made for the inclusion of migrant and mobile populations in Covid-19 responses, specifically vaccination programmes ( Al-Oraibi et al., 2021 ; Beyrer et al., 2021 ; Hoagland and Randrianarisoa, 2021 ; Orcutt et al., 2020 ; UNHCR, UN Committee on Migrant Workers, UN Special Rapporteur on the Human Rights of Migrants, African Commission on Human and Peoples’ Rights, Inter-American Commission on Human Rights, Council of Europe, 2021 ), few good practice examples exist of how to strengthen regional harmonisation and operate inclusive health systems during the pandemic ( Crawshaw et al., 2021 ; Greenaway et al., 2020 ; Knights et al., 2021 ).…”

Section: Moving Forward: Towards Inclusive Covid-19 Programmingmentioning

confidence: 99%

Global health (security), immigration governance and Covid-19 in South(ern) Africa: An evolving research agenda

Vearey¹,

Gruchy²,

Maple³

2021

Journal of Migration and Health

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The Covid-19 pandemic provides a stark reminder of the political tensions associated with the field of immigration and health, highlighting the central role that nationalism, racism and xenophobia play in determining responses to communicable diseases. The blurring of global health, immigration governance, and the global health security agendas has long been recognised. However, an improved understanding of the politics influencing these entanglements, specifically within the context of the Covid-19 response in low- and middle-income country contexts, is urgently needed. This includes – but is not limited to – the immediate concerns surrounding inclusive social, political and medical responses to Covid-19; vaccine nationalism – at both global and national levels; and calls for ‘vaccine passports’. To this end, we draw on the Southern African Development Community (SADC) context – one associated with high levels of diverse population movements and a large burden of communicable diseases – to explore responses to Covid-19. We unpack tensions surrounding the management of migration and the ways in which sovereignty impacts attempts at building regional, coordinated responses to migration and health, and consider how this affects progress towards global health targets. With an initial focus on South Africa, we build on previous work exploring the blurring of global health, immigration governance, and the global health security agendas in SADC, and draw from ongoing research on the governance of migration and health within the region. This includes current and evolving research exploring migration and Covid-19, initiated in March 2020 when the first cases of Covid-19 were identified in Southern Africa. The aim is for these findings to catalyse a new and evolving researh agenda to inform the development and implementation of appropriate pandemic responses in a region associated with some of the highest levels of inequality globally. To this end, an evolving research agenda should be responsive to current needs. We suggest that, in SADC, priority research should focus on improving our understanding of (1) the political factors influencing the (dis)connections between migration and health governance structures in the context of Covid-19, and how to overcome these in the context of a pandemic; and (2) the motivations for and implications of a ‘vaccine passport’ system on movement within and beyond the SADC region. This requires a reactive, cross-disciplinary, regional research network. In a context where funding for research is increasingly inaccessible, this requires innovative, informal, collaborative engagement.

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What must be done to tackle vaccine hesitancy and barriers to COVID-19 vaccination in migrants?

Cited by 114 publications

References 8 publications

Strategies and action points to ensure equitable uptake of COVID-19 vaccinations: A national qualitative interview study to explore the views of undocumented migrants, asylum seekers, and refugees

Strategies and action points to ensure equitable uptake of COVID-19 vaccinations: A national qualitative interview study to explore the views of undocumented migrants, asylum seekers, and refugees

Health and social needs of migrant construction workers for big sporting events

Global health (security), immigration governance and Covid-19 in South(ern) Africa: An evolving research agenda

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