Migration and outbreaks of vaccine-preventable disease in Europe: a systematic review.

Published on Oct 6, 2021in Lancet Infectious Diseases25.071
· DOI :10.1016/S1473-3099(21)00193-6
Anna Deal4
Estimated H-index: 4
(St George's, University of London),
Rae Halliday1
Estimated H-index: 1
(St George's, University of London)
+ 12 AuthorsSally Hargreaves9
Estimated H-index: 9
(St George's, University of London)
Sources
Abstract
Migrant populations are one of several underimmunised groups in the EU or European Economic Area (EU/EEA), yet little is known about their involvement in outbreaks of vaccine-preventable diseases. This information is vital to develop targeted strategies to improve the health of diverse migrant communities. We did a systematic review (PROSPERO CRD42019157473; Jan 1, 2000, to May 22, 2020) adhering to PRISMA guidelines, to identify studies on vaccine-preventable disease outbreaks (measles, mumps, rubella, diphtheria, pertussis, polio, hepatitis A, varicella, Neisseria meningitidis, and Haemophilus influenzae) involving migrants residing in the EU/EEA and Switzerland. We identified 45 studies, reporting on 47 distinct vaccine-preventable disease outbreaks across 13 countries. Most reported outbreaks involving migrants were of measles (n=24; 6496 cases), followed by varicella (n=11; 505 cases), hepatitis A (n=7; 1356 cases), rubella (n=3; 487 cases), and mumps (n=2; 293 cases). 19 (40%) outbreaks, predominantly varicella and measles, were reported in temporary refugee camps or shelters. Of 11 varicella outbreaks, nine (82%) were associated with adult migrants. Half of measles outbreaks (n=11) were associated with migrants from eastern European countries. In conclusion, migrants are involved in vaccine-preventable disease outbreaks in Europe, with adult and child refugees residing in shelters or temporary camps at particular risk, alongside specific nationality groups. Vulnerability varies by disease, setting, and demographics, highlighting the importance of tailoring catch-up vaccination interventions to specific groups in order to meet regional and global vaccination targets as recommended by the new Immunisation Agenda 2030 framework for action. A better understanding of vaccine access and intent in migrant groups and a greater focus on co-designing interventions is urgently needed, with direct implications for COVID-19 vaccine delivery.
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#1Sally Hargreaves (St George's, University of London)H-Index: 9
#2Sally E Hayward (St George's, University of London)H-Index: 5
Last. Bernadette N. Kumar (FHI: Norwegian Institute of Public Health)H-Index: 24
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#2Anna Deal (Lond: University of London)H-Index: 4
Last. Sally Hargreaves (St George's, University of London)H-Index: 9
view all 16 authors...
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#1Anna Deal (St George's, University of London)H-Index: 3
#2Sally E Hayward (St George's, University of London)H-Index: 5
Last. May Rowland-Pomp (St George's, University of London)H-Index: 1
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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 specifical...
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#1Felicity Knights (St George's, University of London)H-Index: 6
#2Jessica Carter (St George's, University of London)H-Index: 5
Last. Sally Hargreaves (St George's, University of London)H-Index: 9
view all 7 authors...
BACKGROUND: The COVID-19 pandemic has prompted considerable changes in delivery of UK primary care, including rapid digitalisation, yet the impact upon marginalised migrant groups is unknown. AIM: To understand the impact of the COVID-19 pandemic on migrants and their access to primary healthcare, and implications for COVID-19 vaccine roll out. DESIGN AND SETTING: Primary care professionals, administrative staff, and migrants (foreign born; >18 years; <10 years in UK), were recruited in three ph...
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The successful development and widespread acceptance of a SARS-CoV-2 vaccine will be a major step in fighting the pandemic, yet obtaining high uptake will be a challenging task, worsened by online misinformation. To help inform successful COVID-19 vaccination campaigns in the UK and US, we conducted a survey to quantify how online misinformation impacts COVID-19 vaccine uptake intent and identify socio-economic groups that are most at-risk of non-vaccination and most susceptible to online misinf...
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#2Anelisa Jaca (South African Medical Research Council)H-Index: 6
Last. Sten H. Vermund (Yale University)H-Index: 84
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Introduction At the 72nd World Health Assembly of May 2019, WHO member states prioritised a global action plan to promote migrant and refugee health. Five months earlier, WHO had declared vaccine hesitancy—the reluctance to vaccinate despite the availability of vaccination services—as one of the top 10 threats to global health. Although vaccination is often a requirement for immigration, repeated outbreaks of vaccine-preventable diseases within certain immigrant communities in some host nations ...
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#1Sally Hargreaves (St George's, University of London)H-Index: 9
#2Bernadette N. Kumar (FHI: Norwegian Institute of Public Health)H-Index: 24
Last. Apostolos Veizis (MSF: Médecins Sans Frontières)H-Index: 8
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Policy makers must include migrant camps in their national plans The world has watched the growing global health crisis caused by covid-19 with alarm, fear, and desperation. One after another, governments, healthcare systems, and individuals are adopting increasingly restrictive measures, with “social distancing” now the norm in most countries. Yet for many people, and especially migrants who have been displaced from their homes, this is not possible. Several tens of thousands of people are livi...
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#1Sadie Bell (Lond: University of London)H-Index: 9
#2Vanessa Saliba (PHE: Public Health England)H-Index: 16
Last. Sandra Mounier-Jack (Lond: University of London)H-Index: 26
view all 4 authors...
Background: Since 2016, large scale measles outbreaks have heavily affected countries across Europe. In England, laboratory confirmed measles cases increased almost four-fold between 2017 and 2018, from 259 to 966 cases. Several of the 2017-18 measles outbreaks in England particularly affected Romanian and Roma Romanian communities, with the first outbreaks in these communities occurring in Birmingham, Leeds and Liverpool. This study explored factors influencing vaccination behaviours amongst Ro...
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#2Anthi ChrysostomouH-Index: 2
Last. Christos Hadjichristodoulou (UTH: University of Thessaly)H-Index: 35
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Hepatitis A is a mandatory notifiable disease in Greece. Here, we present the epidemiological data for 2009-2018 and the results of outbreak investigations performed, and discuss future public health priorities.Overall, 1193 cases were reported; 320 migrants/refugees, 240 Roma, 112 travellers and 521 from the general population. The median age of the affected general population (37 years) had an increasing trend (from 30.8 years in 2009 to 40.5 in 2018, P < 0.001) and was significantly higher th...
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Cited By1
Newest
#1Alison F Crawshaw (St George's, University of London)H-Index: 6
#2Yasmin Farah (St George's, University of London)H-Index: 1
Last. Sally Hargreaves (St George's, University of London)H-Index: 9
view all 14 authors...
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 (PROSPER...
Source
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