New HEN report reveals gaps in protection of refugees and migrants from vaccine-preventable diseases

Refugees and migrants should be vaccinated without unnecessary delay according to the immunization schedules of their host countries. This is the guidance provided by a joint recommendation of WHO, the United Nations Children’s Fund and the United Nations High Commissioner for Refugees.

However, a new report from WHO shows that fewer than one third of the countries in the WHO European Region have any specific directives within their national immunization policies focused on the immunization of refugees and migrants, including children and pregnant women. Children represent approximately 25% of the total migrant population in the Region, and are considered to be at greatest risk of contracting vaccine-preventable diseases.

The newly released Health Evidence Network (HEN) synthesis report is based on a scoping review of existing immunization policies and practices for refugees and migrants in the Region. WHO/Europe conducted the review to help better understand current practice. The report’s findings show that vaccination services targeted to refugees and migrants vary greatly among Member States, but also reveal some commonalities across countries.

According to the report, in most countries the delivery of immunization services is primarily carried out by public health-care systems, but international organizations and nongovernmental organizations are involved in service implementation at the local level.

The report also identifies common barriers for the implementation and use of immunization services across countries. Socioeconomic, sociocultural and educational issues were obstacles in accessing the available immunization services in host countries. Lack of financial and human resources – in particular cultural mediators and/or interpreters – were barriers to effective implementation of the national policies.

Policy considerations to ensure equitable service delivery

Based on the available evidence, the review outlines several policy options to ensure adequate protection of migrants and refugees from vaccine-preventable diseases. These include:

  • designing culturally appropriate vaccination strategies;
  • ensuring political commitment to addressing barriers to vaccination service delivery and utilization;
  • developing realistic implementation plans with robust monitoring and evaluation frameworks;
  • fostering research; and
  • promoting cross-border collaboration and sharing of good practices among countries in the Region.

The report also identifies several critical areas that policy-makers need to address to ensure refugees and migrants have access to equitable and high-quality immunization services. Some of the suggested actions include improving health literacy among migrants and refugees, providing information materials in the migrants’ languages, and offering adequate training and culturally relevant information to health-care providers.

Collaborating to build the evidence base for refugee and migrant health

WHO/Europe, through its migration and health programme, has been pioneering efforts to address the public health aspects of migration, including by using innovative public health approaches to develop an evidence base on refugee and migrant health.

A themed series of HEN synthesis reports on refugees and migrants has been jointly produced by the migration and health programme and the HEN Secretariat located in the knowledge management, evidence and research for policy-making programme in the Division of Information, Evidence, Research and Innovation. The newest HEN report in the series was developed in collaboration with the vaccine-preventable diseases and immunization programme.