Divergent approaches in the vaccination of recently arrived migrants to Europe: a survey of national experts from 32 countries 2017.

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Euro Surveill. 2018 Oct;23(41). doi: 10.2807/1560-7917.ES.2018.23.41.1700772.

Divergent approaches in the vaccination of recently arrived migrants to Europe: a survey of national experts from 32 countries 2017.

Hargreaves S¹²³ Nellums LB¹²³ Ravensbergen SJ⁴³ Friedland JS¹² Stienstra Y⁴ On Behalf Of The Esgitm Working Group On Vaccination In Migrants⁴¹²³.

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Abstract

BackgroundMigrants within the European Union and European Economic Area (EU/EEA) may be underimmunised and lack documentation on previous vaccinations. We investigated approaches to vaccination in recently arrived adult and child migrants and guideline availability and implementation. Methods: Between March and May 2017 a national vaccination expert from every EU/EEA country and Switzerland completed an electronic questionnaire. We used descriptive analyses to calculate percentages and framework analysis to synthesise free-text responses. Results: We approached 32 countries (response rate 100%). Although 28 experts reported vaccination guidance at national level specific guidelines for recently arrived migrants were only available in six countries and not consistently implemented. Twenty-three countries administered vaccinations during on-arrival health checks. Most experts recommended multiple vaccination opportunities be made available: at point of entry (n = 13) or at holding level (reception centres migrant camps detention centres) (n = 21). In 30 countries child migrants without evidence of previous vaccination were re-vaccinated according to the national schedule. Diphtheria-pertussis-tetanus and polio vaccinations were given to migrant children in all countries measles-mumps-rubella (MMR) in 31 countries hepatitis B vaccination in 25. Low levels of catch-up vaccination were reported in adult migrants with only 13 countries offering MMR and 10 countries charging fees. Conclusion: Existing guidance is often not migrant-specific and may not be applied in practice; clarification is needed on which vaccines should be given. Strategies are needed specifically for catch-up vaccination in adult migrants. Vaccinations should be offered in multiple settings free of charge with sufficient guidance and training provided to front-line healthcare professionals.

KEYWORDS:

European Union; immunisation; migrants; public health policy; travel; vaccination

PMID: 30326996 DOI: 10.2807/1560-7917.ES.2018.23.41.1700772