Sofanne Ravensbergen, Nicolas Vignier et al., « National approaches to the vaccination of recently arrived migrants in Europe : A comparative policy analysis across 32 European countries », Travel Medicine and Infectious Disease, nov. 2018

Article paru dans Travel Medi­cine and Infec­tious Disease, en accès libre sur le site de la revue

Résumé

BACKGROUND

Migrants may be unde­rim­mu­nised and at higher risk of vaccine-preven­table diseases, yet there has been no compre­hen­sive exami­na­tion of what poli­cies are currently imple­mented across Europe targe­ting child and adult migrants. We analysed vacci­na­tion poli­cies for migrants in 32 EU/​EEA coun­tries and Switzerland.

METHODS

Using frame­work analysis, we did a compa­ra­tive analysis of national poli­cies and guide­lines pertai­ning to vacci­na­tion in recently arrived migrants through a syste­matic guide­line and lite­ra­ture review and by approa­ching national experts.

RESULTS

Six (18.8%) of 32 coun­tries had compre­hen­sive poli­cies specific to the vacci­na­tion of migrants (2 focused only on child migrants, 4 on both adults and chil­dren). Nine­teen (59.4%) coun­tries applied their national vacci­na­tion sche­dule for migrant vacci­na­tions, predo­mi­nantly focu­sing on chil­dren ; and five (15.6%) coun­tries had circu­lated addi­tional migrant-specific resources to rele­vant health-care provi­ders. In six (18.8%) coun­tries, poli­cies on migrant vacci­na­tion focused on outbreak-specific vaccines only. In 10 (31.3%) coun­tries, poli­cies focused on prio­rity vacci­na­tions, with polio being the vaccine most commonly admi­nis­tered and hete­ro­ge­neity noted in vaccines recom­mended to adults, adoles­cents, and chil­dren. Eigh­teen (56.3%) coun­tries recom­mended that an indi­vi­dual should be consi­dered as unvac­ci­nated where vacci­na­tion records were missing, and vaccines re-admi­nis­tered. Nine (28.1%) coun­tries reported that specific vacci­na­tions were mandatory.

CONCLUSION

There is stri­king varia­tion in poli­cies across Europe regar­ding vacci­na­tions offered and approaches to vacci­na­tion in adult and child migrants. There is a lack of clarity on optimum approaches to vacci­na­tion in migrants, and a need for robust research in this area. More emphasis must be placed on ensu­ring migrant-specific guidance is disse­mi­nated to front-line heal­th­care profes­sio­nals to improve vaccine deli­very and uptake in diverse migra­tion popu­la­tions across the region.