Children from poorer refugee and migrant families have less access to health services and lower vaccination rates than the surrounding population.
Key Evidence: A study found that children of poor labor migrants living in Delhi, India are much less likely to be fully vaccinated than the general population and thus are at greater risk of vaccine-preventable diseases. Only 31% – 53% of children from migrant families were fully immunized (against 7 diseases) by 12 months of age, compared to 72% in the overall population of Delhi — with recent migrants having the lowest rates. There is therefore a need to focus on the delivery of health services to migrants.
Key Evidence: Somali refugee children in Kenya were nearly 60 times more likely than children of the main ethnic group in the study (Kikuyu) to not have received any childhood immunization and more than twice as likely to have not completed their vaccinations. Although Somali children made up less than 8% of the sample, they accounted for nearly half of all non-vaccinated children.
From the VoICE Editors: This study used data from Kenya’s Demographic and Health Survey data.
Key Evidence: Recent migrants face barriers to accessing health care including language and cultural barriers, limited knowledge, food and housing insecurity, stress, and lack of resources available during prolonged travel. In Canada, though foreign-born populations make up only 22% of the total population, 70% of active tuberculosis cases occurred in this population.
Key Evidence: Girls from refugee families in Denmark were 40-56% less likely to receive HPV vaccine through 2 free-of-charge immunization programs than Danish-born girls, and the differences remained significant when income was taken into account. The odds of being vaccinated were lowest for refugees in the country ≤5 years and those from certain countries or regions, indicating the need to reduce cultural, social, and information barriers to immunization, as well as assess immunization programs across increasingly ethnically diverse societies.
Key Evidence: In a study of timely measles vaccination – – defined as vaccination within one month of the recommended age – – children living in Zheijiang province in China whose families immigrated from elsewhere in the country were 2.6 times more likely to receive the first measles dose late and nearly 3 times more likely to receive the second dose late than were children originally from the area.
Key Evidence: Children in Shanghai, China whose families migrated from rural areas — now roughly 40% of the city’s total population — are half as likely as “local” children to receive the first dose of measles vaccine by 9 months of age and 42% less likely to receive the second measles dose by 24 months. The lower rates of timely first dose measles vaccination among rural migrants vs. local children — 78% vs. 89% – – are a key obstacle to measles elimination in China. This indicates a need to specifically target non-local children for vaccination, especially those living in primarily migrant communities.
Key Evidence: A study in Canada linking hospital data with census and immigration databases found that immigrants had age-adjusted hospitalization rates from vaccine-preventable diseases that were 33% higher than the rates of the Canadian-born population (1.6 vs. 1.2 per 10,000,) and rates were highest among refugees (1.7/10,000) and immigrants from East and Southeast Asia (2.1/10,000). Sixty percent of the hospitalizations related to vaccine-preventable diseases among recent immigrants were due to chronic hepatitis B infection, suggesting the need for hepatitis B screening guidelines for migrants, as well as vaccinations against a range of diseases for immigrants prior to or upon their arrival.
Key Evidence: A comprehensive review of the recent evidence on the differences in rates of vaccine preventable diseases and immunization between migrants and non-migrants in high and high-middle income countries suggests that migrants and their children are generally at higher risk of contracting or spreading VPDs compared to locally-born citizens, and in many cases, have lower immunization rates.