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.
| Original language | English |
|---|---|
| Pages (from-to) | e387-e398 |
| Journal | The Lancet Infectious Diseases |
| Volume | 21 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 2021 |
Bibliographical note
Publisher Copyright:© 2021 Elsevier Ltd
Funding
This work has been funded by the National Institute for Health Research (NIHR; NIHR300072). AD and SEH are funded by the Medical Research Council (MR/N013638/1). SH and AFC are funded by the NIHR (NIHR Advanced Fellowship NIHR300072) and the Academy of Medical Sciences (SBF005\1111). This work has been supported by the European Society of Clinical Microbiology and Infectious Diseases Study Group for Infections in Travellers and Migrants (ESGITM). JC is funded by a NIHR in-practice clinical fellowship (NIHR300290). FK is supported by a Health Education England/NIHR Academic Clinical Fellowship. KR is funded by the Rosetrees Trust (M775). SM-J was funded by the NIHR Health Protection Research Unit in Immunisation at the London School of Hygiene & Tropical Medicine in partnership with Public Health England. AM is supported by the NIHR Applied Research Collaboration Northwest London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. This work has been funded by the National Institute for Health Research (NIHR; NIHR300072). AD and SEH are funded by the Medical Research Council (MR/N013638/1). SH and AFC are funded by the NIHR (NIHR Advanced Fellowship NIHR300072) and the Academy of Medical Sciences (SBF005\1111). This work has been supported by the European Society of Clinical Microbiology and Infectious Diseases Study Group for Infections in Travellers and Migrants (ESGITM). JC is funded by a NIHR in-practice clinical fellowship (NIHR300290). FK is supported by a Health Education England/NIHR Academic Clinical Fellowship. KR is funded by the Rosetrees Trust (M775). SM-J was funded by the NIHR Health Protection Research Unit in Immunisation at the London School of Hygiene & Tropical Medicine in partnership with Public Health England. AM is supported by the NIHR Applied Research Collaboration Northwest London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. ESGITM members, Francesco Castelli (University of Brescia, Italy), Edmond Puca (Mother Theresa Hospital Center, Albania), Nick J Beeching (University of Liverpool, UK), S J Ravensbergen (University of Groningen, Netherlands), Ioana Margineanu (University of Groningen, Netherlands), Ymkje Stienstra (University of Groningen, Netherlands).
| Funders | Funder number |
|---|---|
| NIHR Applied Research Collaboration Northwest London | |
| London School of Hygiene and Tropical Medicine | |
| Medical Research Council | MR/N013638/1 |
| National Institute for Health Research | NIHR300072 |
| Academy of Medical Sciences | SBF005\1111 |
| Rosetrees Trust | M775 |
| European Society of Clinical Microbiology and Infectious Diseases | NIHR300290 |
| Rijksuniversiteit Groningen | |
| Università degli Studi di Brescia |
