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干预措施以提高欧盟/欧洲经济区新抵达移民的疫苗接种率和疫苗接种策略的成本效益:系统评价。

Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU/EEA: A Systematic Review.

机构信息

Division of Infectious Diseases, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON K1H 8L1, Canada.

NHMRC Clinical Trials Centre, Sydney Medical School, University of Sydney, Camperdown 1450, Australia.

出版信息

Int J Environ Res Public Health. 2018 Sep 20;15(10):2065. doi: 10.3390/ijerph15102065.


DOI:10.3390/ijerph15102065
PMID:30241320
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6210200/
Abstract

Newly arrived migrants to the EU/EEA (arrival within the past five years), as well as other migrant groups in the region, might be under-immunised and lack documentation of previous vaccinations, putting them at increased risk of vaccine-preventable diseases circulating in Europe. We therefore performed a systematic review conforming to PRISMA guidelines (PROSPERO CRD42016045798) to explore: (i) interventions that improve vaccine uptake among migrants; and (ii) cost-effectiveness of vaccination strategies among this population. We searched MEDLINE, Embase, CINAHL, and Cochrane Database of Systematic Reviews (CDSR) between 1 January 2006 to 18 June 2018. We included three primary intervention studies performed in the EU/EEA or high-income countries and one cost effectiveness study relevant to vaccinations in migrants. Intervention studies showed small but promising impact only on vaccine uptake with social mobilization/community outreach, planned vaccination programs and education campaigns. Targeting migrants for catch-up vaccination is cost effective for presumptive vaccination for diphtheria, tetanus, and polio, and there was no evidence of benefit of carrying out pre-vaccination serological testing. The cost-effectiveness is sensitive to the seroprevalence and adherence to vaccinations of the migrant. We conclude that scarce but direct EU/EEA data suggest social mobilization, vaccine programs, and education campaigns are promising strategies for migrants, but more research is needed. Research should also study cost effectiveness of strategies. Vaccination of migrants should continue to be a public heath priority in EU/EEA.

摘要

新抵达欧盟/欧洲经济区的移民(在过去五年内抵达)以及该地区的其他移民群体可能未接种疫苗或缺乏以前接种疫苗的记录,这使他们面临欧洲流行的疫苗可预防疾病的风险增加。因此,我们按照 PRISMA 指南(PROSPERO CRD42016045798)进行了系统评价,以探讨:(i)提高移民疫苗接种率的干预措施;(ii)该人群疫苗接种策略的成本效益。我们在 2006 年 1 月 1 日至 2018 年 6 月 18 日期间在 MEDLINE、Embase、CINAHL 和 Cochrane 系统评价数据库(CDSR)中进行了搜索。我们纳入了在欧盟/欧洲经济区或高收入国家进行的三项初级干预研究和一项与移民疫苗接种相关的成本效益研究。干预研究表明,社会动员/社区外展、计划免疫规划和教育活动等干预措施仅对疫苗接种率产生了较小但有希望的影响。针对移民进行补种疫苗是针对白喉、破伤风和脊髓灰质炎进行假定疫苗接种具有成本效益的,并且没有证据表明进行疫苗接种前血清学检测有益。成本效益对移民的血清阳性率和疫苗接种依从性敏感。我们的结论是,欧盟/欧洲经济区的数据稀缺但直接表明,社会动员、疫苗接种规划和教育活动是移民的有前途的策略,但需要进一步研究。研究还应研究策略的成本效益。在欧盟/欧洲经济区,为移民接种疫苗应继续作为公共卫生重点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45cb/6210200/d3033a0b0afa/ijerph-15-02065-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45cb/6210200/fbe8c091779b/ijerph-15-02065-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45cb/6210200/d3033a0b0afa/ijerph-15-02065-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45cb/6210200/fbe8c091779b/ijerph-15-02065-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45cb/6210200/d3033a0b0afa/ijerph-15-02065-g002.jpg

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本文引用的文献

[1]
Immunization Offer Targeting Migrants: Policies and Practices in Italy.

Int J Environ Res Public Health. 2018-5-12

[2]
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BMJ Open. 2017-9-11

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