The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
Lancet Infect Dis. 2021 Dec;21(12):e387-e398. doi: 10.1016/S1473-3099(21)00193-6. Epub 2021 Oct 6.
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.
移民群体是欧盟或欧洲经济区（EU/EEA）中未充分免疫的人群之一，但对于他们在疫苗可预防疾病爆发中的参与情况知之甚少。这些信息对于制定针对不同移民群体的目标策略以改善其健康状况至关重要。我们进行了一项系统评价（PROSPERO CRD42019157473；2000 年 1 月 1 日至 2020 年 5 月 22 日），遵循 PRISMA 指南，以确定涉及居住在欧盟/EEA 和瑞士的移民的疫苗可预防疾病爆发（麻疹、腮腺炎、风疹、白喉、百日咳、脊髓灰质炎、甲型肝炎、水痘、脑膜炎奈瑟菌和流感嗜血杆菌）的研究。我们确定了 45 项研究，报告了 13 个国家的 47 种不同的疫苗可预防疾病爆发。报告的大多数涉及移民的爆发是麻疹（n=24；6496 例），其次是水痘（n=11；505 例）、甲型肝炎（n=7；1356 例）、风疹（n=3；487 例）和腮腺炎（n=2；293 例）。19 次（40%）爆发，主要是水痘和麻疹，发生在临时难民营或避难所。在 11 次水痘爆发中，有 9 次（82%）与成年移民有关。麻疹爆发中有一半（n=11）与东欧国家的移民有关。总之，移民参与了欧洲的疫苗可预防疾病爆发，尤其是居住在避难所或临时营地的成年和儿童难民，以及特定国籍群体。脆弱性因疾病、环境和人口统计学因素而异，这突出表明，必须根据新的《2030 年免疫议程》行动框架，针对特定群体量身定制补种疫苗干预措施，以实现区域和全球疫苗接种目标。迫切需要更好地了解移民群体的疫苗获取和接种意愿，并更加注重共同设计干预措施，这对 COVID-19 疫苗的推广具有直接影响。
