Shimada Y, Kobayashi Y
Graduate School of Law and Politics, The University of Tokyo, Japan; Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Japan.
Department of Public Health, Graduate School of Medicine, The University of Tokyo, Japan.
Public Health. 2023 Apr;217:15-21. doi: 10.1016/j.puhe.2023.01.019. Epub 2023 Feb 24.
OBJECTIVES: Undocumented immigrants (UIs) have been reported to suffer from the unequal distribution of COVID-19 vaccination, but this inequality has never been quantified, and the associated factors have not been measured. STUDY DESIGN AND METHODS: We interviewed 190 municipal offices throughout Japan about the access to COVID-19 vaccination for UIs and control group foreigners. Using logistic regression, we investigated the association between assured access and municipal characteristics. RESULTS: Out of the respondent municipalities, 57.5% answered that UIs can apply for a COVID-19 vaccination voucher. Additionally, 31.5% said they had received an inquiry about vaccines from UI individuals. Furthermore, only 23.2% of the municipalities responded that they had issued vouchers for UIs at least once. The control groups were reported to have been given more access to vouchers. Logistic regression showed that the foreign resident ratio, tertiary industry, and university graduation ratio were positively associated with vaccination access. CONCLUSIONS: This study revealed for the first time that UIs are disproportionately marginalized compared with other visitors, implying that "illegality" plays an important role in the context of vaccination eligibility. The street-level vaccination desks of local governments may refuse to supply vaccines. Vaccine equity will be more readily achievable when vaccination access to all populations including UIs is ensured. Such access will also improve overall public health by increasing the vaccination rate.
目的:据报道,无证移民在新冠疫苗接种方面面临不平等分配问题,但这种不平等从未被量化,相关因素也未得到衡量。 研究设计与方法:我们就无证移民和对照组外国人获取新冠疫苗接种情况,采访了日本各地190个市政办公室。通过逻辑回归分析,我们研究了有保障的接种机会与市政特征之间的关联。 结果:在做出回应的市政当局中,57.5%表示无证移民可以申请新冠疫苗接种券。此外,31.5%称他们收到过无证移民个人关于疫苗的咨询。此外,只有23.2%的市政当局回应称他们至少为无证移民发放过一次接种券。据报告,对照组获得接种券的机会更多。逻辑回归分析表明,外国居民比例、第三产业和大学毕业率与疫苗接种机会呈正相关。 结论:本研究首次揭示,与其他访客相比,无证移民在很大程度上被边缘化,这意味着“非法身份”在疫苗接种资格方面起着重要作用。地方政府的街头疫苗接种点可能会拒绝提供疫苗。当确保包括无证移民在内的所有人群都能获得疫苗接种时,疫苗公平性将更容易实现。这样的接种机会也将通过提高接种率改善整体公共卫生状况。
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