Alvarez-Fischer Daniel, Borsche Max, Balck Alexander, Föh Bandik, Hoischen Arnim, Hotak Fawad, Reinhardt Jan, Elsner Susanne A, Peters Elke, Rieck Andrea, Martin Emily L, Künsting Inga, Ehlers Marc, Mischnik Alexander, Taube Stefan, Käding Nadja, Rupp Jan, Katalinic Alexander, Klein Christine
Institute of Neurogenetics, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Institute of Systems Motor Science, Center for Brain, Behavior, and Metabolism, Lübeck, Germany.
BMC Public Health. 2025 Apr 7;25(1):1301. doi: 10.1186/s12889-025-22120-9.
Housing and access to healthcare pose particular challenges to asylum seekers and refugees. The main study aim was to assess their frequency of SARS-CoV-2 infection during the COVID-19 pandemic.
We provide a prospective study on SARS-CoV-2 cases among adult asylum seekers/refugees in Europe over 18 months. Acute SARS-CoV-2 infection and antibody titers were determined in adult refugees living in shared accommodation in Lübeck, Germany, in fall 2020 (TP1) and spring 2021 (TP2) and compared to the results from a local population-based cohort. In spring 2022 (TP3), we determined antibody titers two years into the pandemic and one year of access to vaccination. At TP3, we additionally included a third cohort of recently arrived refugees from Ukraine.
At all three time points, we detected a marked increase in the infection frequency in refugee community shelters compared to the control group. Age, sex, or facility equipment did not impact the results. Refugees living with their own children in the shelter were significantly more often infected than those without. None of the PCR-positive refugees at TP1 and TP2 were aware of their infection. One year later, awareness of having had an infection was still much lower among the refugees compared to the control cohort. Only 32.9% of the asylum seekers were willing to be vaccinated compared to 85.5% in the control population at the beginning of the vaccination period. However, over 90% of the same population was vaccinated one year later. Among newly arrived refugees from Ukraine, uncertainty towards vaccination was significantly increased compared to the control cohort and the group of residing refugees.
Refugees residing in shared accommodations represent a vulnerable group for SARS-CoV-2 infection and transmission. This increased vulnerability does not diminish over time. Initial doubts regarding vaccination are higher among refugees. While this reservation can be overcome, awareness work is paramount and has to start anew with any new refugee wave.
住房和获得医疗保健对寻求庇护者和难民构成了特殊挑战。主要研究目的是评估他们在新冠疫情期间感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的频率。
我们对欧洲成年寻求庇护者/难民中的SARS-CoV-2病例进行了为期18个月的前瞻性研究。2020年秋季（TP1）和2021年春季（TP2），对居住在德国吕贝克集体宿舍的成年难民进行了急性SARS-CoV-2感染和抗体滴度检测，并与当地基于人群的队列研究结果进行比较。2022年春季（TP3），我们在疫情爆发两年和接种疫苗一年后测定了抗体滴度。在TP3时，我们还纳入了第三组来自乌克兰的新抵达难民。
在所有三个时间点，我们发现与对照组相比，难民社区收容所的感染频率显著增加。年龄、性别或设施设备对结果没有影响。在收容所与自己孩子一起生活的难民比没有孩子的难民感染的频率明显更高。TP1和TP2时PCR检测呈阳性的难民中，没有人意识到自己被感染。一年后，与对照组相比，难民中感染过病毒的知晓率仍然低得多。在疫苗接种开始时，只有32.9%的寻求庇护者愿意接种疫苗，而对照组为85.5%。然而，一年后同一人群中超过90%接种了疫苗。与对照组和居住难民组相比，新抵达的乌克兰难民对疫苗接种的不确定性显著增加。
居住在集体宿舍的难民是SARS-CoV-2感染和传播的弱势群体。这种增加的脆弱性不会随着时间的推移而减少。难民对疫苗接种的最初疑虑更高。虽然这种保留态度可以克服，但宣传工作至关重要，并且必须随着每一波新的难民潮重新开展。
