Padhani Zahra Ali, Khan Maryam Hameed, Yasin Rahima, Rahman Abdu R, Lakhani Sohail, Mirani Mushtaq, Jamali Muhammad Khan, Khan Zahid Ali, Khatoon Sana, Partab Riya, Haq Atta Ul, Kampalath Vinay, Hosseinalipour Seyed-Moeen, Blanchet Karl, Das Jai K
Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan.
School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
PLOS Glob Public Health. 2025 Apr 8;5(4):e0004444. doi: 10.1371/journal.pgph.0004444. eCollection 2025.
Migrants and refugees are among the most disadvantaged populations, with limited evidence on the access and uptake of COVID-19 vaccination among them. Therefore this qualitative study explores the behavioral and social drivers of the COVID-19 vaccine among the refugee and migrant population in Pakistan through in-depth interviews and focus group discussions with regular and irregular migrants and refugees residing in Pakistan. Key informant interviews were conducted with stakeholders responsible for overlooking the COVID-19 vaccination process. A total of 18 participants were interviewed to gather insights on COVID-19 vaccine access, uptake, and behaviours among migrants and refugees. Data was collection from June to July 2022, in Karachi, Hyderabad, and Quetta. All the interviews were audio recorded, transcribed, translated, and thematically analysed on Nvivo software. The study found that refugee and migrant communities in Pakistan faced significant challenges to COVID-19 vaccination uptake, with barriers including misconceptions about vaccine safety and efficacy, fears of side effects, and mistrust spread by religious leaders. Participants were refused vaccinations at many centers despite government directives allowing vaccines for those without Computerized National Identity Cards (CNIC). Limited outreach and awareness efforts from the government, fears of identification and deportation, long wait times at vaccination centers, and the absence of female vaccinators in communities with strict gender norms further hindered access. Many participants also reported being charged for vaccination leading to lower vaccine coverage. Despite these challenges, some individuals were motivated to vaccinate due to workplace requirements, peer influence, or personal health concerns. Facilitators included door-to-door vaccination campaigns and school vaccination mandates. Vaccination camps set up by NGOs and government agencies at border areas and migrant-rich districts facilitated access. The study suggests targeted strategies to improve vaccination coverage, including provision of identification documents to migrants, inclusion in policy, and enforcement of multilingual communication to improve healthcare access.
移民和难民是最弱势的群体之一，关于他们接种新冠疫苗的情况和接受程度的证据有限。因此，这项定性研究通过对居住在巴基斯坦的正规和非正规移民及难民进行深入访谈和焦点小组讨论，探讨了巴基斯坦难民和移民群体中新冠疫苗接种的行为和社会驱动因素。与负责监督新冠疫苗接种过程的利益相关者进行了关键信息访谈。总共采访了18名参与者，以了解移民和难民在新冠疫苗接种、接受情况及行为方面的见解。2022年6月至7月在卡拉奇、海得拉巴和奎达收集了数据。所有访谈都进行了录音、转录、翻译，并在Nvivo软件上进行了主题分析。研究发现，巴基斯坦的难民和移民社区在接种新冠疫苗方面面临重大挑战，障碍包括对疫苗安全性和有效性的误解、对副作用的恐惧以及宗教领袖传播的不信任。尽管政府有指令允许为没有计算机化国民身份证（CNIC）的人接种疫苗，但许多中心仍拒绝为参与者接种。政府的宣传和提高认识工作有限、对身份识别和驱逐的恐惧、接种中心的长时间等待，以及在性别规范严格的社区缺乏女性接种人员，进一步阻碍了接种。许多参与者还报告称接种疫苗被收费，导致疫苗接种率较低。尽管存在这些挑战，但由于工作场所要求、同伴影响或个人健康问题，一些人仍有接种疫苗的动力。促进因素包括挨家挨户的疫苗接种运动和学校疫苗接种规定。非政府组织和政府机构在边境地区和移民聚居区设立的疫苗接种营地便利了接种。该研究提出了提高疫苗接种率的针对性策略，包括为移民提供身份证件、纳入政策以及加强多语言沟通以改善医疗服务获取情况。
