Behavioural and social drivers of vaccination among child and adult migrants in Morocco: A qualitative interview study.

BACKGROUND

The World Health Organization's Immunization Agenda 2030 calls for ensuring universal access to vaccination across the life course for all groups including migrants. The aim of this study is to explore factors driving uptake of vaccination among migrants in Morocco.

METHODS

We conducted a multi-site exploratory qualitative study using semi-structured interviews with adult migrants and health professionals in Morocco. We did a hybrid thematic analysis guided by the WHO's Behavioural and Social Drivers of Vaccination (BeSD) uptake framework.

RESULTS

We interviewed 23 migrant participants (15/23 female, mean age 30.0 years ±2.0, average time of stay in Morocco 4.72 years ±8.79) and 8 primary care professionals. We found that although migrant children and adults were entitled to free vaccinations, various individual, social, and practical issues influenced their motivation and uptake. For childhood vaccination, caregivers showed high confidence in vaccine benefits and safety, but faced administrative difficulties, limited information, orientation, and language barriers. For adult vaccination, mistrust and scepticism toward specific vaccines, such as the COVID-19 vaccine, persisted, mainly due to misinformation. Except for the tetanus vaccine for pregnant women and the COVID-19 vaccine, migrant adults were rarely offered adult or catch-up vaccinations, often due to the absence of health worker recommendations and non-verification of vaccine history. Migrants emphasized the need for improved communication with health professionals and addressing language barriers and called for increased sensitization to reduce vaccine scepticism and hesitancy, better information on service locations, particularly through community-based organizations and outreach efforts for hard-to-reach migrants.

CONCLUSIONS

Despite entitlement to vaccination services, vaccination uptake among migrants in Morocco may be influenced by various individual, social, and practical factors. Tailored and targeted interventions are urgently needed, including efforts to prioritize improving communication with health professionals, removing language barriers, and developing appropriate delivery and communication strategies for these communities.