Ikeda Saki, Sudo Kyoko, Iwamoto Azusa, Kanda Miwa, Aoyagi Ritsuko, Ota Sanae, Shakya Mina, Nii Midori, Sawada Takashi, Nakasa Tamotsu, Fujita Masami
Bureau of International Health Cooperation, Japan Institute for Health Security, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
National College of Nursing, Japan, 1-2-1 Umezono, Kiyose-shi, Tokyo, 204-8575, Japan.
J Migr Health. 2025 Apr 5;11:100332. doi: 10.1016/j.jmh.2025.100332. eCollection 2025.
Migrants face significant barriers in accessing healthcare, particularly during public health emergencies such as the COVID-19 pandemic. In Japan, the residency-based healthcare system posed administrative challenges for migrants, especially undocumented individuals, in obtaining vaccination vouchers-a prerequisite for receiving COVID-19 vaccines. The COVID-19 Vaccination Information Center for International Citizens (COVIC) was established to bridge this gap by offering multilingual support and direct casework assistance.
This study employed a case study design, analyzing 275 inquiries involving 418 migrants who sought assistance from COVIC between September 2021 and March 2022. Using Castañeda et al.'s framework on migration and health, administrative barriers were examined, and COVIC's role as a navigator was evaluated. Descriptive statistics were used to assess COVIC's impact on vaccine access.
The majority of migrants seeking assistance (38.5 %) were undocumented, and 91.3 % of them lacked a vaccination voucher before contacting COVIC. The intervention facilitated voucher issuance for 73.8 % of migrants who inquired about it. While COVIC successfully helped all short-term and mid-to-long-term residents obtain vouchers, only 54.2 % of undocumented migrants were able to receive one, reflecting persistent systemic exclusions.
COVIC played a crucial role in mitigating administrative barriers, yet structural limitations prevented full healthcare access for undocumented migrants. These findings underscore the need for standardized administrative policies, integrated navigator programs, and inclusive healthcare strategies to enhance equitable access for migrant populations in future health crises.
移民在获得医疗保健方面面临重大障碍，尤其是在诸如新冠疫情等突发公共卫生事件期间。在日本，基于居住权的医疗保健系统给移民，尤其是无证移民在获取疫苗接种凭证（接种新冠疫苗的先决条件）方面带来了行政挑战。为弥合这一差距，设立了国际公民新冠疫苗接种信息中心（COVIC），提供多语言支持和直接的个案工作援助。
本研究采用案例研究设计，分析了2021年9月至2022年3月期间向COVIC寻求帮助的418名移民的275次咨询。运用卡斯塔涅达等人关于移民与健康的框架，审视行政障碍，并评估COVIC作为导航者的作用。使用描述性统计来评估COVIC对疫苗获取的影响。
寻求帮助的移民中，大多数（38.5%）为无证移民，其中91.3%在联系COVIC之前没有疫苗接种凭证。该干预措施为73.8%咨询此事的移民促成了凭证发放。虽然COVIC成功帮助所有短期和中长期居民获得了凭证，但只有54.2%的无证移民能够获得，这反映出系统性排斥依然存在。
COVIC在减轻行政障碍方面发挥了关键作用，但结构性限制使无证移民无法充分获得医疗保健。这些发现凸显了制定标准化行政政策、整合导航项目和包容性医疗保健策略的必要性，以在未来的健康危机中增强移民群体获得公平医疗服务的机会。
