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Benedict Kpozehouen E, Macintyre CR, Tan TC. Determinants of uptake of influenza, zoster and pneumococcal vaccines in patients with cardiovascular diseases. Vaccine 2024; 42:3404-3409. [PMID: 38704255 DOI: 10.1016/j.vaccine.2024.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 02/13/2024] [Accepted: 04/09/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Globally, cardiovascular disease (CVD) is the leading cause of death and illness. Vaccine-preventable infections may increase acute coronary vascular disease events and the risk of complications. Low vaccine coverage has been reported among adults at high risk of complications from vaccine-preventable infections. There is a gap in research evidence around determinants of uptake of vaccines among adults with CVD. This study examined the uptake of influenza, pneumococcal and zoster vaccines and the determinants of uptake of the vaccines among cardiac patients. METHOD A prospective cross-sectional study was carried out among hospitalised cardiac patients through an interviewer-administered questionnaire. Descriptive statistics were used to investigate self-reported uptake of influenza, pneumococcal and zoster vaccines. Univariate and multivariate analyses of participants' social demographic and clinical characteristics were conducted to identify factors for receiving influenza vaccine. RESULTS Low vaccination rates among 104 participants were found for influenza (45.2%), pneumococcal (13.5%) and zoster (5.8%) vaccines. The most common reason for not receiving influenza vaccine was concern about side effects. Lack of awareness about the pneumococcal and zoster vaccines was the main reason for the poor uptake of these vaccines. Australia-born participants were more likely to receive influenza vaccine than overseas-born participants. Working-age participants and, interestingly, people living with a current smoker were less likely to receive influenza vaccine. CONCLUSION Influenza, pneumococcal and zoster vaccine uptake among cardiac patients was low. Encouraging physician recommendations for vaccination for cardiac patients under 65 years of age and addressing vaccination challenges among people from culturally and linguistically diverse backgrounds and pharmacy, workplace, and hospital vaccination may help increase vaccination uptake among cardiac patients.
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Affiliation(s)
| | | | - Timothy C Tan
- Department of Cardiology, Blacktown Hospital, NSW 2148, Australia; Western Sydney University, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Australia
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Hashemi L, Ghasemi M, Bartley A, Fenaughty J, Pirouzi M, Grant C. Migration and infant immunization timeliness in New Zealand: Evidence from the Growing Up in New Zealand study. Vaccine 2024; 42:2229-2238. [PMID: 38472065 DOI: 10.1016/j.vaccine.2024.02.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Migration has been recognized as an important determinant of child health outcomes including childhood vaccination status. This paper aims to examine the association between parental migration status and a less studied aspect of child immunization outcomes, namely timeliness, within the context of New Zealand (NZ), a country characterized by a substantial proportion of its resident population born overseas. Additionally, the study explored the impact of residential duration on children's immunization timeliness. METHODS The data was taken from a large, representative population-based cohort study in NZ (Growing Up in NZ study). A total of 6156 children and their parents, comprising 2241 foreign-born and 3915 NZ-born mothers and a sub-group of their partners were included in the analysis. The survey data was linked with the National Immunization Register dataset. Timely immunization was defined as receiving two vaccines at each scheduled vaccination point (at six-week, three-month, and five-month, totaling six doses of vaccines) within 30 days of their due date. We examined the associations between parental migration status, maternal residential duration, and child immunization timeliness while controlling for socio-economic variations. The results were presented as adjusted odds ratios (AORs) with 95 % confidence intervals (CIs). RESULTS The findings revealed that after adjustment for socioeconomic differences, children of foreign-born mothers exhibited higher odds of receiving all six studied vaccine doses on time compared to children of native-born mothers (AOR 1.51, 95 %CI:1.27-1.78). Similarly, having a foreign-born father was also significantly associated with timely completion of all six vaccine doses. Children of recent immigrants who had resided in the country for less than five years demonstrated higher odds of timely vaccination of all six vaccine doses compared to children of settled immigrants who had lived in the country for five or more years (AOR 1.65, 95 %CI: 1.25-2.19). CONCLUSION This study revealed a significant pattern in NZ where immigrants exhibited higher rates of timely immunization for their children compared to native-born parents. However, the findings also underscore the importance of providing support to settled immigrants, as their children experienced declines in timely vaccination rates compared to children of recent immigrants and even those born to NZ-born parents.
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Affiliation(s)
- Ladan Hashemi
- Social and Community Health, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Maryam Ghasemi
- Faculty of Counselling, Human Services and Social Work, University of Auckland, Auckland, New Zealand.
| | - Allen Bartley
- Faculty of Counselling, Human Services and Social Work, University of Auckland, Auckland, New Zealand.
| | - John Fenaughty
- Faculty of Counselling, Human Services and Social Work, University of Auckland, Auckland, New Zealand.
| | - Maryam Pirouzi
- Health Systems, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Cameron Grant
- Paediatrics, Child and Youth Health, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
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Peprah P, Lloyd J, Harris M. Health literacy and cultural responsiveness of primary health care systems and services in Australia: reflections from service providers, stakeholders, and people from refugee backgrounds. BMC Public Health 2023; 23:2557. [PMID: 38129802 PMCID: PMC10734201 DOI: 10.1186/s12889-023-17448-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Primary health care [PHC] services with general practitioners (GPs) as the first point of access to health care services for people from refugee backgrounds in Australia can play a crucial role in building health literacy and promoting access to culturally appropriate services. To achieve equitable access and engagement, services and systems must be responsive to diverse health literacy and cultural needs. This study aims to explore how primary health services respond as a system and organisation to the health literacy and cultural needs of people from refugee backgrounds in Australia. METHODS This exploratory qualitative study involved 52 semi-structured interviews among 19 Africans from refugee backgrounds, 14 service providers, including GPs and nurses, and 19 other stakeholders, such as service managers/directors. Participants resided in New South Wales, Victoria, and Queensland. Interviews were audio-recorded, transcribed, and coded into QSR NVivo 12. Data analysis was guided by reflexive thematic analysis. FINDINGS Three interrelated themes were identified from the data relating to the health literacy and cultural responsiveness of PHC systems and services. The first theme, 'variable and ad hoc organisational response to health literacy and culturally responsive care,' demonstrated that some organisations did not systematically address the inherent complexity of navigating the health system nor the capacity of services and providers to respond to the cultural needs of people from refugee backgrounds. The second theme, 'individual provider responsibility,' captured the individual providers' interpersonal and relational efforts in supporting the health literacy and cultural needs of people from refugee backgrounds based on their motivation and adaptation. The third theme, 'refugee patient responsibility,' encapsulated people from refugee backgrounds' adaptations to and learning of the health system to navigate and access services. CONCLUSION Health literacy and culturally responsive practices need to be systematised by PHC organisations to be implemented and sustained over time. There is a need for diversity in the organisational leadership and health care workforce, organisational commitment, health literacy and culturally responsive care policies, provider training, and auditing practice as essential components of the change process. Engaging with refugee communities would allow services to focus on people from refugee backgrounds' needs by design.
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Affiliation(s)
- Prince Peprah
- Social Policy Research Centre, University of New South Wales, Sydney, NSW, 2052, Australia.
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Jane Lloyd
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, 2052, Australia
- Australia's National Research Organisation for Women's Safety, Sydney, NSW, 2000, Australia
| | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, 2052, Australia
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Tuckerman J, Kaufman J, Overmars I, Holland P, Danchin M. Barriers to COVID-19 vaccination of migrant populations: A qualitative interview study of immunisation providers in Victoria, Australia. Vaccine 2023; 41:5085-5089. [PMID: 37460355 DOI: 10.1016/j.vaccine.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/04/2023] [Accepted: 07/02/2023] [Indexed: 08/07/2023]
Abstract
INTRODUCTION This study aimed to understand barriers and enablers, future strategies, communication approaches and resources needed for COVID-19 vaccination among migrant communities in Melbourne, Australia. MATERIAL AND METHODS We interviewed 24 immunisation providers who deliver immunisation services to migrant populations in Melbourne. We used the WHO Behavioural and Social Drivers framework (underlined) to organise barriers and enablers to COVID-19 vaccination. RESULTS Participants believed migrants had concerns about vaccine safety and efficacy and saw vaccines as minimally beneficial in the 'low COVID-19' environment of Australia (what people think and feel). Healthcare providers with established relationships within migrant communities played key roles in vaccine advocacy (social processes). Migrants' vaccine motivation was mediated by health literacy, institutional trust and previous experiences with health services. Practical issues included perceived lack of information on vaccine booking process and accessibility challenges. CONCLUSIONS Strategies to increase migrant vaccine coverage should utilise immunisation providers with community links and trusted local vaccine ambassadors to engage and address community vaccine concerns.
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Affiliation(s)
- Jane Tuckerman
- Murdoch Children's Research Institute, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia.
| | - Jessica Kaufman
- Murdoch Children's Research Institute, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia
| | | | - Philippa Holland
- City of Melbourne Immunisation Team, Melbourne, Victoria, Australia
| | - Margie Danchin
- Murdoch Children's Research Institute, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia; Department of General Medicine, The Royal Children's Hospital, Australia
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Kpozehouen EB, Heywood AE, Menzies R, Seale H, Brotherton J, Raina Macintyre C. Informing the design of a whole of life immunisation register for Australia. Vaccine 2023; 41:3011-3018. [PMID: 37037706 DOI: 10.1016/j.vaccine.2023.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 02/26/2023] [Accepted: 03/17/2023] [Indexed: 04/12/2023]
Abstract
INTRODUCTION In 2016, Australia launched a whole life immunisation register, the Australian Immunisation Register (AIR), building on a universal childhood register established in 1997. Immunisation Information Systems are well established in Europe, the US and elsewhere. However, a national system covering immunisation across the lifespan, with complete capture of the population and satisfactory data quality, is rare. METHODS A national workshop was convened in 2016 with key stakeholders from the government, new and existing vaccine users, and vaccine providers to review the ideal features of the AIR to ensure optimal effectiveness. This workshop focused on the functionality needed to identify population groups newly included in the register and support the achievement of high immunisation coverage in these groups eligible for National Immunisation Program vaccines. RESULTS Key recommendations included the need for bidirectional data flow between the AIR and providers; systematic approaches to the capture and recording of accurate and complete data to ascertain important denominators for subpopulations, includingAboriginal and Torres Strait Islander status, medical risk factors, occupation, ethnicity, country of birth, and vaccines given during pregnancy; linkage with other government datasets including notifiable diseases; the capture of adverse events following immunisation; ease of access by patients, providers; and by researchers. CONCLUSIONS Some recommendations from the workshop have informed the development and future utility of the AIR. Some recommendations from the workshop have been integrated into the current iteration of the AIR, which is more important than ever given the roll-out of COVID-19 vaccines. The accuracy and validity of data have subsequently improved through data entry controls, data integrity checks and reporting requirements. Access to AIR data for research remains protracted and costly, limitingresearch potential.
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Affiliation(s)
| | - Anita E Heywood
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Australia
| | - Robert Menzies
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Australia
| | - Holly Seale
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Australia
| | - Julia Brotherton
- Melbourne School of Population and Global Health, University of Melbourne, Australia; Formerly Australian Centre for the Prevention of Cervical Cancer, East Melbourne, Australia
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Chen H, Lei W, Wei Z, Wang F. The determinants of COVID-19 vaccine uptake among migrants from 109 countries residing in China: A cross-sectional study. Front Public Health 2023; 10:1023900. [PMID: 36726617 PMCID: PMC9884687 DOI: 10.3389/fpubh.2022.1023900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 12/19/2022] [Indexed: 01/19/2023] Open
Abstract
Background The present study aimed to investigate the prevalence of COVID-19 vaccine uptake among foreign migrants in China and to explore the determinants of their vaccine uptake behavior. Methods From June to October 2021, we used convenience and snowball sampling to recruit a sample of 764 participants from five cities in which the overwhelming majority of foreign migrants in China live. The chi-square (χ2) tests were used to examine vaccination distribution according to demographic characteristics. Multivariate logistic regression models visualized by forest plot were used to investigate the associations between significant determinants and vaccine uptake. Results Overall, the prevalence of vaccination rate was 72.9% [95% confidence interval (CI): 69.9-76.0%]. Migrants whose social participation was very active [adjusted odds ratio (AOR): 2.95, 95% CI: 1.36-6.50, P = 0.007] or had perceived COVID-19 progression prevention by the vaccine (AOR: 1.74, 95% CI: 1.01-3.02, P = 0.012) had higher odds of vaccination compared to those whose social participation was inactive or who did not have this perception. Migrants who perceived the vaccine uptake process as complex (AOR: 0.47, 95% CI: 0.27-0.80, P = 0.016) or were unsure of their physical suitability for the vaccine (AOR: 0.40, 95% CI: 0.24-0.68, P < 0.001) had lower odds of vaccination compared to those who did not have these perceptions. Furthermore, migrants from emerging and developing Asian countries (AOR: 2.32, 95% CI: 1.07-5.21, P = 0.04) and the Middle East and Central Asia (AOR: 2.19, 95% CI: 1.07-4.50, P = 0.03) had higher odds of vaccination than those from major advanced economies (G7) countries, while migrants from other advanced economic countries (OR: 0.27, 95% CI: 0.11-0.63, P = 0.003) had lower odds of vaccination than those from G7 countries. Conclusion It may be beneficial to promote vaccine uptake among migrants by ensuring effective community engagement, simplifying the appointment and uptake process, and advocating the benefits and target populations of the COVID-19 vaccine.
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Affiliation(s)
- Hao Chen
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - Weitian Lei
- School of Politics and International Relations, East China Normal University, Shanghai, China
| | - Zhengyi Wei
- School of Politics and International Relations, East China Normal University, Shanghai, China
| | - Fan Wang
- Fudan Development Institute, Fudan University, Shanghai, China,*Correspondence: Fan Wang ✉
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Uptake of influenza, pneumococcal and herpes zoster vaccines among people with heart failure and atrial fibrillation. Vaccine 2022; 40:7709-7713. [PMID: 36379753 DOI: 10.1016/j.vaccine.2022.10.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 10/30/2022] [Accepted: 10/31/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Cardiovascular diseases are the major cause of hospitalisation and death globally. Infections exacerbate cardiovascular events among cardiac patients, contributing to all-cause mortality. Vaccination is a cheap and effective intervention that can prevent infection. In Australia, influenza, pneumococcal and herpes zoster vaccines are recommended and funded for high-risk adults such as cardiac patients. There is high prevalence of high-risk adults in Western Sydney. OBJECTIVES This study investigates the uptake of influenza, pneumococcal and herpes zoster vaccines in patients admitted with heart failure and atrial fibrillation in a tertiary hospital in Western Sydney and factors associated with the uptake of the vaccines. METHODS Consecutive patients' hospitalised between 2014 and 2018 with heart failure or atrial fibrillation as principal diagnoses were identified. Information on patients' social demographic, clinical and vaccination status was collected and described using descriptive analysis. Univariate and multivariate analyses were conducted to determine factors associated with the uptake of the vaccines. RESULTS Low uptake for pneumococcal (40-45 %) and herpes zoster (15 %) vaccines were found. Prevalence of influenza vaccination was lower among participants younger than 65 (51-72 %) than in older ones (78-96 %). Australia-born participants were more likely to receive pneumococcal vaccine than those born overseas (OR 2.02, 95 % CI 1.05-3.89). Participants 65 years or older and those with comorbidities such as hypertension, COPD and chronic renal impairment were more likely to receive the vaccines. CONCLUSION Multidisciplinary strategies are needed to improve access to vaccination, community knowledge, community engagement, and healthcare provider support to provide appropriate care to migrants and younger cardiac patients and reduce morbidity and mortality in this high-risk group.
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Overmars I, Kaufman J, Holland P, Danchin M, Tuckerman J. Catch-up immunisation for migrant children in Melbourne: A qualitative study with providers to determine key challenges. Vaccine 2022; 40:6776-6784. [PMID: 36243589 DOI: 10.1016/j.vaccine.2022.08.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 08/01/2022] [Accepted: 08/26/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Current models of immunisation service delivery in Australia are not meeting the needs of migrant children, who experience a higher burden of vaccine preventable disease and lower immunisation rates compared to non-migrant children. Understanding the experiences of immunisation providers is critical for designing effective and tailored interventions to improve this service. This study aimed to identify the facilitators and barriers to providers delivering a comprehensive catch-up immunisation service to migrant children in Melbourne, Australia. METHODS Semi-structured interviews with council and general practice immunisation providers were conducted. Recorded interviews were transcribed and coded inductively using thematic analysis. Identified themes were then deductively categorised according to the Capability, Opportunity and Motivation of Behaviour (COM-B) model. RESULTS Twenty-four providers (five practice nurses, six general practitioners, six council nurses and seven council administration officers) were interviewed between March and June 2021. Fourteen themes were identified that contributed to the delivery of an effective catch-up immunisation service. Capability themes included training, experience and skills to perform the service and communicate with families. Opportunity themes incorporated time, workplace norms, traits of migrant families, costs, systems and resources. Themes related to motivation were provider responsibility, beliefs about migrant health, and immunisation prioritisation. CONCLUSIONS Key barriers for providers to deliver a comprehensive catch-up immunisation service were related to opportunity. Developing an online tool to support catch-up schedule development and reporting, and funding provider time to calculate the schedule are primary actions that could overcome opportunity barriers. Capability and motivation barriers for general practitioners included limited time, skills, and motivation compared to nurses. These barriers may be overcome with improvements to training that focus on upskilling nurses to deliver the catch-up service. Service delivery challenges are multifactorial, requiring a range of strategies to optimise this service and increase immunisation coverage in migrant children.
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Affiliation(s)
- Isabella Overmars
- School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia; Vaccine Uptake Group, Murdoch Children's Research Institute, Parkville, VIC, Australia.
| | - Jessica Kaufman
- Vaccine Uptake Group, Murdoch Children's Research Institute, Parkville, VIC, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | | | - Margie Danchin
- Vaccine Uptake Group, Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Department of General Medicine, The Royal Children's Hospital Melbourne, VIC, Australia
| | - Jane Tuckerman
- Vaccine Uptake Group, Murdoch Children's Research Institute, Parkville, VIC, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
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Rajkumar V, McCausland K, Lobo R. A Rapid Review of Interventions to Increase Hepatitis B Testing, Treatment, and Monitoring among Migrants Living in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105947. [PMID: 35627481 PMCID: PMC9141177 DOI: 10.3390/ijerph19105947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/08/2022] [Accepted: 05/11/2022] [Indexed: 02/01/2023]
Abstract
Chronic hepatitis B (CHB) disproportionately affects migrants with low health literacy and help-seeking behaviour living in high-income countries. Evidence of effective interventions is required to increase hepatitis B (HBV) testing, treatment, and monitoring. Available evidence from Medline, Embase, Scopus, Google, and Google Scholar was identified, collated, and synthesised. Inclusion criteria included grey and peer-reviewed literature published in English between January 2012 and December 2021. Systematic reviews and meta-analyses were excluded. Seventeen peer-reviewed articles met the inclusion criteria. Most interventions were conducted at the individual level and were typically outreach testing initiatives. One study was conducted at a structural level. All studies were successful in encouraging HBV screening uptake, and 10 studies demonstrated effective linkage to care. Two studies showed evidence of monitoring participants post-intervention. Most interventions had more female than male participants. Interventions conducted across community and clinical-based settings had more participants engage in screening and/or linkage to care in community settings. Effective interventions to prevent HBV transmission and CHB-related morbidity and mortality were approaches that utilised linguistic-specific and culturally appropriate resources to successfully engage migrants. Community outreach programmes that educate participants about HBV transmission, screening, and treatment can promote community dialogue and understanding to reduce stigma and discrimination.
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Affiliation(s)
- Vishnupriya Rajkumar
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (K.M.); (R.L.)
- Correspondence:
| | - Kahlia McCausland
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (K.M.); (R.L.)
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Roanna Lobo
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (K.M.); (R.L.)
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), School of Population Health, Curtin University, Bentley, WA 6102, Australia
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10
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Nyanchoga MM, Lee P, Barbery G. Exploring electronic health records to estimate the extent of catch-up immunisation and factors associated with under-immunisation among refugees and asylum seekers in south east Queensland. Vaccine 2021; 39:6238-6244. [PMID: 34556368 DOI: 10.1016/j.vaccine.2021.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 07/21/2021] [Accepted: 09/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Australia is one of the leading countries resettling people from refugee-like backgrounds. Catch-up immunisation is a key priority in this cohort. However, few studies have included asylum seekers and the adult age group in their study sample. In addition, Electronic Health Records (EHR) has recently been recognised as a vital tool in big data analysis with the capacity to contribute to informed strategic decision making. As such, the main aim of this study is to explore EHR routinely used in a specialised refugee clinic in South East Queensland to estimate the extent of catch-up immunisation and assess the factors associated with under-immunisation among refugees and asylum seekers. METHODS A quantitative study involving a secondary data analysis on a pre-existing dataset was undertaken. Relevant data was extracted from the EHR in the clinic. SPSS was used to perform Statistical data analysis. RESULTS The majority of clients originated from Papua New Guinea, followed by Iran and Afghanistan. When assessing the uptake of catch-up immunisations among refugees and asylum seekers, MMR (Measles-Mumps-Rubella), Polio and DTP (Diphtheria-Tetanus-Pertussis) had the highest uptake, while HPV (Human Papilloma Virus), Pneumococcal and Hib (Haemophilus influenza type b) immunisations had the lowest uptake. Binary logistic regression revealed that the younger patients, the refugees (compared to asylum seekers) and those with a longer residential duration in Australia are at a higher risk of being under-immunised. CONCLUSION This study indicates that the broader group of immigrants, and in particular refugees and asylum seekers, do not represent a homogenous group in terms of immunisation coverage, and that each cohort should be carefully considered during immunisation interventions and strategies. This will be particularly important during targeted health promotions and future immunisation programs in this cohort.
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Affiliation(s)
| | - Patricia Lee
- Senior Lecturer, School of Medicine, Gold Coast Campus, Griffith University, Southport, QLD 4222, Australia.
| | - Gaery Barbery
- Lecturer, Health Services Management, School of Medicine, Griffith University, South Bank, QLD 4101, Australia.
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Netfa F, King C, Davies C, Rashid H, Tashani M, Booy R, Skinner SR. Knowledge, Attitudes, and Perceptions of the Arabic-Speaking Community in Sydney, Australia, toward the Human Papillomavirus (HPV) Vaccination Program: A Qualitative Study. Vaccines (Basel) 2021; 9:vaccines9090940. [PMID: 34579177 PMCID: PMC8473026 DOI: 10.3390/vaccines9090940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Little is known about acceptability of the human papillomavirus (HPV) vaccine among parents of adolescents from culturally and linguistically diverse backgrounds in Australia. This study aimed to explore the knowledge and attitudes of parents from Arabic backgrounds towards HPV vaccination offered to their children in the national school-based vaccination program. Methods: Qualitative interviews were conducted in Western Sydney, with parents of adolescents from Arabic backgrounds. Recruitment was via informal personal contacts and passive snowballing. Face-to-face semi-structured interviews were conducted in Arabic. These were audio-recorded, transcribed, and translated into English. Thematic analysis was used to identify emerging themes. Results: Commonly identified themes across fifteen interviews included: (1) lack of awareness and knowledge of HPV and its vaccination, (2) awareness and understanding of the government vaccination information sheet, (3) parents’ preferences for information provision, (4) the role of parents’ religious beliefs in forming attitudes about HPV vaccination, and (5) lost opportunities to educate parents about HPV vaccination during general practitioner (GP) visits. Conclusion: The findings point to the need to address cultural, language, and communication barriers to improve awareness and acceptability of HPV vaccination in the Arabic community. Educational strategies should be tailored to this community based on their specific information needs and preferences.
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Affiliation(s)
- Faeza Netfa
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
- Correspondence: or ; Tel.: +61-2-9351-2222; Fax: +61-29845-1418
| | - Catherine King
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Cristyn Davies
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Harunor Rashid
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Mohamed Tashani
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- Faculty of Medicine, University of Tripoli, Tripoli 13275, Libya
| | - Robert Booy
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - S. Rachel Skinner
- Discipline of Child and Adolescent Health, The University of Sydney Children’s Hospital Westmead Clinical School, Westmead, NSW 2145, Australia; (C.K.); (C.D.); (H.R.); (M.T.); (R.B.); (S.R.S.)
- Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
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12
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Evaluating the health literacy demand and cultural appropriateness of online immunisation information available to refugee and migrant communities in Australia. Vaccine 2020; 38:6410-6417. [DOI: 10.1016/j.vaccine.2020.07.071] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 11/21/2022]
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Bellamy K, Ostini R, Martini N, Kairuz T. Insights from the coalface: barriers to accessing medicines and pharmacy services for resettled refugees from Africa. Aust J Prim Health 2019; 25:118-124. [PMID: 30721646 DOI: 10.1071/py18092] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 12/03/2018] [Indexed: 11/23/2022]
Abstract
Resettled refugees in Australia have been shown to exhibit a high prevalence of limited health literacy and are at greater risk of mismanaging their medication and not being able to access the healthcare services they need. The aim of the current study is to explore the barriers to accessing medicines and pharmacy services in Queensland, Australia, among resettled refugees from Africa; this research was conducted from the perspectives of healthcare professionals and people who help the refugees to resettle in their adopted country (resettlement workers). A 'generic qualitative' approach was used in this study. In-depth interviews were conducted among healthcare professionals (two GPs, nine pharmacists and three nurse practitioners) and resettlement workers. Participants were recruited via a purposive snowball sampling method in the cities of Brisbane and Townsville, Queensland, Australia. Twenty-four in-depth interviews were conducted; 14 with healthcare professionals. Three key themes emerged from the data: (1) Communication Barriers; (2) Navigating the Health System; and (3) Belief Systems and Culture. Perceptions of those 'at the coalface' - healthcare professionals and people who are responsible for assisting refugees to resettle in Australia - provide insight into the language and cultural challenges experienced by resettled refugees from Africa regarding access to the Australian health system, including medicines and pharmacy services.
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Affiliation(s)
- Kim Bellamy
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, Qld 4102, Australia; and Corresponding author.
| | - Remo Ostini
- Rural Clinical School, The University of Queensland, Toowoomba, Qld 4350, Australia
| | - Nataly Martini
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Grafton, Auckland 1023, New Zealand
| | - Therese Kairuz
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW 2308, Australia
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14
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Migration Health: Highlights from Inaugural International Society of Travel Medicine (ISTM) Conference on Migration Health. Curr Infect Dis Rep 2019; 21:48. [PMID: 31734735 DOI: 10.1007/s11908-019-0705-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE OF REVIEW International migration is a global phenomenon that is growing in scope, complexity and impact. The inaugural International Society of Travel Medicine (ISTM) International Conference on Migration Health provided a forum to discuss scientific evidence on the broad issues relevant to migration health. This review summarises the key health issues, with a focus on infectious diseases, current effective strategies and future considerations presented at this forum and in the recent literature. RECENT FINDINGS Migrants face health disparities for both communicable and non-communicable diseases. Their heightened infectious disease risks, compared to host populations, are related to pre-migration exposures, the circumstances of the migration journey and the receptivity and access to health services in their receiving countries. While the prevalence of infectious diseases identified through screening programmes are generally low, delays in diagnosis and treatment for a range of treatable infectious diseases result in higher morbidity and mortality among migrants. Barriers to care in host countries occur at the patient, provider and health systems levels. Coordinated and inclusive health services, healthcare systems and health policies, responsive to patient diversity reduce these barriers. Structural barriers to healthcare provision impede equitable care to migrants and refugees. Public health and medical professionals have a role in advocating for policy reforms.
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15
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Abdi I, Menzies R, Seale H. Barriers and facilitators of immunisation in refugees and migrants in Australia: an east-African case study. Vaccine 2019; 37:6724-6729. [PMID: 31537444 DOI: 10.1016/j.vaccine.2019.09.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/31/2019] [Accepted: 09/06/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Immunisation programs available in low and middle-income countries include fewer vaccines in comparison to Australia's National Immunisation Program. As a result, refugees and migrants may have a heightened risk of being inadequately immunised upon arrival to Australia. Several studies have suggested that East African immigrants have low vaccination coverage. As such, the aim of this study was to explore the underlying attitudes, barriers and facilitators to immunisation in east African communities in two states of Australia: New South Wales and Victoria. METHODS A qualitative study involving 17 semi-structured, in-depth interviews were undertaken with East African refugees and migrants living in two states of Australia: New South Wales and Victoria. These refugees and migrants were from four key East African countries: Kenya, Somalia, Ethiopia and South Sudan. Thematic analysis was undertaken to analyse and interpret the results. RESULTS Language barriers, low risk perception and a lack of education were the key barriers identified by participants. Facilitators mentioned included the development of resources in participants' languages and the implementation of reminder systems consistently across all GP practices. There was also a unanimous agreement amongst participants that community organisations need to play a greater role in the dissemination of information about immunisation. CONCLUSIONS Further research needs to be undertaken with regards to how education about immunisation is delivered and disseminated to refugee and migrant communities. Current findings also support the need to improve the health literacy of refugees and migrants by providing culturally and linguistically appropriate resources in participants' respective languages.
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Affiliation(s)
- Ikram Abdi
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Robert Menzies
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Holly Seale
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
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16
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Ozawa S, Yemeke TT, Evans DR, Pallas SE, Wallace AS, Lee BY. Defining hard-to-reach populations for vaccination. Vaccine 2019; 37:5525-5534. [PMID: 31400910 PMCID: PMC10414189 DOI: 10.1016/j.vaccine.2019.06.081] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/24/2019] [Accepted: 06/25/2019] [Indexed: 12/29/2022]
Abstract
Extending the benefits of vaccination to everyone who is eligible requires an understanding of which populations current vaccination efforts have struggled to reach. A clear definition of "hard-to-reach" populations - also known as high-risk or marginalized populations, or reaching the last mile - is essential for estimating the size of target groups, sharing lessons learned based on consistent definitions, and allocating resources appropriately. A literature review was conducted to determine what formal definitions of hard-to-reach populations exist and how they are being used, and to propose definitions to consider for future use. Overall, we found that (1) there is a need to distinguish populations that are hard to reach versus hard to vaccinate, and (2) the existing literature poorly defined these populations and clear criteria or thresholds for classifying them were missing. Based on this review, we propose that hard-to-reach populations be defined as those facing supply-side barriers to vaccination due to geography by distance or terrain, transient or nomadic movement, healthcare provider discrimination, lack of healthcare provider recommendations, inadequate vaccination systems, war and conflict, home births or other home-bound mobility limitations, or legal restrictions. Although multiple mechanisms may apply to the same population, supply-side barriers should be distinguished from demand-side barriers. Hard-to-vaccinate populations are defined as those who are reachable but difficult to vaccinate due to distrust, religious beliefs, lack of awareness of vaccine benefits and recommendations, poverty or low socioeconomic status, lack of time to access available vaccination services, or gender-based discrimination. Further work is needed to better define hard-to-reach populations and delineate them from populations that may be hard to vaccinate due to complex refusal reasons, improve measurement of the size and importance of their impact, and examine interventions related to overcoming barriers for each mechanism. This will enable policy makers, governments, donors, and the vaccine community to better plan interventions and allocate necessary resources to remove existing barriers to vaccination.
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Affiliation(s)
- Sachiko Ozawa
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA; Department of Maternal and Child Health, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Tatenda T Yemeke
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | | | - Sarah E Pallas
- Global Immunization Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Aaron S Wallace
- Global Immunization Division, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Bruce Y Lee
- Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Global Obesity Prevention Center (GOPC), Johns Hopkins University, Baltimore, MD, USA
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17
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Heywood AE, López-Vélez R. Reducing infectious disease inequities among migrants. J Travel Med 2019; 26:5198602. [PMID: 30476162 DOI: 10.1093/jtm/tay131] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/13/2018] [Accepted: 11/20/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND migration has reached unprecedented levels, with 3.6% of the world's population living outside their country of birth. Migrants comprise a substantial proportion of high-income country populations, are at increased risk of a range of infectious diseases, compared to native-born populations and may experience worse health outcomes due to barriers accessing timely diagnoses and treatment. Poor access to essential healthcare services can be attributed to several factors, including language and cultural barriers and lack of specific inclusive health policies. METHODS This review draws on evidence from the immigrant health and travel medicine literature, with a focus on infectious disease risks. It presents strategies to reduce barriers to healthcare access through health promotion and screening programs both at the community and clinic level and the delivery of linguistically and culturally competent care. The Methods: Salud Entre Culturas (SEC) 'Health Between Cultures' project from the Tropical Medicine Unit at the Hospital Ramon y Cajal in Madrid is described as an effective model of care. RESULTS For those providing healthcare to migrant populations, the use of community-consulted approaches are considered best practice in the development of health education, health promotion and the delivery of targeted health services. At the clinic-level, strategies optimizing care for migrants include the use of bilingual healthcare professionals or community-based healthcare workers, cultural competence training of all clinic staff, the appropriate use of trained interpreters and the use of culturally appropriate health promotion materials. CONCLUSIONS Multifaceted strategies are needed to improve access, community knowledge, community engagement and healthcare provider training to provide appropriate care to migrant populations to reduce infectious disease disparities.
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Affiliation(s)
- Anita E Heywood
- Level 3, Samuels Building, School of Public Health and Community Medicine, UNSW Sydney, NSW, Australia
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Department of Infectious Diseases, Ramón y Cajal University Hospital, Madrid, Spain
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Krishnaswamy S, Cheng AC, Wallace EM, Buttery J, Giles ML. Understanding the barriers to uptake of antenatal vaccination by women from culturally and linguistically diverse backgrounds: A cross-sectional study. Hum Vaccin Immunother 2018; 14:1591-1598. [PMID: 29494274 DOI: 10.1080/21645515.2018.1445455] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
The role of maternal vaccination in reducing neonatal morbidity and mortality is expanding but uptake remains suboptimal. While the barriers to uptake have been well described, women from minority groups have not been well represented in previous studies. In this study we examine the facilitators and barriers to uptake of antenatal vaccination by women from culturally and linguistically diverse backgrounds in Melbourne, Australia. 537 women attending antenatal care completed a survey; 69% were born overseas. 63% had or intended to receive pertussis vaccine and 57% had or intended to receive influenza vaccine during their pregnancy. On multivariable analysis, predictors of uptake of pertussis vaccine were healthcare provider recommendation (OR 10, 95% CI 5-21, p < 0.001) and belief maternal pertussis vaccination is safe (OR 36, 95% CI 18-70, p < 0.001). For influenza vaccine, predictors of uptake were previous receipt of influenza vaccine (OR 8, 95% CI 5-15, p < 0.001) and healthcare provider recommendation (OR 30, 95% CI 16-56, p < 0.001). Lack of healthcare provider recommendation was the main reason for non-vaccination (17/46, 37%). While most women were aware of and intended to receive recommended vaccinations, recently arrived migrant women (resident in Australia for less than two years) were less likely to be aware of pertussis vaccine (15/22, 68% vs 452/513, 88%, p = 0.01) and less likely to believe it to be safe during pregnancy (4/22, 18% vs 299/514, 58%, p < 0.001). This highlights the important role of healthcare providers in recommending and educating women, particularly newly arrived migrant women, in their decisions about vaccination during pregnancy.
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Affiliation(s)
- Sushena Krishnaswamy
- a The Ritchie Centre, Department of Obstetrics and Gynaecology , Monash University , Clayton , Victoria , Australia.,b Monash Infectious Diseases, Monash Health , Clayton , Victoria , Australia
| | - Allen C Cheng
- c Department of Infectious Diseases , Alfred Health , Prahran , Victoria , Australia.,d Department of Epidemiology and Preventive Medicine , Monash University, The Alfred Centre , Melbourne , Victoria , Australia
| | - Euan M Wallace
- a The Ritchie Centre, Department of Obstetrics and Gynaecology , Monash University , Clayton , Victoria , Australia.,e Safer Care Victoria , Victorian Department of Health and Human Services , Melbourne , Victoria , Australia
| | - Jim Buttery
- f Infection and Immunity, Monash Children's Hospital , Clayton , Victoria , Australia.,g Monash Centre for Health Research and Implementation, Department of Epidemiology and Preventive Medicine , Monash University , Clayton , Victoria , Australia
| | - Michelle L Giles
- a The Ritchie Centre, Department of Obstetrics and Gynaecology , Monash University , Clayton , Victoria , Australia.,c Department of Infectious Diseases , Alfred Health , Prahran , Victoria , Australia
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19
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Wilson L, Rubens-Augustson T, Murphy M, Jardine C, Crowcroft N, Hui C, Wilson K. Barriers to immunization among newcomers: A systematic review. Vaccine 2018; 36:1055-1062. [PMID: 29395515 DOI: 10.1016/j.vaccine.2018.01.025] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/09/2018] [Accepted: 01/10/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Currently, there is a lack of comprehensive evidence exploring vaccine decision-making among newcomers. We conducted a systematic review of qualitative studies aimed at identifying factors that influence newcomers' decision-making with regards to vaccination. METHODS We conducted a search of MEDLINE, EMBASE, CINAHL and Cochrane Central. To be included, studies needed to employ a qualitative methodology and address newcomer attitudes, beliefs, and/or perceptions regarding vaccination. Two independent reviewers screened the articles for relevant information and applied a content analysis methodology to code the identified barriers. RESULTS Twenty-one studies were included in this review, and four types of barriers were identified: cultural factors, knowledge barriers, insufficient access to healthcare, and vaccine hesitancy. Insufficient knowledge about vaccination and the virus being prevented and concerns about safety were the most commonly reported barriers. A sub-analysis of barriers specific to HPV indicated that cultural beliefs about sexuality and incomplete knowledge about the role of HPV in the development of cervical cancer are major barriers to vaccine uptake. CONCLUSION Strategies to improve vaccination uptake in newcomers should consider focusing on the barriers identified in this review while taking into account the unique opportunities for promoting uptake within newcomer populations.
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Affiliation(s)
- Lindsay Wilson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada.
| | - Taylor Rubens-Augustson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada; Faculty of Medicine, Lund University, Box 117, 221 00 Lund, Sweden.
| | - Malia Murphy
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada.
| | - Cindy Jardine
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, AB T6G 1C9, Canada.
| | - Natasha Crowcroft
- Public Health Ontario, 480 University Avenue, Toronto, ON M5G 1V2, Canada; Laboratory Medicine and Pathobiology, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada.
| | - Charles Hui
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON K1H 8M5, Canada.
| | - Kumanan Wilson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada.
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20
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Menzies RI, Royle J, MacIntyre CR. Vaccine myopia: adult vaccination also needs attention. Med J Aust 2017; 207:407. [DOI: 10.5694/mja17.00677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 07/17/2017] [Indexed: 11/17/2022]
Affiliation(s)
| | - Jenny Royle
- University of New South Wales, Sydney, NSW
- NEST Family Wellness Clinic, Melbourne, VIC
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21
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Mahimbo A, Seale H, Heywood AE. Immunisation for refugees in Australia: a policy review and analysis across all States and Territories. Aust N Z J Public Health 2017; 41:635-640. [PMID: 28898492 DOI: 10.1111/1753-6405.12710] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/01/2017] [Accepted: 06/01/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Although people of refugee background are likely to be under-immunised before and after resettlement, no study to date has evaluated refugee specific immunisation policies in Australia. We developed a framework to analyse immunisation policies across Australia to highlight the strengths and gaps so as to inform development of more effective refugee specific immunisation policies. METHODS We sourced publicly available immunisation policy documents from state and territory government websites. Content analysis of seven policy documents was undertaken using a developed framework comprising crucial policy determinants. RESULTS Immunisation policy differed substantially across the jurisdictions. While most policies did not highlight the importance of data collection on immunisation for refugees and the public funding of vaccines for refugees, policy determinants such as accessibility and obligations were fulfilled by most jurisdictions. CONCLUSION Our findings indicate stark differences in immunisation policy for people of refugee background across Australia. Highlighted gaps demonstrate the need to revise current policies so that they are aligned with their intended outcome of enhancing uptake of vaccines and improving immunisation coverage among resettled refugees in Australia. Implications for public health: Immunisation policy development for refugees needs to be robust enough to ensure equitable health services to this group.
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Affiliation(s)
- Abela Mahimbo
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, New South Wales
| | - Holly Seale
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, New South Wales
| | - Anita E Heywood
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, New South Wales
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