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Wulkotte E, Schmid-Küpke N, Bozorgmehr K, Razum O, Wichmann O, Neufeind J. Barriers and drivers to COVID-19 vaccination among the migrant and non-migrant population in Germany, 2021. Eur J Public Health 2024; 34:530-536. [PMID: 38335139 PMCID: PMC11161154 DOI: 10.1093/eurpub/ckae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND During the Coronavirus Disease 2019 (COVID-19) pandemic, immunization programmes struggled to reach all population groups equally. While migrant groups face multiple barriers to health systems, including vaccination, little is known about their vaccine uptake. METHODS We conducted a cross-sectional telephone survey on adults with and without migration history in Germany to investigate barriers and drivers to COVID-19 vaccination (11 April 2021 to 18 December 2021). Interviews were conducted in six languages. We used logistic regression models and a mediation model to analyze the association between migration history and vaccine uptake. Furthermore, we determined the effect of psychological determinants (5C model) on vaccine uptake. RESULTS The survey comprised 2039 individuals, including 1015 with migration history. Of these, 448 were interviews conducted in languages other than German. Individuals with migration history had a significantly lower vaccine uptake but, while still unvaccinated, had a higher intention to get vaccinated (P = 0.015) compared with those without migration history. The association between migration history and vaccine uptake was no longer significant when other factors were included in the regression model (odds ratio = 0.9; 95% confidence interval: 0.57-1.47). Socio-economic index, language skills and discrimination experience fully mediated this association. Among the psychological determinants, 'higher confidence' and 'higher collective responsibility' increased the chance of individuals with migration history to be vaccinated. CONCLUSION Migration history alone cannot explain vaccine uptake; socio-economic index, language skills and discrimination experiences need to be considered. To achieve vaccine equity, future public health policy should aim to reduce relevant barriers through tailored interventions.
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Affiliation(s)
- Elisa Wulkotte
- Immunization Unit, Robert Koch Institute, Berlin, Germany
| | | | - Kayvan Bozorgmehr
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Section Equity Studies & Migration, University Hospital Heidelberg, Heidelberg, Germany
| | - Oliver Razum
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Ole Wichmann
- Immunization Unit, Robert Koch Institute, Berlin, Germany
| | - Julia Neufeind
- Immunization Unit, Robert Koch Institute, Berlin, Germany
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Gualdi-Russo E, Zaccagni L. COVID-19 Vaccination and Predictive Factors in Immigrants to Europe: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2024; 12:350. [PMID: 38675733 PMCID: PMC11054178 DOI: 10.3390/vaccines12040350] [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: 02/19/2024] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024] Open
Abstract
Vaccination plays a pivotal role in the control of infectious disease outbreaks. Hesitancy/refusal of the vaccine by immigrants poses a serious threat to their and society's health. We reviewed studies regarding COVID-19 vaccine uptake in Europe by first-generation immigrants. A systematic review (PROSPERO: CRD42023432142), conducted until 31 October 2023 using Web of Science, PubMed, and Scopus, identified 295 potential articles. Of these, 16 conducted on 2,009,820 immigrants in nine European countries met the eligibility criteria. Most studies were of medium/high quality according to the Newcastle-Ottawa Scale adapted for observational studies. Factors that affected the uptake or hesitancy/refusal to vaccinate, with particular regard to gender, age, and country of origin, were examined. The meta-analysis of eight studies revealed that the pooled estimated prevalence of COVID-19 vaccine uptake in first-generation immigrants was 71.3% (95% CI: 70.0-72.5%), corresponding to 13.3% less than the host country population (95% CI: 10.2-16.4%). Limitations of included studies and this review were deeply discussed, highlighting the need for further research on the effect of acculturation on second-generation immigrants. European governments need to ensure equal availability of COVID-19 and other health-saving vaccines to all immigrants in the future by overcoming cultural barriers, building trust in institutions, and improving communication.
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Affiliation(s)
- Emanuela Gualdi-Russo
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, 44121 Ferrara, Italy;
| | - Luciana Zaccagni
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, 44121 Ferrara, Italy;
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
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Dimka J. COVID-19 vaccination and infection among people with self-reported chronic health conditions and disabilities vs. people without medical risk factors in a survey sample from Oslo. Vaccine X 2023; 15:100409. [PMID: 38161989 PMCID: PMC10755100 DOI: 10.1016/j.jvacx.2023.100409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 01/03/2024] Open
Abstract
People with disabilities and chronic health conditions are at higher risk of poor outcomes to COVID-19, yet may have lower rates of vaccination due to differences in prioritization strategies, accessibility issues, vaccine hesitancy, and other factors. Survey data from Oslo are used to investigate differences in self-reported vaccine offer, uptake, and hesitancy, as well as COVID-19 infection, for individuals with self-reported medical risk factors classified as chronic health conditions or disabilities according to likely societal perceptions. Compared to participants who reported no pre-existing medical conditions, people with chronic health conditions were more likely to have a confirmed diagnosis, be offered and take the vaccine, and have lower hesitancy, while people with disabilities generally had either no differences in or less optimal outcomes. Results suggest possible biases in vaccine recommendations and raise questions about accessibility and communication strategies, with important implications for pandemic preparedness and public health communication and practice.
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Aysit E, Ikiisik H, Cakir M, Maral I. The Relationship of COVID-19 Vaccination Status with Health Literacy of Syrians Living in Istanbul. Vaccines (Basel) 2023; 11:1394. [PMID: 37766072 PMCID: PMC10534562 DOI: 10.3390/vaccines11091394] [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: 06/02/2023] [Revised: 07/26/2023] [Accepted: 08/15/2023] [Indexed: 09/29/2023] Open
Abstract
Health literacy is an important determinant of health care use among refugees and migrant communities. This present study aimed to evaluate the relationship between health literacy levels, sociodemographic characteristics, and the status of receiving the COVID-19 vaccine in Syrians under "Temporary Protection" in Istanbul. This study was conducted in February, March, and May 2022 in an Extended Migrant Health Center in Istanbul, with a survey prepared in Arabic under observation. A total of 571 questionnaires were analyzed. The mean age of the participants was 31.92 ± 6.14, and 80.7% were female and 26.6% were high school graduates. A total of 55.0% of Syrians have not had any of the COVID-19 vaccines. The health literacy level of 1.1% of the immigrants was determined as "excellent", 68.7% as "inadequate", 20.7% as "problematic/limited", and 9.6% as "adequate". According to the logistic regression model, being male, of elder age, middle and above economic status, and having a chronic disease in the family were determined as the variables associated with the status of being vaccinated against COVID-19. Refugees are a group often exposed to inequalities in access to health services. Increasing health literacy in these groups will provide a significant improvement in access to and use of health services.
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Affiliation(s)
- Esmehan Aysit
- Department of Public Health, Faculty of Medicine, Istanbul Medeniyet University, Istanbul 34700, Turkey; (H.I.); (M.C.); (I.M.)
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Jonnagaddala J, Hoang U, Wensaas KA, Tu K, Ortigoza A, Silva-Valencia J, Cuba-Fuentes MS, Godinho MA, de Lusignan S, Liaw ST. Integrated Management Systems (IMS) to Support and Sustain Quality One Health Services: International Lessons from the COVID-19 Pandemic by the IMIA Primary Care Working Group. Yearb Med Inform 2023; 32:55-64. [PMID: 37414035 PMCID: PMC10751124 DOI: 10.1055/s-0043-1768725] [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] [Indexed: 07/08/2023] Open
Abstract
OBJECTIVES One Health considers human, animal and environment health as a continuum. The COVID-19 pandemic started with the leap of a virus from animals to humans. Integrated management systems (IMS) should provide a coherent management framework, to meet reporting requirements and support care delivery. We report IMS deployment during, and retention post the COVID-19 pandemic, and exemplar One Health use cases. METHODS Six volunteer members of the International Medical Association's (IMIA) Primary Care Working Group provided data about any IMS and One Health use to support the COVID-19 pandemic initiatives. We explored how IMS were: (1) Integrated with organisational strategy; (2) Utilised standardised processes, and (3) Met reporting requirements, including public health. Selected contributors provided Unified Modelling Language (UML) use case diagram for a One Health exemplar. RESULTS There was weak evidence of synergy between IMS and health system strategy to the COVID-19 pandemic. However, there were rapid pragmatic responses to COVID-19, not citing IMS. All health systems implemented IMS to link COVID test results, vaccine uptake and outcomes, particularly mortality and to provide patients access to test results and vaccination certification. Neither proportion of gross domestic product alone, nor vaccine uptake determined outcome. One Health exemplars demonstrated that animal, human and environmental specialists could collaborate. CONCLUSIONS IMS use improved the pandemic response. However, IMS use was pragmatic rather than utilising an international standard, with some of their benefits lost post-pandemic. Health systems should incorporate IMS that enables One Health approaches as part of their post COVID-19 pandemic preparedness.
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Affiliation(s)
| | - Uy Hoang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | | | - Karen Tu
- Department of Family & Community Medicine, University of Toronto, Ontario, Canada
| | - Angela Ortigoza
- Department of Family & Community Medicine, University of Toronto, Ontario, Canada
| | - Javier Silva-Valencia
- Center for Research in Primary Health Care (CINAPS), School of Medicine, Universidad Peruana Cayetano Heredia, Peru
| | - María Sofía Cuba-Fuentes
- Center for Research in Primary Health Care (CINAPS), School of Medicine, Universidad Peruana Cayetano Heredia, Peru
| | | | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
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Alimoradi Z, Sallam M, Jafari E, Potenza MN, Pakpour AH. Prevalence of COVID-19 vaccine acceptance among migrant and refugee groups: A systematic review and meta-analysis. Vaccine X 2023; 14:100308. [PMID: 37223070 PMCID: PMC10163798 DOI: 10.1016/j.jvacx.2023.100308] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/07/2023] [Accepted: 04/26/2023] [Indexed: 05/25/2023] Open
Abstract
Objectives Understanding COVID-19 vaccine hesitancy among migrant and refugee groups is critical for achieving vaccine equity. Therefore, we aimed to estimate the prevalence of COVID-19 vaccine acceptance among migrant and refugee populations. Methods A systematic review (PROSPERO: CRD42022333337) was conducted (December 2019-July 2022) using PubMed, Scopus, Web of Science, ProQuest and Google Scholar. Results Nineteen studies from 12 countries were included. The pooled estimated prevalence of COVID-19 vaccine willingness among migrant and refugee groups was 70% (19 studies, 95% CI: 62.3-77.4%, I2: 99.19%, τ2: 0.03). Female and male participants did not differ significantly with each other (p = 0.64). Although no individual variable contributed statistically significantly in multivariable meta-regression analysis, the multivariable model that considered methodological quality, mean age of participants, participant group and country of origin explained 67% of variance. Discussion Proportions of migrant/refugee groups receiving COVID-19 vaccinations approximated those observed among general populations. Additional studies are needed to examine factors relating to vaccine willingness to identify the most significant factors that may be targeted in interventions.
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Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Elahe Jafari
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Marc N. Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center and Wu Tsai Institute, Yale School of Medicine / Yale University, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
| | - Amir H. Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Akintunde TY, Chen JK, Ibrahim E, Isangha SO, Sayibu M, Musa TH. Factors associated with COVID-19 vaccine uptake among foreign migrants in China. Heliyon 2023; 9:e17567. [PMID: 37533745 PMCID: PMC10292914 DOI: 10.1016/j.heliyon.2023.e17567] [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: 11/01/2022] [Revised: 06/14/2023] [Accepted: 06/21/2023] [Indexed: 08/04/2023] Open
Abstract
Background/Purpose The COVID-19 outbreak created unique policy challenges for vaccinating special groups like migrants. As part of sustainable development goals, the equitable distribution of the COVID-19 vaccine can contribute to ensuring health for all. This study examined COVID-19 vaccine uptake among foreign migrants in China based on sociodemographics, cultural beliefs, past vaccine behaviors, and psychosocial factors. Design An online cross-sectional survey was conducted among foreign migrants in mainland China via social media platforms from 21 November through 20 December 2021. Bivariate (unadjusted odd-ratio) and multivariate logistic regression analyses were performed to establish the correlates of COVID-19 vaccine uptake. Result Surveyed foreign migrants that are culture neutral (AOR: 2.5, CI: 95%, 1.02-5.90, p = 0.044), willing to pay for vaccination (AOR: 2.27, CI: 95%, 1.18-3.98, p = 0.012), believe in vaccine efficacy (AOR: 3.00, CI: 95%, 1.75-5.16, p < 0.000), have poor psychological health (AOR: 1.96, CI: 95%, 1.14-3.38, p = 0 0.014), and have higher perceived seriousness of COVID-19 (AOR: 2.12, CI: 95%, 1.26-3.57, p = 0.005) are more likely to receive COVID-19 vaccine. Those migrants with a history of declining vaccination (AOR: 0.34, CI: 95%, 0.18-0.65, p = 0.000) and middle-income earners $1701-3500 (AOR: 0.43, CI: 95%, 0.23-0.82, p = 0.010) are less likely to receive the COVID-19 vaccine. Conclusion This study brings a unique perspective to understanding vaccine behavior among international migrants in China. There is an urgent call from the World Health Organization and countries for complete vaccination and efforts to improve vaccine coverage. However, fewer studies have been conducted globally on the vaccination of migrant populations. The current study provides empirical information to increase the knowledge of the correlates of vaccine behavior among immigrants in countries around the globe. Future studies should conduct cross-country comparisons to understand the factors associated with increasing vaccination rates among immigrant populations to formulate a strong policy to increase vaccine coverage among immigrant populations across countries.
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Affiliation(s)
- Tosin Yinka Akintunde
- Department of Sociology, School of Public Administration, Hohai University, China
- Department of Social Work, Chinese University of Hong Kong, Hong Kong
| | - Ji-Kang Chen
- Department of Social Work, Chinese University of Hong Kong, Hong Kong
| | - Elhakim Ibrahim
- Department of Demography, College for Health, Community and Policy, The University of Texas, San Antonio, TX, United States
| | - Stanley Oloji Isangha
- Department of Social and Behavioral Sciences, College of Liberal Art and Social Sciences, City University of Hong Kong, Hong Kong
| | - Muhideen Sayibu
- Department of Sci-Tech Communication and Policy, University of Science and Technology of China, Anhui, Hefei, China
| | - Taha Hussein Musa
- Department of Epidemiology and Health Statistics, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
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Kumar BN, Diaz E, Castaneda AE, Ahrne M, NØrredam ML, Puthoopparambil SJ. Migration health research in the Nordic countries: Priorities and implications for public health. Scand J Public Health 2022; 50:1039-1046. [PMID: 36245405 DOI: 10.1177/14034948221125037] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The past 50 years have witnessed an increase in immigration to the Nordic countries from and beyond neighbouring countries in Europe. Diversity implies variations and differences in health status and health outcomes both within and across populations. Migrant health research has not been prioritized and health policies and practice, especially long-term national plans, often exclude migrants. In this article, we briefly trace the history, the groups, reasons for migration and the road to migrant health research in Norway, Sweden, Finland and Denmark. We discuss the case for data and research including needs, basis for data collection and the methodological challenges. We provide a brief snapshot of migrant health research, identify current gaps and discuss the implications for research. We recommend a regional Nordic strategy to promote intercountry exchange, sharing and learning. Finally, we reflect on the larger picture, implications for policy and practice that could enable societal conditions to reduce avoidable health inequalities.
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Affiliation(s)
| | | | | | - Malin Ahrne
- Public Health Agency of Sweden, Solna, Sweden
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