1
|
Khammarnia M, Setoodehzadeh F, Baygi MZ. UNICEF Support Vaccination Campaign for Immigrant in Iran: A Country of EMRO Region. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:1211-1212. [PMID: 38912137 PMCID: PMC11188638 DOI: 10.18502/ijph.v53i5.15604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 09/19/2023] [Indexed: 06/25/2024]
Abstract
The Article Abstract is not available.
Collapse
Affiliation(s)
- Mohammad Khammarnia
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Fatemeh Setoodehzadeh
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mehdi Zanganeh Baygi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| |
Collapse
|
2
|
Nolan MB, Chrenka E, Walker P, Steiner A, Rodrigues KK, Michel JJ, Yun K, Payton C, Young J, Mamo B, Frumholtz M, DeSilva M. COVID-19 vaccine uptake among non-US-born populations in the United States, 2020-2022. Vaccine 2024; 42:3115-3121. [PMID: 38604910 DOI: 10.1016/j.vaccine.2024.04.029] [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: 05/01/2023] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND In the United States (US), COVID-19 vaccination rates among non-US-born individuals (i.e., refugees, immigrants, and migrants [RIM]) are variable. Understanding baseline COVID-19 vaccine coverage among these populations and determining if disparities exist is essential for quality improvement initiatives and public health interventions. METHODS Baseline COVID-19 vaccination rates for both primary series and booster doses were calculated at four health systems located in Minnesota, Colorado, and Pennsylvania participating in the Minnesota Department of Health's Center of Excellence in Newcomer Health. Patients aged ≥5 years as of 1/1/22, seen for ≥1 primary care visit during 7/1/2019-6/30/22 were included. Descriptive statistics were calculated for three measures of COVID-19 vaccine coverage during 12/14/2020-6/30/2022: 1) initiation of primary series; 2) completion of primary series; 3) completion of first booster. We calculated vaccine coverage rates for the entire population and stratified by subgroup including country of origin, refugee status, and primary language preference. RESULTS We included 1,624,573 patients eligible for COVID-19 primary series vaccine and 907,749 eligible for COVID-19 booster vaccination. The percent of eligible patients who completed a COVID-19 primary series (63.4 %) and booster dose (66.2 %) were similar. Completion of the primary series was higher for non-US-born persons (72.7 %) compared with US born persons (65.4 %), similar among refugees (63.5 %) and non-refugees (63.4 %), and lower in patients with language preference other than English (62.7 %) compared with English preferring patients (63.6 %). Booster completion was lower for non-US-born persons (61.8 %), refugees (46.7 %), and patients with language preference other than English (55.3 %) compared with US-born (70 %), non-refugees (66.3 %), and English preferring patients (67.3 %) respectively. CONCLUSIONS This evaluation identified disparities in COVID-19 vaccination rates among non-US-born persons and persons with a language preference other than English living in the US. Targeted outreach efforts may be beneficial in reaching these populations.
Collapse
Affiliation(s)
- Margaret B Nolan
- HealthPartners Institute, 8170 33rd Ave S, Bloomington, MN 55425, USA.
| | - Ella Chrenka
- HealthPartners Institute, 8170 33rd Ave S, Bloomington, MN 55425, USA
| | - Patricia Walker
- HealthPartners Institute, 8170 33rd Ave S, Bloomington, MN 55425, USA
| | - Abigail Steiner
- Denver Health & Hospital Authority, 777 Bannock Street, Denver, CO 80204, USA
| | | | - Jeremy J Michel
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104, USA
| | - Katherine Yun
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104, USA
| | - Colleen Payton
- Thomas Jefferson University, 4201 Henry Ave, Philadelphia, PA 19144, USA; Moravian University, Bethlehem, PA, USA
| | - Janine Young
- UC San Diego School of Medicine, San Diego, CA, USA
| | - Blain Mamo
- Minnesota Department of Health, St. Paul, MN, USA
| | | | - Malini DeSilva
- HealthPartners Institute, 8170 33rd Ave S, Bloomington, MN 55425, USA
| |
Collapse
|
3
|
Andersson LMC, Punzi E. Caring for Undocumented Migrants: Significance of Recognition and Respect during Healthcare Encounters. Issues Ment Health Nurs 2024; 45:365-370. [PMID: 38564680 DOI: 10.1080/01612840.2024.2319640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Undocumented migrants are often in a position of extreme vulnerability and experience many barriers to accessing mental health care. It is crucial that health professionals understand this and quickly establish trust and respect. If the stressful living conditions that contribute to the distress of undocumented migrants are recognized, compassionate and trauma-informed care is enhanced. In this regard, it is important that health professionals understand the fear of being expelled from a country. This paper discusses problems that arise when health professionals interact with undocumented migrants and the need to quickly convey recognition to establish trust and respect. We argue that insights from Axel Honneth's social philosophical theory of recognition and disrespect can further enhance health professionals strategies to improve their verbal and non-verbal communication and thereby increase access to health care for undocumented migrants. We suggest ideas for codifying this knowledge in health care policies and guidelines.
Collapse
Affiliation(s)
| | - Elisabeth Punzi
- Department of Social Work, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
4
|
Gomez W, Fernández-Niño JA, Guillén JR, Stevenson M, Ortíz J, Barriga Talero MÁ, López JJ, Núñez RL, Spiegel P, Page KR, Ramirez Correa JF, Porras DM, Wirtz AL. The impact of policy and policy communication on COVID-19 vaccination inequalities among Venezuelan refugees and migrants in Colombia: a comparative cross-sectional interrupted time-series analysis. BMJ Glob Health 2024; 9:e014464. [PMID: 38453517 PMCID: PMC10921509 DOI: 10.1136/bmjgh-2023-014464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/06/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Equitable access to vaccines for migrants and refugees is necessary to ensure their right to health and to achieve public health goals of reducing vaccine-preventable illness. Public health policies require regulatory frameworks and communication to effect uptake of effective vaccines among the target population. In Colombia, the National COVID-19 Vaccination Plan implicitly included Venezuelan refugees and migrants; however, initial communication of the policy indicated that vaccine availability was restricted to people with regular migration status. We estimated the impact of a public announcement, which clarified access for refugees and migrants, on vaccination coverage among Venezuelans living in Colombia. METHODS Between 30 July 2021 and 5 February 2022, 6221 adult Venezuelans participated in a cross-sectional, population-based health survey. We used a comparative cross-sectional time-series analysis to estimate the effect of the October 2021 announcement on the average biweekly change in COVID-19 vaccine coverage of Venezuelans with regular and irregular migration status. RESULTS 71% of Venezuelans had an irregular status. The baseline (preannouncement) vaccine coverage was lower among people with an irregular status but increased at similar rates as those with a regular status. After the announcement, there was a level change of 14.49% (95% CI: 1.57 to 27.42, p=0.03) in vaccination rates among individuals with irregular migration status with a 4.61% increase in vaccination rate per biweekly period (95% CI: 1.71 to 7.51, p=0.004). By February 2022, there was a 26.2% relative increase in vaccinations among individuals with irregular migration status compared with what was expected without the announcement. CONCLUSION While there was no policy change, communication clarifying the policy drastically reduced vaccination inequalities across migration status. Lessons can be translated from the COVID-19 pandemic into more effective global, regional and local public health emergency preparedness and response to displacement.
Collapse
Affiliation(s)
- Wilson Gomez
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Julián A Fernández-Niño
- Center for Humanitarian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Megan Stevenson
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | | | - Ricardo Luque Núñez
- Government of Colombia Ministry of Health and Social Protection, Bogotá, Colombia
| | - Paul Spiegel
- Center for Humanitarian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kathleen R Page
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Humanitarian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Medicine, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | - Andrea L Wirtz
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Humanitarian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
5
|
Koku EF, Johnson-Yengbeh N, Muhr A. Addressing COVID-19 Vaccine Hesitancy and Uptake Among African Immigrants: Lessons from a Community-Based Outreach Program. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01947-9. [PMID: 38443740 DOI: 10.1007/s40615-024-01947-9] [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: 11/13/2023] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 03/07/2024]
Abstract
In 2021, the African Cultural Alliance of North America (ACANA) implemented a community-based vaccine education and outreach program to decrease hesitancy and increase COVID-19 vaccine uptake among African immigrants in Philadelphia. The program had three components: (1) tailored messaging on the benefits of vaccines by trusted community health navigators in familiar languages/dialects, (2) use of educational/tabling events, and (3) establishment of a vaccine clinic in community settings. Using secondary data analysis, in-depth interviews, focus group discussions and a self-administered survey, we explored (i) the impact and effectiveness of the outreach program and extent of vaccine uptake, (ii) African immigrants' beliefs about the COVID-19 pandemic and the vaccine, and (iii) barriers and facilitators of vaccine knowledge, uptake, and hesitancy. Our analysis showed that ACANA's outreach program was effective in addressing several cultural, logistic, and systematic barriers to vaccine uptake. The program distributed 2000 educational/informational flyers, reached 3000 community members via social media campaigns, and an additional 2320 through other person-to-person outreach events. The program was effective and resulted in the vaccination of 1265 community members over the course of the outreach. The impact of this outreach underscores the critical role of community-based organizations in addressing COVID-19 vaccine hesitancy and increasing vaccine uptake in underserved and minority communities. The paper concludes with suggestions and recommendations for using community-based outreach programs to increase COVID-19 vaccine uptake and decrease hesitancy.
Collapse
Affiliation(s)
- Emmanuel F Koku
- Department of Sociology, Drexel University, 3201 Arch Street, Room 288, Philadelphia, PA, 19104, USA.
| | - Nettie Johnson-Yengbeh
- Health Department, African Cultural Alliance of North America (ACANA), 5530 Chester Ave, Philadelphia, PA, 19143, USA
| | - Ava Muhr
- Health Department, African Cultural Alliance of North America (ACANA), 5530 Chester Ave, Philadelphia, PA, 19143, USA
- School of Social and Political Science, University of Edinburgh, 15a George Square, EH8 9LD, Edinburgh, UK
| |
Collapse
|
6
|
Garcini LM, Vázquez AL, Abraham C, Abraham C, Sarabu V, Cruz PL. Implications of Undocumented Status for Latinx Families During the COVID-19 Pandemic: A Call to Action. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:10-23. [PMID: 36689639 PMCID: PMC10710880 DOI: 10.1080/15374416.2022.2158837] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND A disproportionate number of COVID-19 cases and deaths have been reported among Latinxs in the U.S. Among those most affected by the pandemic are marginalized families, including those that are undocumented and mixed-status, in which some, but not all members are undocumented. Undocumented and mixed-status families face multiple and chronic daily stressors that compromised their health and wellbeing. Salient stressors faced by undocumented Latinx families include poverty, social disadvantage, discrimination, dangerous living and working conditions, and limited access to healthcare. These stressors are frequently compounded with trauma, fear of detention, deportation, and family separation. PURPOSE Informed by the literature and insights from our community-based work to address the health needs of undocumented and mixed status Latinx families during the pandemic, this paper uses a social determinants of health lens to present a narrative summary that highlights four primary psychosocial stressors faced by these families and their implications for mental health. DISCUSSION These include stressors pertaining to (a) anti-immigrant rhetoric and actions; (b) family stressors and disruptions in family dynamics; (c) economic changes and financial losses; and (c) limited access to healthcare. Implications of the aforesaid stressors on the mental health of undocumented families and youth are also discussed. In addition, recommendations are provided for the provision of mental health services, best practices, and resources from a strengths-based approach.
Collapse
Affiliation(s)
- Luz M. Garcini
- Department of Psychological Sciences, Rice University
- Center for the United States and Mexico, Baker Institute for Public Policy, Rice University
| | | | | | - Ciciya Abraham
- Department of Sciences, University of Texas at San Antonio
| | - Vyas Sarabu
- Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio
| | - Pamela Lizette Cruz
- Center for the United States and Mexico, Baker Institute for Public Policy, Rice University
| |
Collapse
|
7
|
Bojorquez-Chapela I, Rojas-Botero ML, Marín DP, Riveros MA, Roa AY, Fernández-Niño JA. Incorporating migrants into National COVID-19 Vaccination Plans in Latin America: A comparative analysis of policies in seven countries. J Migr Health 2023; 9:100207. [PMID: 38053942 PMCID: PMC10694650 DOI: 10.1016/j.jmh.2023.100207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 11/11/2023] [Accepted: 11/15/2023] [Indexed: 12/07/2023] Open
Abstract
Vaccination against COVID-19 is an essential public health tool for pandemic control. Inclusion of migrants in COVID-19 vaccination is not only ethically necessary from a right-to-health perspective but also technically indispensable for disease control. This study aimed to characterize the inclusion of international migrants, refugees, and asylum seekers in COVID-19 vaccination policies in Latin American countries that have the greatest recent increase in the reception of migrants. We conducted a content analysis of public policy documents issued between March 11, 2020, and June 30, 2022 by the Ministries of Health of seven countries: Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico and Peru. Documents were located through Ministries of Health web pages, references in scientific literature, and the Pan American Health Organization's Information Platform on Health and Migration in the Americas. A content analysis was performed of the documents that were located, along six dimensions: migrants' right to vaccination, temporality of vaccination, administrative discretion, policies to facilitate access, language or cultural considerations, and normative, ethical or technical justifications provided. Eighty-six public policy documents were reviewed. Their contents showed that none of the countries explicitly excluded migrants from vaccination, nor did they explicitly define restrictions on this population. One barrier that was detected was to require identity documents in order to be vaccinated or to receive a vaccination certificate, which could be difficult for migrants to obtain. Few countries defined actions to facilitate or promote the vaccination of migrants. The documents that mentioned justifications for vaccinating migrants presented reasons that were mainly based on the recognition of the right to health, the principle of non-discrimination and equity. The countries studied generally had inclusive policies but were limited in terms of dealing with potential barriers to access. The lack of mechanisms to guarantee the right to health is a limitation that countries in the region should address.
Collapse
Affiliation(s)
| | | | | | | | | | - Julián Alfredo Fernández-Niño
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, US
- Departamento de Salud Pública, Universidad del Norte, Barranquilla, Colombia
| |
Collapse
|
8
|
Rocha-Jimenez T, Olivari C, Martínez A, Knipper M, Cabieses B. "Border closure only increased precariousness": a qualitative analysis of the effects of restrictive measures during the COVID-19 pandemic on Venezuelan's health and human rights in South America. BMC Public Health 2023; 23:1846. [PMID: 37735379 PMCID: PMC10515012 DOI: 10.1186/s12889-023-16726-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND In 2010, a political and social crisis pushed thousands of Venezuelans out of their country; today, seven million Venezuelans live abroad. In addition, during the COVID-19 pandemic, border closure increased and affected specific vulnerable migration flows, such as Venezuelans trying to migrate to Chile through the Northern borders. In this context, there is little evidence of migrants' health status and needs, their access to health services, and other basic needs (e.g., housing) from a human rights perspective. Therefore, we qualitatively explored the effects of border closure due to the COVID-19 pandemic on Venezuelan migrants' health and human rights, focusing on access to healthcare in the Northern Chilean border that adjoins Peru and Bolivia. METHODS Following a case-study qualitative design, we conducted an ethnography that included participatory observation of relevant sites (e.g., hospitals, main squares, migrant shelters) in Antofagasta, Iquique, and Arica and 30 in-depth interviews with actors in the health sector (n = 7), experts from the non-governmental sector (n = 16), and governmental actors (n = 7) in three large cities close to the Northern border. RESULTS We found four main dimensions: (i) border and migration processes, (ii) specific groups and intersectionality, (iii) barriers to healthcare services, and (iv) regional and local responses to the crisis during the COVID-19 pandemic. Programs characterized by the presence of healthcare providers in the field were essential to attend to migrants' health needs at borders. CONCLUSIONS Coordination between actors is crucial to implement regional protocols that respond to current migration phenomena and migrants' health needs. Health policies using a human rights approach are urgently required to respond to migrants' healthcare needs at borders in South America.
Collapse
Affiliation(s)
- Teresita Rocha-Jimenez
- Society and Health Research Center, School of Psychology, Faculty of Social Sciences and Arts, Universidad Mayor, Santiago, Chile
- Millennium Nucleus On Sociomedicine, Santiago, Chile
| | - Carla Olivari
- Society and Health Research Center, School of Psychology, Faculty of Social Sciences and Arts, Universidad Mayor, Santiago, Chile
| | - Alejandra Martínez
- Center for Technology and Behavioral Health, Dartmouth College, Hanover, New Heaven, USA
| | - Michael Knipper
- Global Health, Migration and Medical Humanities, University of Giessen, Giessen, Germany
- Board of Lancet Migration Latin America, Lima, Peru
| | - Báltica Cabieses
- Board of Lancet Migration Latin America, Lima, Peru.
- Centre for Global Intercultural Health (CeSGI), Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
| |
Collapse
|
9
|
Atak M, Sezerol MA, Değer MS, Kurubal H. Factors Associated with the Prevalence of Postpartum Anxiety Disorder and Depression in Syrian Migrant Women Living in Turkey: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2517. [PMID: 37761714 PMCID: PMC10530885 DOI: 10.3390/healthcare11182517] [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: 07/31/2023] [Revised: 08/22/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
The global migration trend has brought attention to the mental health of immigrant populations, especially postpartum women. The prevalence of postpartum anxiety and depression among these populations remains a growing concern. This study aimed to explore the factors associated with postpartum anxiety and depression among immigrant women, with a special emphasis on Syrian migrants in Turkey. A cross-sectional design was employed, enrolling postpartum women who visited the Strengthened Migrant Health Center in Istanbul between July and December 2022. Data were collected using a three-part questionnaire comprising sociodemographic details and scores from the Edinburgh Postpartum Depression Scale (EPDS) and Beck Anxiety Scale (BAI). The average age of participants was 25.73 years. The mean EPDS and BAI scores were low at 1.27 and 3.85, respectively. Notably, 97.1% of women scored below the EPDS cut-off point of 13. EPDS scores showed a significant relationship between income levels and COVID-19 vaccination status, while BAI scores were significantly associated with educational levels. There was an inverse correlation between EPDS scores and the number of cohabitants in a household. The observed low rates of postpartum depression and anxiety could be attributed to the accessible health services and psychosocial support for immigrants in Turkey. It would be useful to conduct multicenter and comprehensive epidemiological studies on migrant puerperas.
Collapse
Affiliation(s)
- Muhammed Atak
- Department of Public Health, Istanbul Medical Faculty, Istanbul University, Istanbul 34093, Türkiye
- Epidemiology Program, Institute of Health Sciences, İstanbul Medipol University, Istanbul 34810, Türkiye;
| | - Mehmet Akif Sezerol
- Epidemiology Program, Institute of Health Sciences, İstanbul Medipol University, Istanbul 34810, Türkiye;
- Health Management Program, Graduate Education Institute, Maltepe University, Istanbul 34857, Türkiye
- Department of Public Health, School of Medicine, Istanbul Medipol University, Istanbul 34810, Türkiye
- Sultanbeyli District Health Directorate, Istanbul 34935, Türkiye
| | - Mehmet Sait Değer
- Department of Public Health, Medical Faculty, Hitit University, Corum 19030, Türkiye;
| | - Hamza Kurubal
- Klinik Porta Westfalica GmbH & Co. KG, Steinstrasse 65, 32547 Bad Oeynhausen, Germany;
| |
Collapse
|
10
|
Cogordan C, Fressard L, Ramalli L, Rebaudet S, Malfait P, Dutrey-Kaiser A, Attalah Y, Roy D, Berthiaume P, Gagneur A, Verger P. Motivational interview-based health mediator interventions increase intent to vaccinate among disadvantaged individuals. Hum Vaccin Immunother 2023; 19:2261687. [PMID: 37772602 PMCID: PMC10543359 DOI: 10.1080/21645515.2023.2261687] [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: 05/25/2023] [Accepted: 09/19/2023] [Indexed: 09/30/2023] Open
Abstract
Coverage for recommended COVID-19 and diphtheria-tetanus-poliomyelitis (DTP) booster shots is often inadequate, especially among disadvantaged populations. To help health mediators (HMs) involved in outreach programs deal with the problems of vaccine hesitancy (VH) in these groups, we trained them in motivational interviewing (MI). We evaluated the effectiveness of this training among HMs on their MI knowledge and skills (objective 1) and among the interviewees on their vaccination readiness (VR) and intention to get vaccinated or accept a booster against COVID-19 and/or DTP (objective 2). Two MI specialists trained 16 HMs in a two-day workshop in May 2022. The validated MISI questionnaire evaluated HMs' acquisition of MI knowledge and skills (objective 1). Trained HMs offered an MI-based intervention on vaccination to people in disadvantaged neighborhoods of Marseille (France). Those who consented completed a questionnaire before and after the interview to measure VR with the 7C scale and intentions regarding vaccination/booster against COVID-19 and DTP (objective 2). The training resulted in HMs acquiring good MI skills (knowledge, application, self-confidence in using it). HMs enrolled 324 interviewees, 96% of whom completed both questionnaires. VR increased by 6%, and intentions to get vaccinated or update COVID-19 and DTP vaccination increased by 74% and 52% respectively. Nearly all interviewees were very satisfied with the interview, although 21% still had questions about vaccination. HMs assimilated MI principles well. MI use in outreach programs appears to show promise in improving vaccine confidence and intentions among disadvantaged people.
Collapse
Affiliation(s)
- Chloé Cogordan
- Southeastern Health Regional Observatory, ORS PACA, Marseille, France
| | - Lisa Fressard
- Southeastern Health Regional Observatory, ORS PACA, Marseille, France
| | - Lauriane Ramalli
- Santé publique France (French National Public Health Agency), Marseille, France
| | - Stanislas Rebaudet
- Hôpital Européen, Marseille, France
- UMR1252 SESSTIM, Aix-Marseille University, Inserm, IRD, ISSPAM, Marseille, France
| | - Philippe Malfait
- Santé publique France (French National Public Health Agency), Marseille, France
| | | | | | - David Roy
- Centre de recherche du CHUS, Sherbrooke, QC, Canada
| | | | - Arnaud Gagneur
- Centre de recherche du CHUS, Sherbrooke, QC, Canada
- Department of Pediatrics, Sherbrooke University, Sherbrooke, QC, Canada
| | - Pierre Verger
- Southeastern Health Regional Observatory, ORS PACA, Marseille, France
| |
Collapse
|
11
|
Morisod K, Nikles J, Miauton A, Maussang LB, Vermeulen BP, Bodenmann P. COVID-19 Vaccination Program for Undocumented Migrants: Notes from the Field of a Regional Center of General Medicine and Public Health, Canton of Vaud, Switzerland. J Immigr Minor Health 2023:10.1007/s10903-023-01479-0. [PMID: 37079242 PMCID: PMC10116085 DOI: 10.1007/s10903-023-01479-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2023] [Indexed: 04/21/2023]
Abstract
The COVID-19 pandemic highlighted health inequities for vulnerable populations and the need for more equitable care and access to vaccination. This article described the implementation of a COVID-19 vaccination program for undocumented migrants in a regional academic center of general medicine and public health (Unisanté). The vaccination program's specific components included: triple coordination between the health authorities, the regional center and community partners, a walk-in and free service, no health insurance required, qualified nursing and administrative staff with previous experience with vulnerable populations, translated information materials and interpreters, a guarantee of confidentiality and a widespread communication campaign within the communities. In total, 2'351 undocumented migrants from 97 nationalities received at least one dose of mRNA COVID-19 vaccine (Spikevax) and 2242 were considered fully vaccinated. Although it was hard to assess its global effectiveness, the program vaccinated a significant number of undocumented adult migrants in the Canton of Vaud. The difficulties linked to the pandemic context, the heavy workload for healthcare staff and the limited resources were overcome by strong collaborations between the different actors involved throughout the program. Targeted public health policies, such as vaccination programs for undocumented migrants, are essential to guarantee equitable care, especially in pandemic times.
Collapse
Affiliation(s)
- Kevin Morisod
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland.
- Chair of medicine for vulnerable populations, University of Lausanne, Lausanne, Switzerland.
| | - Justin Nikles
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Alix Miauton
- Department of Ambulatory Care, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | | | - Brigitte Pahud Vermeulen
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Patrick Bodenmann
- Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
- Chair of medicine for vulnerable populations, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
12
|
Roederer T, Mollo B, Vincent C, Leduc G, Sayyad-Hilario J, Mosnier M, Vandentorren S. Estimating COVID-19 vaccine uptake and its drivers among migrants, homeless and precariously housed people in France. COMMUNICATIONS MEDICINE 2023; 3:30. [PMID: 36801917 PMCID: PMC9939372 DOI: 10.1038/s43856-023-00257-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/07/2023] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND Migrants, people experiencing homelessness (PEH), or precariously housed (PH) are at high risk for COVID-19 infection, hospitalization, and death from COVID-19. However, while data on COVID-19 vaccine uptake in these populations are available in the USA, Canada, and Denmark, we are lacking, to the best of our knowledge, data from France. METHODS In late 2021, we carried out a cross-sectional survey to determine COVID-19 vaccine coverage in PEH/PH residing in Ile-de-France and Marseille, France, and to explore its drivers. Participants aged over 18 years were interviewed face-to-face where they slept the previous night, in their preferred language, and then stratified for analysis into three housing groups (Streets, Accommodated, and Precariously Housed). Standardized vaccination rates were computed and compared to the French population. Multilevel univariate and multivariable logistic regression models were built. RESULTS We find that 76.2% (95% confidence interval [CI] 74.3-78.1) of the 3690 participants received at least one COVID-19 vaccine dose while 91.1% of the French population did so. Vaccine uptake varies by stratum, with the highest uptake (85.6%; reference) in PH, followed by Accommodated (75.4%; adjusted odds-ratio = 0.79; 95% CI 0.51-1.09 vs. PH) and lowest in Streets (42.0%; AOR = 0.38; 95%CI 0.25-0.57 vs. PH). Use for vaccine certificate, age, socioeconomic factors, and vaccine hesitancy is associated with vaccination coverage. CONCLUSIONS In France, PEH/PH, and especially the most excluded, are less likely than the general population to receive COVID-19 vaccines. While vaccine mandate has proved an effective strategy, targeted outreach, on-site vaccinations, and sensitization activities are strategies enhancing vaccine uptake that can easily be replicated in future campaigns and other settings.
Collapse
Affiliation(s)
| | - Bastien Mollo
- grid.452373.40000 0004 0643 8660Epicentre, Paris, France ,grid.452373.40000 0004 0643 8660Médecins Sans Frontières, Paris, France ,grid.411119.d0000 0000 8588 831XInfectious and Tropical Diseases Department, Bichat-Claude Bernard Hospital, AP-HP, Paris, France
| | | | - Ghislain Leduc
- grid.452373.40000 0004 0643 8660Epicentre, Paris, France
| | | | | | - Stéphanie Vandentorren
- grid.493975.50000 0004 5948 8741Santé Publique France, Saint Maurice, France ,grid.508062.90000 0004 8511 8605University of Bordeaux, INSERM UMR 1219-Bordeaux Population Health, Bordeaux, France
| |
Collapse
|
13
|
Vaccine Uptake and COVID-19 Frequency in Pregnant Syrian Immigrant Women. Vaccines (Basel) 2023; 11:vaccines11020257. [PMID: 36851135 PMCID: PMC9966866 DOI: 10.3390/vaccines11020257] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/16/2023] [Accepted: 01/21/2023] [Indexed: 01/27/2023] Open
Abstract
Immigrants have difficulties in the use of essential health services such as vaccinations. Vaccine uptake among pregnant immigrant women is very low. The aim of the study was to examine the vaccination status of pregnant immigrant women who received health services in an immigrant health center (IHC) affiliated to primary health care institutions. The research is a retrospective-designed cross-sectional type of study. The study sample consists of pregnant Syrian women who received health care from the strengthened IHC of a District Health Directorate in Istanbul between August 2020 and 2022. Age, trimesters, number of pregnancies, high-risk pregnancy status, vaccination dates and status against influenza, COVID-19 and tetanus, and vaccine types of COVID-19 were evaluated. The statistical significance level was determined as p < 0.05. None of the pregnant women had received the influenza vaccine. Of the women whose tetanus vaccine data were evaluated, 29.7% had received at least two doses of the tetanus vaccine. Of the pregnant women, 19.4% were vaccinated against COVID-19 with a minimum two doses and 4.2% had a COVID-19 infection during their pregnancy. None of the women with the COVID-19 infection were fully vaccinated against COVID-19. The vaccine uptake of pregnant immigrant women is very low. Public health interventions are needed to improve vaccination coverage among disadvantaged groups.
Collapse
|
14
|
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.
Collapse
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 ✉
| |
Collapse
|
15
|
Shannon G, Morgan R, Zeinali Z, Brady L, Couto MT, Devakumar D, Eder B, Karadag O, Mukherjee M, Peres MFT, Ryngelblum M, Sabharwal N, Schonfield A, Silwane P, Singh D, Van Ryneveld M, Vilakati S, Watego C, Whyle E, Muraya K. Intersectional insights into racism and health: not just a question of identity. Lancet 2022; 400:2125-2136. [PMID: 36502850 DOI: 10.1016/s0140-6736(22)02304-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 12/13/2022]
Abstract
Intersectionality is a useful tool to address health inequalities, by helping us understand and respond to the individual and group effects of converging systems of power. Intersectionality rejects the notion of inequalities being the result of single, distinct factors, and instead focuses on the relationships between overlapping processes that create inequities. In this Series paper, we use an intersectional approach to highlight the intersections of racism, xenophobia, and discrimination with other systems of oppression, how this affects health, and what can be done about it. We present five case studies from different global locations that outline different dimensions of discrimination based on caste, ethnicity and migration status, Indigeneity, religion, and skin colour. Although experiences are diverse, the case studies show commonalities in how discrimination operates to affect health and wellbeing: how historical factors and coloniality shape contemporary experiences of race and racism; how racism leads to separation and hierarchies across shifting lines of identity and privilege; how racism and discrimination are institutionalised at a systems level and are embedded in laws, regulations, practices, and health systems; how discrimination, minoritisation, and exclusion are racialised processes, influenced by visible factors and tacit knowledge; and how racism is a form of structural violence. These insights allow us to begin to articulate starting points for justice-based action that addresses root causes, engages beyond the health sector, and encourages transnational solidarity.
Collapse
Affiliation(s)
- Geordan Shannon
- Institute for Global Health, University College London, London, UK.
| | - Rosemary Morgan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Leanne Brady
- Emergency Medical Services, Western Cape Department of Health, Cape Town, South Africa
| | - Marcia Thereza Couto
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Delan Devakumar
- Institute for Global Health, University College London, London, UK
| | - Ben Eder
- Institute of Development Studies, University of Sussex, Brighton, UK
| | - Ozge Karadag
- Center for Sustainable Development, Earth Institute, Columbia University, New York, NY, USA
| | | | | | - Marcelo Ryngelblum
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Nidhi Sabharwal
- Centre for Policy Research in Higher Education, National Institute of Educational Planning and Administration, New Delhi, India
| | - Amos Schonfield
- Oxford Department of International Development, University of Oxford, Oxford, UK
| | - Pamela Silwane
- Gugulethu Community Action Network, Cape Town Together Community Action Network, Cape Town, South Africa
| | - David Singh
- School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Manya Van Ryneveld
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Siyasanga Vilakati
- Phillipi Community Action Network, Cape Town Together Community Action Network, Cape Town, South Africa
| | - Chelsea Watego
- School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Eleanor Whyle
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Kui Muraya
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| |
Collapse
|