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Efird and Pollie Bith-Melander Received: The World Health Organization recommends that host countries ensure appropriate vaccinations to refugees, asylum seekers and migrants. However, information on vaccination strategies targeting migrants in host countries is limited.
In — we carried out a survey among national experts from governmental bodies of 15 non-EU countries of the Mediterranean and Black Sea in order to document and share national vaccination strategies targeting newly arrived migrants.
Eight countries offer migrant children all the vaccinations included in their national immunization schedule; three provide only selected vaccinations, mainly measles and polio vaccines.
Ten and eight countries also offer selected vaccinations to adolescents and adults respectively. Eight countries provide vaccinations at the community level; seven give priority vaccines in holding centres or at entry sites.
Data on administered vaccines are recorded in immunization registries in nine countries. Although differing among countries, indications for immunizing migrants are in place in most of them.
However, we cannot infer from our findings whether those strategies are currently functioning and whether barriers to their implementation are being faced. Further studies focusing on these aspects are needed to develop concrete and targeted recommendations for action.
Since migrants are moving across countries, development of on-line registries and cooperation between countries could allow keeping track of administered vaccines in order to appropriately plan immunization series and avoid unnecessary vaccinations. Introduction The World Health Organization WHO states that there is no systematic association between migration and the importation of infectious diseases.
However, conditions that migrants face during their exhausting journeys, such as lack of sufficient water, and inadequate shelter and sanitation, increase the risk of acquiring communicable diseases [ 1 ]. In addition, crowded settings such as holding centres face an increased risk of outbreaks due to diseases such as measles, influenza, varicella and meningococcal disease.
This risk depends on the length of stay and on concurrent sanitary conditions [ 23456 ]. Unfortunately, despite the widespread availability of vaccines, misconceptions about vaccines and, consequently, vaccination hesitancy are globally increasing in the general population [ 789 ].
Many host countries have sub-optimal vaccination coverage rates with, in some cases, decreasing trends [ 10 ]. This is also the case for consolidated immunizations programmes like poliomyelitis vaccination. For example, in Italy vaccination coverage among children has been decreasing since The Regional Certification Commission for Poliomyelitis Eradication has repeatedly identified Bosnia and Herzegovina, Romania and Ukraine as at high risk for transmission in the event of wild poliovirus importation [ 12 ].
An outbreak of circulating vaccine-derived poliovirus occurred in Ukraine in September [ 13 ]. Also, although targeted for elimination, in WHO counted 30, measles cases in the European Region nearly doubled in comparison to the previous year [ 14 ] and measles outbreaks continue to occur in many countries of the Region independently of refugee and migrant population movement [ 1214 ], confirming that pockets of susceptible individuals are still present in recipients countries.
Decreasing immunization coverage combined with access barriers to immunization in countries of transit and destination could hypothetically lead to a scenario where rapid inflows of large numbers of unvaccinated people could increase existing immunity gaps.
It is very hard to infer the occurrence of measles or other vaccine preventable diseases VPD among migrants in Europe due to the incompleteness of surveillance in relation to migrant health [ 615 ]. In European countries, evidence of low seroprevalence rates for several VPDs among high risk migrant groups and refugee children [ 2021 ] and of lower vaccination coverage among regular migrant populations compared with local populations [ 22 ] have also been documented.
While population movement across the Mediterranean Basin has historical origins, in the last five years migration flows across the Mediterranean Region have increased [ 2324 ].
An increasing number of incoming migrants, with different migration statuses and diverse health needs, is challenging public health authorities in countries within the Mediterranean migratory system to ensure equitable access to disease prevention and control services, including for vaccine preventable diseases.
This concern, initially mainly of countries of destination, is becoming broader as countries on both sides of the Mediterranean basin, traditionally of transit, are becoming long term or final destinations for a growing number of migrants [ 2627 ]. Evidence from a cross-sectional study conducted in among 22 countries bordering the Mediterranean EU and non EU [ 28 ] has shown that, although eligibility of migrants to immunization services offered as part of national immunization programs is almost universal, informal barriers to immunization services e.
This general policy needs implementation strategies adapted at country level to meet the challenges and opportunities of each context. Furthermore, national strategies need to be shaped into procedures that involve deliberate actions to achieve the goals set out in the strategy and into regulations that imply an organization setting out the rules and monitoring their implementation [ 2930 ].
Therefore, existence of regulations, procedures and national strategic and implementation plans indicates that a general policy has been translated at national level. Information on immunization strategies targeting newly arrived migrants in all countries bordering the Southern Mediterranean and Black Sea is not readily available.
In this project, existing strategies for immunization of newly arrived migrants in non-EU countries of this Region were documented in order to address this information gap and promote the sharing of information and experiences.Cambridge University Press, Cambridge, UK, and New York, NY, USA.
4 17 Methodology The Guidelines are based on a detailed review of the methodologies, approaches and governance mechanisms practised in national disaster risk assessment . JSTOR is a digital library of academic journals, books, and primary sources.
Wilhelm Reich (/ r aɪ x /; German: ; 24 March – 3 November ) was an Austrian doctor of medicine and psychoanalyst, a member of the second generation of analysts after Sigmund Freud.
The author of several influential books, most notably Character Analysis (), The Mass Psychology of Fascism (), and The Sexual Revolution .
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