Background: Many asylum-seekers to Denmark come from war-torn countries where conflict and insufficient health care infrastructures disrupt vaccine programmes and result in very few children and their families presenting documentation of vaccinations on their arrival in asylum-centers. There is a need to explore how healthcare providers, in the absence of vaccine documentation, determine the vaccination needs of newly arrived refugee children. Methods: To explore the tactics employed by healthcare professionals who screen and vaccinate asylum-seeking children in Denmark, we conducted semi-structured interviews between December 2015 and January 2016 with six healthcare professionals, including three doctors and three public health nurses. The interviews were digitally recorded, transcribed and subjected to a thematic network analysis. Results: The analysis revealed that healthcare providers adopt a number of tactics to ascertain children's immunization needs. They ask into the children's vaccination history through the use of qualified interpreters; consult WHO lists of immunization programmes worldwide; draw on tacit knowledge about country vaccination programmes; consider the background of parents; err on the side of caution and revaccinate. Conclusions: This is one of the first studies to demonstrate the tactics employed by healthcare providers to ascertain the immunization needs of asylum-seeking children in a western receiving country. The findings suggest a need for clear guidance at a national level on how to determine the vaccination needs of asylum-seeking children, and an international effort to secure reliable immunization documentation for migrant populations, for example through virtual immunization records. © 2018 The Author(s).

Asylum-seeking children Tactics Vaccination Refugee children Denmark Healthcare workers Immunization

Needs Assessment Parents Health Personnel health science Vaccines Allied Health Personnel refugee multicenter study nurse clinical trial health care personnel vaccine human Refugees middle aged Denmark statistics and numerical data professional practice Aged qualitative research Humans Adolescent male semi structured interview female preschool child patient referral preventive health service Infant Child, Preschool Referral and Consultation Article organization and management genetic transcription vaccination child parent relation documentation paramedical personnel Child