International Journal of Environmental Research and Public Health
Volume 15, Issue 10, 2018

Interventions to improve vaccination uptake and cost effectiveness of vaccination strategies in newly arrived migrants in the EU/EEA: A systematic review (Article) (Open Access)

Hui C.* , Dunn J. , Morton R. , Staub L.P. , Tran A. , Hargreaves S. , Greenaway C. , Biggs B.A. , Christensen R. , Pottie K.
  • a Division of Infectious Diseases, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON K1H 8L1, Canada
  • b Division of Infectious Diseases, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON K1H 8L1, Canada
  • c NHMRC Clinical Trials Centre, Sydney Medical School, University of Sydney, Camperdown, 1450, Australia
  • d NHMRC Clinical Trials Centre, Sydney Medical School, University of Sydney, Camperdown, 1450, Australia
  • e NHMRC Clinical Trials Centre, Sydney Medical School, University of Sydney, Camperdown, 1450, Australia
  • f International Health Unit, Section of Infectious Diseases and Immunity, Imperial College London, London, W12 0NN, United Kingdom, The Institute for Infection and Immunity, St George’s, University of London, London, SW17 0RE, United Kingdom
  • g Division of Infectious Diseases and Clinical Epidemiology, SMBD-Jewish General Hospital, McGill University, Montreal, QC H3T 1E2, Canada
  • h Department of Medicine/RMH at the Doherty Institute, University of Melbourne, Melbourne, 3000, Australia, The Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, 3050, Australia
  • i Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, 2000, Denmark
  • j Bruyere Research Institute, Ottawa, ON K1N 5C8, Canada, Departments of Family Medicine and Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON K1G 5Z3, Canada

Abstract

Newly arrived migrants to the EU/EEA (arrival within the past five years), as well as other migrant groups in the region, might be under-immunised and lack documentation of previous vaccinations, putting them at increased risk of vaccine-preventable diseases circulating in Europe. We therefore performed a systematic review conforming to PRISMA guidelines (PROSPERO CRD42016045798) to explore: (i) interventions that improve vaccine uptake among migrants; and (ii) cost-effectiveness of vaccination strategies among this population. We searched MEDLINE, Embase, CINAHL, and Cochrane Database of Systematic Reviews (CDSR) between 1 January 2006 to 18 June 2018. We included three primary intervention studies performed in the EU/EEA or high-income countries and one cost effectiveness study relevant to vaccinations in migrants. Intervention studies showed small but promising impact only on vaccine uptake with social mobilization/community outreach, planned vaccination programs and education campaigns. Targeting migrants for catch-up vaccination is cost effective for presumptive vaccination for diphtheria, tetanus, and polio, and there was no evidence of benefit of carrying out pre-vaccination serological testing. The cost-effectiveness is sensitive to the seroprevalence and adherence to vaccinations of the migrant. We conclude that scarce but direct EU/EEA data suggest social mobilization, vaccine programs, and education campaigns are promising strategies for migrants, but more research is needed. Research should also study cost effectiveness of strategies. Vaccination of migrants should continue to be a public heath priority in EU/EEA. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.

Author Keywords

Migrants Health systems Refugees VPD Cost effectiveness Immunisation strategies

Index Keywords

literature review immigrant refugee Cost benefit analysis economics Europe disease treatment diphtheria pertussis poliomyelitis tetanus vaccine human epidemiology middle aged statistics and numerical data Aged high income country Young Adult Humans migrant psychology Adolescent Infant, Newborn male preschool child Aged, 80 and over Infant preventive health service very elderly Child, Preschool newborn female European Union Article social adaptation patient compliance intervention study adult migration serology seroepidemiology Prospero Immunization Programs Transients and Migrants Delivery of Health Care vaccination poliomyelitis seroprevalence Seroepidemiologic Studies immunization cost-benefit analysis diphtheria systematic review health care delivery tetanus public health cost effectiveness analysis public health campaign Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85053781647&doi=10.3390%2fijerph15102065&partnerID=40&md5=abe4c45c276245f1b314c3aa13c7c512
DOI: 10.3390/ijerph15102065
ISSN: 16617827
Cited by: 7
Original Language: English