Strategies and action points to ensure equitable uptake of COVID-19 vaccinations: A national qualitative interview study to explore the views of undocumented migrants, asylum seekers, and refugees.
Strategies and action points to ensure equitable uptake of COVID-19 vaccinations: A national qualitative interview study to explore the views of undocumented migrants, asylum seekers, and refugees.
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DOI：
10.1016/j.jmh.2021.100050
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发表时间：
2021
影响因子：
4.6
通讯作者：
ESCMID Study Group for Infections in Travellers and Migrants (ESGITM)
中科院分区：
文献类型：
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作者：
Deal A;Hayward SE;Huda M;Knights F;Crawshaw AF;Carter J;Hassan OB;Farah Y;Ciftci Y;Rowland-Pomp M;Rustage K;Goldsmith L;Hartmann M;Mounier-Jack S;Burns R;Miller A;Wurie F;Campos-Matos I;Majeed A;Hargreaves S;ESCMID Study Group for Infections in Travellers and Migrants (ESGITM)
早期证据证实，在已建立的少数民族人群中，COVID-19疫苗接种率较低，但很少关注了解移民中疫苗犹豫和疫苗接种障碍。在英国和欧洲，越来越多的危险移民（包括无证移民、寻求庇护者和难民）被认为是免疫接种不足的群体，可能被排除在卫生系统之外，但人们对他们对COVID-19疫苗的具体看法知之甚少，这对于确定加强疫苗推广的关键解决方案和行动要点至关重要。我们对2020年9月至2021年3月期间移民身份不稳定的最近抵达英国的移民（外国出生，18岁以上；在英国不满10年）进行了深入的半结构化定性访谈研究，寻求他们对加强COVID-19疫苗交付和吸收的战略的投入。我们使用“3c”模型（信心、自满和便利）来探索COVID-19疫苗犹豫、障碍和可及性。数据采用专题框架方法进行分析。数据收集一直持续到数据饱和，并且没有出现新的概念。该研究已获得伦敦大学伦理委员会（REC 2020.00630）的批准。我们接触了全国20个移民支持团体，招募了32名移民（平均年龄37.1岁，21名[66%]女性，平均在英国的时间为5.6年[SD为3.7年]），包括来自15个不同国家（世卫组织5个区域）的难民（n = 3）、寻求庇护者（n = 19）、无证移民（n = 8）和有限居留许可的移民（n = 2）。32名移民中有23人（72%）报告对接受COVID-19疫苗犹豫不决，2人（6%）肯定不会接受疫苗。与会者就疫苗内容、副作用、缺乏以适当语言提供的可获得信息、对卫生系统缺乏信任以及认为需求低等问题表达了关切。据报告，他们在获得COVID-19疫苗方面遇到了一系列障碍，并对他们的社区将被排除在外或在推广过程中失去优先地位表示担忧。无证移民表示，如果他们去接种疫苗，他们担心会被指控并面临移民检查。在政府最近宣布可以在不接受移民检查的情况下获得COVID-19疫苗后接受采访的参与者（n = 10）仍然不知道这一点。与会者表示，获取的便利性将是他们决定是否接受疫苗的关键因素，并提出了初级保健服务的替代接入点（例如，食品库、社区中心和慈善机构等可信赖地点的无预约中心），同时促进所有人的初级保健注册，并与社区密切合作，提供有关COVID-19疫苗接种的无障碍信息。不稳定的移民可能会对接受COVID-19疫苗犹豫不决，并面临多种独特的获取障碍，需要简单而创新的解决方案来确保公平获取和利用。疫苗犹豫以及对应享有权利和相关接入点的认识不足，可以通过明确、可获得和量身定制的宣传运动轻松解决，这些运动由边缘化移民社区内的可靠来源共同制作和提供。这些发现与英国以及其他移民人口多样化的欧洲和高收入国家的COVID-19疫苗接种计划直接相关。NIHR。
Early evidence confirms lower COVID-19 vaccine uptake in established ethnic minority populations, yet there has been little focus on understanding vaccine hesitancy and barriers to vaccination in migrants. Growing populations of precarious migrants (including undocumented migrants, asylum seekers and refugees) in the UK and Europe are considered to be under-immunised groups and may be excluded from health systems, yet little is known about their views on COVID-19 vaccines specifically, which are essential to identify key solutions and action points to strengthen vaccine roll-out. We did an in-depth semi-structured qualitative interview study of recently arrived migrants (foreign-born, >18 years old; <10 years in the UK) to the UK with precarious immigration status between September 2020 and March 2021, seeking their input into strategies to strengthen COVID-19 vaccine delivery and uptake. We used the ‘Three Cs’ model (confidence, complacency and convenience) to explore COVID-19 vaccine hesitancy, barriers and access. Data were analysed using a thematic framework approach. Data collection continued until data saturation was reached, and no novel concepts were arising. The study was approved by the University of London ethics committee (REC 2020.00630). We approached 20 migrant support groups nationwide, recruiting 32 migrants (mean age 37.1 years; 21 [66%] female; mean time in the UK 5.6 years [SD 3.7 years]), including refugees (n = 3), asylum seekers (n = 19), undocumented migrants (n = 8) and migrants with limited leave to remain (n = 2) from 15 different countries (5 WHO regions). 23 (72%) of 32 migrants reported being hesitant about accepting a COVID-19 vaccine and two (6%) would definitely not accept a vaccine. Participants communicated concerns over vaccine content, side-effects, lack of accessible information in an appropriate language, lack of trust in the health system and low perceived need. A range of barriers to accessing the COVID-19 vaccine were reported and concerns expressed that their communities would be excluded from or de-prioritised in the roll-out. Undocumented migrants described fears over being charged and facing immigration checks if they present for a vaccine. Participants (n = 10) interviewed after recent government announcements that COVID-19 vaccines can be accessed without facing immigration checks remained unaware of this. Participants stated that convenience of access would be a key factor in their decision around whether to accept a vaccine and proposed alternative access points to primary care services (for example, walk-in centres in trusted places such as foodbanks, community centres and charities), alongside promoting registration with primary care for all, and working closely with communities to produce accessible information on COVID-19 vaccination. Precarious migrants may be hesitant about accepting a COVID-19 vaccine and face multiple and unique barriers to access, requiring simple but innovative solutions to ensure equitable access and uptake. Vaccine hesitancy and low awareness around entitlement and relevant access points could be easily addressed with clear, accessible, and tailored information campaigns, co-produced and delivered by trusted sources within marginalised migrant communities. These findings have immediate relevance to the COVID-19 vaccination initiatives in the UK and in other European and high-income countries with diverse migrant populations. NIHR.
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DOI：
10.1016/s0140-6736(20)32642-8
发表时间：
2021-01-02
期刊：
Lancet (London, England)
影响因子：
--
作者：
Burgess RA;Osborne RH;Yongabi KA;Greenhalgh T;Gurdasani D;Kang G;Falade AG;Odone A;Busse R;Martin-Moreno JM;Reicher S;McKee M
通讯作者：
McKee M
影响因子：
5.5
作者：
Giambi, Cristina;Del Manso, Martina;Ramsay, Mary
通讯作者：
Ramsay, Mary
影响因子：
5.5
作者：
Larson, Heidi J.;Jarrett, Caitlin;Wilson, Rose
通讯作者：
Wilson, Rose
影响因子：
4.6
作者：
Nezafat Maldonado BM;Collins J;Blundell HJ;Singh L
通讯作者：
Singh L
影响因子：
8.1
作者：
Mukumbang FC
通讯作者：
Mukumbang FC