Migration and outbreaks of vaccine-preventable disease in the UK and Europe

英国和欧洲疫苗可预防疾病的迁移和爆发

• 批准号: 2444355
• 金额: --
• 依托单位: St George's, University of London
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2444355
• 关键词: Migration; outbreaks; vaccine; preventable; disease

The substantial recent rise in migration to and within Europe has been linked to the resurgence and spread of re-emerging infectious diseases in European countries, including vaccine-preventable diseases (VPDs) such as measles and rubella. The European Vaccine Action Plan, approved in 2015, calls on all Member States in the region to pay particular attention to migrants, international travellers and marginalised communities, to ensure their access to effective and culturally appropriate catch-up vaccination services on arrival to host countries, in order to reach Herd Immunity Threshold (HIT) targets with the aim of eliminating diseases such as measles from the Region. However, there remain major data gaps in relation to the links between migration, immunisation coverage and vaccination intent and uptake in these populations as well as VPD incidence and outbreaks. These data are now critical to acquire if we are going to strengthen vaccination catch-up strategies for at-risk migrant groups, develop innovative new tools and approaches, and thereby reduce the risk of VPD outbreaks and incidence of disease. This project uses a mixed methods approach to address the below aims:1. To synthesise existing evidence on the role of migration in the UK and Europe in outbreaks of VPDs I will carry out a systematic review following PRISMA guidelines, searching three major bibliographic databases for for published literature relating to vaccine-preventable disease outbreaks involving migrants in all EU countries. Data on scale of outbreaks, involvement and demographics of migrant populations and any other relevant information will be extracted and narratively synthesised.2. To assess immunisation coverage and vaccination uptake in migrant populations in the UK and Europe I will do retrospective quantitative analyses on two large datasets on immunisation coverage among migrants. The first database, available as part of an IOM-PHE collaboration, describes pre-entry health assessments and immunisation coverages of 12,xxx UK-bound refugees, and will allow me to explore levels of immunisation in this population as well as factors associated with varying coverage. The second dataset, which consists of Danish registry data, will allow me to compare immunisation coverage and uptake in host and migrant populations in Denmark, data which is not available in the UK.3. To explore the effect of COVID-19 on access to healthcare for precarious migrants in the UK, including confidence in and access to COVID-19 vaccinesIn the context of the COVID-19 pandemic, many migrant groups in the UK have been disproportianetely affected by the pandemic, both directly in terms of morbidity and mortality, but also in reduced access to healthcare and in social or economic terms. I will carry out a qualitative study with precarious migrants in the UK (undocumented, asylum seekers, refugees) to explore effects of the pandemic on livelihoods and access to healthcare as well as views on the vaccine roll-out.4. To investigate views on routine vaccines and and identify opportunities for improving service delivery post-COVID-19 pandemicBased on findings around key at-risk migrant groups in the UK and Europe from the quantitative analyses (Aims and 2), I will identify specific communities who we will seek to work with to understand views on routine vaccination in the UK and potential opportunities for improving service delivery. This will be done through a large qualitative study to understand barriers and facilitators to healthcare, views and concerns about the NHS and vaccination access in the UK and history of accessing medical care or catch-up vaccination since leaving their home country.

最近向欧洲和欧洲内部移民的大幅增加与欧洲国家重新出现的传染病的复苏和传播有关，包括麻疹和风疹等疫苗可预防的疾病。2015年批准的《欧洲疫苗行动计划》呼吁该地区所有成员国特别关注移民、国际旅行者和边缘化社区，确保他们在抵达东道国时获得有效和文化上适当的补充疫苗接种服务，以达到牛群免疫阈值（HIT）目标，从而在该地区消除麻疹等疾病。然而，在这些人群的移民、免疫覆盖率和疫苗接种意向和接种率以及VPD发病率和暴发之间的联系方面，仍然存在重大数据缺口。如果我们要加强高危移民群体的疫苗接种追赶战略，开发创新的新工具和方法，从而降低VPD爆发和疾病发生的风险，这些数据现在至关重要。本项目采用混合方法来实现以下目标：1.为了综合现有的证据，在英国和欧洲的移民在VPD的爆发的作用，我将进行系统的审查后PRISMA指南，搜索三个主要的书目数据库，为已发表的文献涉及疫苗可预防的疾病爆发在所有欧盟国家的移民。将提取和叙述性地综合关于疫情规模、涉及情况和移民人口统计数据以及任何其他相关信息。为了评估英国和欧洲移民人口的免疫覆盖率和疫苗接种率，我将对移民免疫覆盖率的两个大型数据集进行回顾性定量分析。第一个数据库是国际移民组织与公共卫生和环境部合作的一部分，描述了12，xxx名前往英国的难民的入境前健康评估和免疫接种覆盖率，并将使我能够探索这一人群的免疫接种水平以及与不同覆盖率相关的因素。第二个数据集由丹麦登记数据组成，将使我能够比较丹麦的宿主和移民人口的免疫覆盖率和吸收率，这些数据在英国不可用。探索COVID-19对英国不稳定移民获得医疗保健的影响，包括对COVID-19疫苗的信心和获得COVID-19疫苗的机会在COVID-19大流行的背景下，英国的许多移民群体受到了疫情的严重影响，无论是在发病率和死亡率方面，还是在获得医疗保健的机会减少以及社会或经济方面。我将对在英国的不稳定移民（无证移民、寻求庇护者、难民）进行定性研究，探讨疫情对生计和医疗保健的影响，以及对疫苗推广的看法。调查对常规疫苗的看法，并确定在COVID-19大流行后改善服务提供的机会根据定量分析（目标和2）中关于英国和欧洲主要高危移民群体的发现，我将确定我们将寻求合作的特定社区，以了解英国对常规疫苗接种的看法和改善服务提供的潜在机会。这将通过一项大型定性研究来完成，以了解医疗保健的障碍和促进因素，对英国NHS和疫苗接种的看法和担忧，以及自离开本国以来获得医疗保健或追赶疫苗接种的历史。