In our study published in the journal BMC Medicine, we report significant vulnerabilities to infectious diseases among UK migrants due to under-vaccination for diseases preventable through routine immunisations – such as measles, mumps, rubella, and polio. Our mixed-methods study, conducted between May 2021 and September 2022 across several London-based general practices, sheds light on the urgent need for improved healthcare strategies that ensure migrants receive necessary catch-up vaccinations.
Background
Migrants in the UK and Europe are often at increased risk of vaccine-preventable diseases (VPDs) due to incomplete childhood vaccinations and systemic marginalisation from health services. The COVID-19 pandemic further exacerbated these disparities, highlighting the critical gaps in vaccination coverage among adult and adolescent migrants. The study aimed to quantify these vaccination gaps and explore new strategies to improve vaccination uptake through better integration into primary care systems.
Study Insights
The “Vacc on Track” study involved 57 migrants from 18 countries, revealing a troubling landscape of under-vaccination:
- 86% of the participants needed catch-up vaccinations for MMR.
- 88% required catch-up for tetanus, diphtheria, and polio (Td/IPV).
- Despite high referrals for catch-up vaccinations (93%), completion rates were dismally low, with only 12% completing the Td/IPV series and 64% completing the MMR.
Barriers and Facilitators
We identified numerous barriers to effective vaccination, including:
- Lack of systematic approaches to catch-up vaccination upon migrants’ arrival.
- Primary care staff’s limited awareness and implementation of vaccination guidelines.
- Structural challenges such as limited appointment availability and follow-up.
Conversely, potential facilitators highlighted the importance of staff champions and community-based approaches to improve vaccination uptake. These insights suggest that primary care can play a pivotal role in reducing health inequalities by adopting more culturally competent and accessible vaccination strategies.
Conclusion
The study underscores a pressing public health issue: the need to better integrate catch-up vaccinations within primary care to protect vulnerable populations against VPDs. By strengthening existing pathways and enhancing staff training and resources, healthcare systems can make significant strides toward ensuring that all community members, regardless of their origin, are protected against preventable diseases.
Moving Forward
our findings emphasise the need for further research and larger trials to refine and implement effective strategies that ensure equitable healthcare access. As the UK continues to navigate the challenges posed by migration and health disparities, such studies are essential for informing policy and practice, aiming for a healthier, more inclusive society. This research not only highlights the gaps but also charts a course for future action, aiming to transform insights into impactful health interventions.