Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU/EEA

A Systematic Review

Charles Hui, Jessica Dunn, Rachael Morton, Lukas P Staub, Anh Tran, Sally Hargreaves, Christina Greenaway, Beverly Ann Biggs, Robin Christensen, Kevin Pottie

Research output: Contribution to journalReviewResearchpeer-review

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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.

Original languageEnglish
Article number2065
JournalInternational Journal of Environmental Research and Public Health
Volume15
Issue number10
Number of pages13
ISSN1661-7827
DOIs
Publication statusPublished - 20. Sep 2018
Externally publishedYes

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Cost-Benefit Analysis
Community-Institutional Relations
Education
Diphtheria
Seroepidemiologic Studies
Research
MEDLINE
Documentation
Databases
Guidelines
Population

Keywords

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Cost-Benefit Analysis
  • Delivery of Health Care/economics
  • Europe/epidemiology
  • European Union
  • Female
  • Humans
  • Immunization Programs/economics
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Seroepidemiologic Studies
  • Transients and Migrants/psychology
  • Vaccination/economics
  • Young Adult
  • Health systems
  • Refugees
  • VPD
  • Cost effectiveness
  • Immunisation strategies
  • Migrants

Cite this

Hui, Charles ; Dunn, Jessica ; Morton, Rachael ; Staub, Lukas P ; Tran, Anh ; Hargreaves, Sally ; Greenaway, Christina ; Biggs, Beverly Ann ; Christensen, Robin ; Pottie, Kevin. / Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU/EEA : A Systematic Review. In: International Journal of Environmental Research and Public Health. 2018 ; Vol. 15, No. 10.
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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.",
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author = "Charles Hui and Jessica Dunn and Rachael Morton and Staub, {Lukas P} and Anh Tran and Sally Hargreaves and Christina Greenaway and Biggs, {Beverly Ann} and Robin Christensen and Kevin Pottie",
year = "2018",
month = "9",
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Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU/EEA : A Systematic Review. / Hui, Charles; Dunn, Jessica; Morton, Rachael; Staub, Lukas P; Tran, Anh; Hargreaves, Sally; Greenaway, Christina; Biggs, Beverly Ann; Christensen, Robin; Pottie, Kevin.

In: International Journal of Environmental Research and Public Health, Vol. 15, No. 10, 2065, 20.09.2018.

Research output: Contribution to journalReviewResearchpeer-review

TY - JOUR

T1 - Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU/EEA

T2 - A Systematic Review

AU - Hui, Charles

AU - Dunn, Jessica

AU - Morton, Rachael

AU - Staub, Lukas P

AU - Tran, Anh

AU - Hargreaves, Sally

AU - Greenaway, Christina

AU - Biggs, Beverly Ann

AU - Christensen, Robin

AU - Pottie, Kevin

PY - 2018/9/20

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N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Child

KW - Child, Preschool

KW - Cost-Benefit Analysis

KW - Delivery of Health Care/economics

KW - Europe/epidemiology

KW - European Union

KW - Female

KW - Humans

KW - Immunization Programs/economics

KW - Infant

KW - Infant, Newborn

KW - Male

KW - Middle Aged

KW - Seroepidemiologic Studies

KW - Transients and Migrants/psychology

KW - Vaccination/economics

KW - Young Adult

KW - Health systems

KW - Refugees

KW - VPD

KW - Cost effectiveness

KW - Immunisation strategies

KW - Migrants

U2 - 10.3390/ijerph15102065

DO - 10.3390/ijerph15102065

M3 - Review

VL - 15

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

SN - 1661-7827

IS - 10

M1 - 2065

ER -