Novel ways to drive catch-up vaccination of adult migrants in UK primary care: a pilot study
European journal of public health(2023)
摘要
Abstract Adult and adolescent migrants to Europe may have missed routine vaccinations and must be aligned with European schedules, but awareness and implementation of catch-up guidelines in UK primary care is poor. We conducted a pilot study of novel primary care mechanisms (May ‘21-Sept ‘22) to explore under-immunisation and increase catch-up vaccination of migrants ( > =16 years, born outside W. Europe, N. America, Australia, or New Zealand) in 2 London boroughs. We recorded vaccination history, past vaccine-preventable diseases (VPD), and prompted staff to offer MMR, Td/IPV, HPV, MenACWY vaccines according to UK guidelines on uncertain or incomplete immunisation status. Data were analysed in STATA12. We included 57 participants (mean age 41 [SD 7.2] years; 62% female; mean 11.3 [SD 9.1] years in UK) from 18 countries. Demographic distributions were not significantly different between boroughs (sites) for age, sex, or years in UK, but differed by birth region (p < 0.0001). Nearly all participants required vaccination for MMR (86%) and Td/IPV (88%), suggesting migrants would benefit from catch-up vaccination on arrival.12/22 participants reported a past VPD (15 cases including measles, rubella, pertussis, active TB, HPV, hepatitis A, HPV, meningitis). 93% of participants were referred for catch-up vaccination and 81% had at least one dose (at study end). Start of vaccination was higher in Site 2 (100%) than Site 1 (44%). Half (30, 59%) of those referred for MMR completed the course (2 doses) by study end. Less than half (17, 41%) referred for Td/IPV had received at least 1 dose at study end. Direct and indirect barriers exist to delivering catch-up vaccines to migrants, including staff knowledge/training; incomplete vaccination records; lack of incentives, time and care pathways. Designated staff champions, financial incentives and awareness are needed to drive catch-up vaccination in primary care, alongside novel ways to deliver vaccinations at scale and in the community. Key messages • Designated staff champions, incentives and other mechanisms to raise staff awareness and willingness to engage with guidelines are needed to drive catch-up vaccination in primary care. • Novel ways to deliver vaccinations at scale and use of community-based or community-led interventions are needed to advance vaccine equity and ensure inclusion of marginalised migrant groups.
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关键词
vaccination,adult migrants,primary care
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