Vaccination models of delivery for refugees and migrants: a global scoping review

Refugees and migrants face inequities in healthcare and vaccination access. Diverse vaccination programs have been implemented globally among refugee and migrant populations targeting vaccine hesitancy and other barriers to vaccination. The aim of this scoping review was to provide an overview of current models of vaccination delivery of COVID-19 and other vaccines to inform best practices of vaccine delivery for refugee and migrant populations.

A scoping review was conducted according to PRISMA guidelines. Eleven electronic databases, including SCOPUS, Embase, Medline, and Web of Science, as well as grey literature, were searched with keywords including: 'COVID-19', 'vaccines','immunizations', 'refugees', 'asylum seekers', and 'migrants'. The search included all studies published between January 2000 and October 2023 to capture COVID-19 and other vaccine models of delivery. The main outcome was models of delivery of COVID-19 vaccines and other vaccines for refugee or migrant populations. Models of vaccination delivery were reviewed and analyzed with the 2022 World Health Organization's Strengthening COVID-19 vaccine demand and uptake in refugees and migrants: An operational guide (2022 WHO Guide) as a guiding framework.

A total of n = 11,825 unique studies were identified through database searches. Thirty-three (n = 33) studies were included in this review. Fifteen studies (n = 15) related to the COVID-19 vaccine and eighteen studies (n = 18) focused on other vaccines. Studies were mainly implemented in high-income countries with the majority from the United States (n = 17). Studies targeted various migrant groupings (i.e., migrants, immigrants, refugees, and asylum-seekers), ethnic groups, and age groups globally, including various underserved populations including migrant populations. There was general alignment with most of the 2022 WHO Guide priority action areas across both COVID-19 and other vaccine studies, pointing to ongoing understandings of the importance of administratively accessible and culturally/linguistically appropriate models of vaccine delivery for refugee and migrant populations. Increasingly dominant approaches in the COVID-19 pandemic include multipronged strategies with wide community and multisectoral collaborations to co-design strategies addressing barriers. Additionally, COVID-19 vaccination models increasingly utilized innovative social media and customization strategies, including targeted communication campaigns responsive to misinformation. Although there are increased calls for the use of data to design and evaluate interventions, notable gaps remain in the collection, use and reporting of data used to conduct interventions.

Findings summarize vaccination models of delivery for COVID-19 and other vaccines for diverse refugee and migrant populations globally. Healthcare professionals, policy makers, and vaccination campaign planners can draw and build from strategies employed in other settings as aligned with WHO priority actions to increase equitable access to vaccines for refugee and migrant communities. Further collection and use of disaggregated and real-time data to inform and evaluate customized strategies for specific migrant groups is recommended to improve understandings of equitable vaccine delivery models.