. 2018 Oct 11;23(41):1700772. doi: 10.2807/1560-7917.ES.2018.23.41.1700772

Table 2. Findings and points of action for governments, researchers and policy makers proposed by the vaccine expert survey, 2017 (n = 32 EU/EEA countries).

Findings	Suggested solutions
• There are a variety of approaches to vaccination of both adult and child migrants across the EU/EEA. • Where guidance exists, it is in most cases not migrant-specific and often not applied in practice. • Considerable variation in approaches exists between adults and children. Child migrants with uncertain vaccination status are in most countries re-vaccinated according to the national vaccination schedule. Adults often receive no catch-up vaccination, or for priority vaccinations only. • Adult migrants may be charged for vaccinations received at statutory health services in some countries, which may deter them from seeking vaccination and other preventative healthcare. • There is considerable variation among experts as to which vaccines should be offered to recently arrived migrants, particularly adults, and experts call for clear evidence-based guidance on this issue. • It is unclear where vaccination should be offered to improve uptake. Most experts agreed that focus should be soon after arrival, at the holding level (reception centres, refugee camps or detention centres) and be better promoted.	• Develop EU-level guidelines for vaccination of recently arrived adult and child migrants, with clarification given on which vaccines should be offered. • Multiple approaches are needed to engage and promote vaccination uptake in migrants, across multiple locations. • Vaccination needs to be free of charge for all migrant groups, including undocumented migrants. • Better explore models of best practice from across the EU/EEA to assess innovative strategies to improve vaccine delivery to adult and child migrants. • High quality studies are needed assessing vaccination implementation and cost-effectiveness in migrant populations. • Explore options for improving data collection and surveillance on vaccination coverage and burden of vaccine-preventable diseases in migrant populations across Europe. • Explore options for improving data capture to avoid duplication of efforts and unnecessary repeat vaccination along the migration trajectory (for example by non-governmental organisations in transit camps and also at statutory health services) after arrival to Europe (e.g. use of mobile phones, electronic vaccination cards and personal health records). • Explore the role of migrants (including underimmunised internal EU migrants and of adolescent and adult migrants), in outbreaks of vaccine-preventable diseases in the EU through robust research, and identify strategies to facilitate improved vaccine coverage in these groups.

Findings

Suggested solutions

• There are a variety of approaches to vaccination of both adult and child migrants across the EU/EEA.
• Where guidance exists, it is in most cases not migrant-specific and often not applied in practice.
• Considerable variation in approaches exists between adults and children. Child migrants with uncertain vaccination status are in most countries re-vaccinated according to the national vaccination schedule. Adults often receive no catch-up vaccination, or for priority vaccinations only.
• Adult migrants may be charged for vaccinations received at statutory health services in some countries, which may deter them from seeking vaccination and other preventative healthcare.
• There is considerable variation among experts as to which vaccines should be offered to recently arrived migrants, particularly adults, and experts call for clear evidence-based guidance on this issue.
• It is unclear where vaccination should be offered to improve uptake. Most experts agreed that focus should be soon after arrival, at the holding level (reception centres, refugee camps or detention centres) and be better promoted.

• Develop EU-level guidelines for vaccination of recently arrived adult and child migrants, with clarification given on which vaccines should be offered.
• Multiple approaches are needed to engage and promote vaccination uptake in migrants, across multiple locations.
• Vaccination needs to be free of charge for all migrant groups, including undocumented migrants.
• Better explore models of best practice from across the EU/EEA to assess innovative strategies to improve vaccine delivery to adult and child migrants.
• High quality studies are needed assessing vaccination implementation and cost-effectiveness in migrant populations.
• Explore options for improving data collection and surveillance on vaccination coverage and burden of vaccine-preventable diseases in migrant populations across Europe.
• Explore options for improving data capture to avoid duplication of efforts and unnecessary repeat vaccination along the migration trajectory (for example by non-governmental organisations in transit camps and also at statutory health services) after arrival to Europe (e.g. use of mobile phones, electronic vaccination cards and personal health records).
• Explore the role of migrants (including underimmunised internal EU migrants and of adolescent and adult migrants), in outbreaks of vaccine-preventable diseases in the EU through robust research, and identify strategies to facilitate improved vaccine coverage in these groups.

EU/EEA: European Union/European Economic Area.

Table 2. Findings and points of action for governments, researchers and policy makers proposed by the vaccine expert survey, 2017 (n = 32 EU/EEA countries).

Table 2. Findings and points of action for governments, researchers and policy makers proposed by the vaccine expert survey, 2017 (n = 32 EU/EEA countries).