Objectives
Asylum-seekers to Europe may come from war-torn countries where health systems have broken down, and there is evidence that asylum-seeking children have low coverage of childhood vaccinations, as well as uptake of immunisations in host countries. Such gaps in immunisation have important implications for effective national vaccination programmes. How we approach vaccination in children and adults entering Western Europe, where as a group they face barriers to health services and screening, is a growing debate, however there is limited data on the vaccination status of these hard to reach communities and robust evidence is needed to inform immunisation strategies. The aim of this study was to explore the vaccination status and needs of asylum-seeking children and adolescents in Denmark.
Study design
We conducted a retrospective data analysis of anonymised patient records for asylum-seeking children and adolescents extracted from the Danish Red Cross database.
Methods
We retrospectively searched the Danish Red Cross database for children and adolescents (age 3 months to 18 years) with active asylum applications in Denmark as of October 28th, 2015. Data were extracted for demographic characteristics, vaccination status, and vaccinations needed by asylum-seeking children presenting to Red Cross asylum centres for routine statutory health screening.
Results
We explored the vaccination status and needs of 2,126 asylum-seeking children and adolescents. 64% of the study population was male and 36% was female. Eight nationalities were represented, where 33% of the total of children and adolescents were not immunised in accordance with Danish national guidelines, while 7% were considered partly vaccinated, and 60% were considered adequately vaccinated. Afghan (57% not vaccinated/unknown) and Eritrean (54% not vaccinated/unknown) children were the least likely to be vaccinated of all nationalities represented, as were boys (37% not vaccinated/unknown) compared with girls (27% not vaccinated/unknown) and children and adolescents aged between 12-18 (48% not vaccinated/unknown) compared with 6-11 year olds (26%) and 0-5 year olds (22%). The health screenings resulted in 1,328 vaccinations. The most commonly needed vaccines were DTaP/IPV/Hib which comprised 49% of the vaccines distributed, followed by the Prevenars (28%) and MMRs (23%).
Conclusions
The finding that nearly 1/3 of asylum-seeking children and adolescents in Denmark were in need of further vaccinations highlights the gaps in immunisation coverage in these populations. These results point to the need to improve access to health services and promote national vaccine programmes targeted at these communities to facilitate vaccination uptake and increase immunisation coverage in order to reduce the risk of preventable infectious diseases among asylum-seeking children.