Strengthening COVID-19 vaccine demand and uptake in refugees and migrants: an operational guide to support all those responsible for planning and…

Executive summary

The COVID-19 pandemic has exacerbated existing inequalities in certain populations, which may include refugees and migrants. These populations may face a range of personal, social and physical barriers to uptake of COVID-19 vaccines that will underpin their decisions, motivation and ability to be vaccinated as rapid rollout of COVID-19 vaccines takes place globally; to date these populations have shown lower COVID-19 vaccination uptake and intent to vaccinate in the few countries where this has been measured. WHO recommends that vaccine prioritization within countries should include refugees and migrants and calls for affordable, non-discriminatory access to vaccines for all populations.

This document has been developed as an operational guide to support policy-makers, planners and implementers at national and local levels, including in governments, nongovernmental organizations (NGOs), WHO country offices and other stakeholders responsible for the rollout of COVID-19 vaccines to refugee and migrant populations. The guide is designed to provide practical support, strategies and good practices for understanding and addressing personal, social and practical barriers to COVID-19 vaccines among refugee and migrant populations, acknowledging that they may face a range of unique barriers to accessing immunization systems that need to be better considered by policy-makers and planners.

This guide provides an overview of key activities and considerations for increasing confidence and uptake of COVID-19 vaccines in refugee and migrant populations with the aim of supporting the operationalization of the recent WHO interim guidance COVID-19 Immunization in Refugees and Migrants: Principles and Key Considerations. The guide covers data collection, coordination of policy and planning, implementing communication strategies, social media monitoring, community engagement, capacity-building, and monitoring and evaluation.

The guide should be read in conjunction with a range of relevant supporting reports and guidance documents from WHO (for example on allocation and prioritization of COVID-19 vaccination, prioritizing uses of COVID-19 vaccines when supply is limited, and guidance on acceptance and demand) and relevant organizations. At each point in the guide, these supporting documents are grouped together as key resources to support each of the priority areas outlined. To facilitate use of this guide, a checklist of key action points is also provided. This guide is highly relevant as a supporting tool for the delivery of all vaccinations to refugee and migrant populations.

To support the development of the document, a rapid evidence review was carried out of peer-reviewed and grey literature on barriers to vaccination in refugees and migrants worldwide. In addition, evidence, action points, and case studies were identified through compiling documents, guidelines and toolkits developed by WHO and other relevant organizations. Information was also obtained from expert members of a WHO-convened technical working group, a series of regional dialogues and a final consultation with key NGOs, WHO representatives and international and regional representatives from international organizations.

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Strengthening COVID-19 vaccine demand and uptake in refugees and migrants: an operational guide to support all those responsible for planning and...