- Government policies, operational realities and administrative requirements like identification cards and residency permits may be impeding access to national vaccination efforts for some migrants in 53 of the more than 160 countries where the International Organization for Migration (IOM) has collected information on access so far. Irregular and undocumented migrants and those forcibly displaced are at particular risk.
"We have been impressed with efforts made in dozens of countries to make vaccination roll-outs as equitable as possible, but barriers to health services have been systemic since before the pandemic and remain a reality for too many migrants in too many places," said IOM Director General António Vitorino.
"What we are seeing in some cases is a disconnect between what is being committed to on paper and what is actually happening in practice."
Some 47 countries have already taken concrete steps to ensure that migrants, including those in irregular situations, can access the vaccine. Many nations are still awaiting doses to begin their vaccination roll-outs. Even when they start, IOM has identified more than 53 countries, territories or areas where current policies and operational realities will make vaccine access unattainable for the most vulnerable.
IOM notes with particular concern close to 40 countries where administrative processes - such as requirements to present a national ID or valid residence permit, or to pre-register with national insurance schemes - may present an obstacle for some categories of migrants and forcibly displaced persons.
Other types of barriers have been identified in several locations, including prioritization of citizens and exclusion of non-nationals from vaccination campaigns; the lack of a "firewall" between health providers and immigration authorities which leads many migrants in irregular situations to fear arrest or deportation should they seek immunization; general vaccine hesitancy due to insufficient targeted outreach through linguistically and culturally appropriate channels; continued mobility as a challenge for vaccines requiring two doses, and the need to have a smartphone, a computer or an internet connection to enroll.
The Organization's ongoing review of migrant access in practice - which differs from desk reviews of the national deployment and vaccination plans being undertaken by other stakeholders - has also brought to light the many encouraging initiatives taken by governments who recognize that vaccine equity is critical to overcome the health, economic and mobility crises posed by this pandemic.
Among the good practices noted are:
- Accepting any form of identification document, no matter its expiration date, with no questions asked about the person's immigration status.
- Pro-actively reaching out to migrant communities, in tailored languages and through relevant communication channels to build trust and create vaccine demand.
- Deploying mobile vaccination teams to reach remote areas where primary health services remain scarce.
- Guaranteeing that there will be no reporting to immigration authorities following immunization.
- Granting residency rights or visa extensions for migrants in irregular situations, to ensure they can access social benefits, including health care.
Working hand-in-hand with national health authorities, the World Health Organization (WHO), the UN Refugee Agency (UNHCR), Gavi (the Vaccine Alliance), the UN Children's Fund (UNICEF) and other key partners, IOM has been advocating for such measures to bridge the gaps, and has been providing governments with technical, policy and operational support, upon request.
"There is still time to course-correct for vaccine equity wherever there is the political will to do so," said Director General Vitorino. "It is often in the day-to-day processes and administrative requirements in health centres that the fight for true inclusion is won or lost, so I call on all governments to clear the path towards COVID-19 immunization for all."
