Description
Introduction
Nepal has a longstanding tradition of providing asylum for around 20,000 refugees, including those from Tibet, Bhutan and other states whereas the migrants include a large proportion of both external and internal migrants. The needs and determinants of COVID-19 vaccination uptake and coverage among refugees, migrants in regular situation (MIRS) and migrants in irregular (MIIS) is undocumented that precludes advocacy toward inclusive vaccination policies and ultimately undermines effective rollout. Therefore, this study aims to provide an estimation of COVID-19 vaccination coverage as well as produce evidence on the barriers and facilitators to vaccination among these three different groups.
Methodology
A total of 210 household surveys were conducted among the migrants and refugees from three provinces- Bagmati, Koshi and Gandaki of Nepal. The interviews were conducted over a period of a month- July 2022 via face-to-face interviews through the deployment of structured questionnaires. The questionnaire comprised of respondent’ssociodemographic characteristics, concerns on COVID-19 infection, vaccination coverage, motivations and barriers and vaccination campaigns, including access to information on COVID-19. We also calculated the COVID-19 Vaccine Equity Index (CVEI) for the 3 group of participants. Descriptive analyses were conducted on quantitative data and the analysis was done in STATA 15. The ethical approval for the study was provided from Nepal Health Research Council, Kathmandu University Institutional Review Committee and University of Geneva.
Results and Discussions
The participants consisting of 66 regular migrants (30.2%), 43 irregular migrants (20.8%) and 101 refugees(49%) were included in our study. Out of 210 participants, 202 (96.2%) were vaccinated against COVID-19. Out of them, 52.9% had received full dose, and 43.3% had received partial dose of COVID-19 vaccine.
The inclusive vaccination policy in Nepal has been an enabling factor for the fair access to COVID-19 vaccine among refugees and migrants. Availability of vaccine at free of cost, choice for vaccine, timely information on the vaccination, and multiple vaccination centres were found to be the facilitators for the COVID-19 vaccination. However, obstacles like the need for specific identity documents, misinformation concerning vaccine safety, concerns about potential side effects, and language barriers were identified as significant barriers impeding vaccine acceptance.
The CVEI results suggested that among the three group, the refugees had favorable access to the COVID-19 vaccine. The group of regular migrants had less access to the vaccine than the general population. (CVEI refugees=0.486 & CVEI regular migrants= 1.333)
Conclusion
Despite the commendable vaccination coverage of 96.2% among the participants, disparities persist in terms of full and partial vaccination rates among these groups. This indicates the imperative need for tailored interventions and targeted strategies to improve vaccine accessibility among different migrant groups, considering their unique challenges and barriers.
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