Refugees and Migrants Must Be Prioritized in COVID-19 Vaccination Programs
SAEM PULSE | JANUARY-FEBRUARY 2022
By Vinay Kampalath, MD, DTMH; Catalina González Marqués, MD, MPH; Ruhul Abid, MD, PhD; and Stephanie C. Garbern, MD, DTMH on behalf of the SAEM Global Emergency Medicine Academy
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The last twenty years have seen the scale and number of global humanitarian crises grow to unprecedented levels. Ongoing humanitarian crises, or events that threaten the health, safety, or wellbeing of a population, include Yemen’s civil war with resultant famine, Bangladesh’s Rohingya refugee crisis, the Venezuelan economic crisis, and the Tigray conflict in Ethiopia. Globally, 235 million people needed humanitarian assistance in 2021 according to the United Nations’ (UN) Office for the Coordination of Humanitarian Affairs. Many of today’s humanitarian crises, which have arisen from protracted conflict, have produced large-scale forced displacement and, as a result, millions of refugees
and migrants. Unfortunately, despite pleas from health care workers and humanitarian organizations, refugees and migrants have yet to be adequately prioritized in global COVID-19 vaccine programs. Humanitarian crises produce a variety of health impacts, including violent trauma, post-traumatic stress, gender-based violence, and vaccine-preventable illnesses. Due to difficulties in testing and epidemiological surveillance, the prevalence of COVID-19 in humanitarian settings is likely underreported. The pandemic has disrupted health care in conflict-affected countries in several ways. In conflict settings, supply chain interruptions have impacted access to medicine,
equipment, and personnel, essential childhood vaccinations have been delayed, and fragile health systems have been forced to reroute scarce resources to COVID-19 response. Refugees and migrants are particularly vulnerable to the effects of COVID-19. Infection prevention guidelines, such as social distancing and self-isolation, are nearly impossible for people living in crowded camplike settings. Refugees and migrants also encounter multiple barriers in accessing timely health care. They often lack financial, logistic, or linguistic resources to access care in new health care systems and may delay care seeking out of fear deportation or detention, in addition to fears of contracting COVID-19.
