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The immune status of migrant populations in Europe and implications for vaccine-preventable disease control: a systematic review and meta-analysis.

Cherri, Z; Lau, K; Nellums, LB; Himmels, J; Deal, A; McGuire, E; Mounier-Jack, S; Norredam, M; Crawshaw, A; Carter, J; et al. Cherri, Z; Lau, K; Nellums, LB; Himmels, J; Deal, A; McGuire, E; Mounier-Jack, S; Norredam, M; Crawshaw, A; Carter, J; Seedat, F; Clemente, NS; Bouaddi, O; Friedland, JS; Edelstein, M; Hargreaves, S (2024) The immune status of migrant populations in Europe and implications for vaccine-preventable disease control: a systematic review and meta-analysis. J Travel Med, 31 (6). taae033. ISSN 1708-8305 https://doi.org/10.1093/jtm/taae033
SGUL Authors: Crawshaw, Alison Fiona

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Abstract

BACKGROUND: Ensuring vaccination coverage reaches established herd immunity thresholds (HIT) is the cornerstone of any vaccination programme. Diverse migrant populations in European countries have been associated with cases of vaccine-preventable diseases (VPD) and outbreaks, yet it is not clear to what extent they are an under-immunised group. METHODS: We did a systematic review and meta-analysis to synthesise peer-reviewed published primary research reporting data on the immune status of migrants in EU/EEA countries, the UK and Switzerland, calculating their pooled immunity coverage for measles, mumps, rubella, and diphtheria using random-effects models. We searched on Web of Science, Embase, Global Health and MEDLINE (January 1st 2000 to June 10th 2022), with no language restrictions. The protocol is registered with PROSPERO (CRD42018103666). FINDINGS: Of 1103 abstracts screened, 62 met eligibility criteria, of which 39 were included in the meta-analysis. The meta-analysis included 75 089 migrants, predominantly from outside Europe. Pooled immunity coverage among migrant populations was well below the recommended HIT for diphtheria (n = 7, 57.4% [95% CI: 43.1-71.7%] I2 = 99% vs HIT 83-86%), measles (n = 21, 83.7% [95% CI: 79.2-88.2] I2 = 99% vs HIT 93-95%), and mumps (n = 8, 67.1% [95% CI: 50.6-83.6] I2 = 99% vs HIT 88-93%), and midway for rubella (n = 29, 85.6% [95% CI: 83.1-88.1%] I2 = 99% vs HIT 83-94%), with high heterogeneity across studies. INTERPRETATION: Migrants in Europe are an under-immunised group for a range of important VPDs, with this study reinforcing the importance of engaging children, adolescents, and adults in 'catch-up' vaccination initiatives on arrival for vaccines, doses, and boosters they may have missed in their home countries. Co-designing strategies to strengthen catch-up vaccination across the life-course in under-immunised groups is an important next step if we are to meet European and global targets for VPD elimination and control and ensure vaccine equity.

Item Type: Article
Additional Information: © International Society of Travel Medicine 2024. Published by Oxford University Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: 1103 Clinical Sciences, 1117 Public Health and Health Services, 1506 Tourism, Tropical Medicine
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: J Travel Med
ISSN: 1708-8305
Language: eng
Dates:
DateEvent
August 2024Published
29 February 2024Published Online
15 February 2024Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
NIHR300072National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
NIHR134801National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
SBF005\1111Academy of Medical Scienceshttp://dx.doi.org/10.13039/501100000691
MR/N013638/1Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
LCF/PR/SP21/52930003La Caixa FoundationUNSPECIFIED
NIHR300290National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
NIHR200929National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
PubMed ID: 38423523
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/116312
Publisher's version: https://doi.org/10.1093/jtm/taae033

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