Abstract

Background: Migrants in Europe often face barriers to vaccination, increasing their vulnerability to vaccine-preventable diseases (VPDs). Despite policies promoting catch-up immunisation on arrival, data on VPD burden and outcomes among migrants remain limited. This systematic review synthesises evidence on the prevalence, incidence, mortality, and outcomes of VPDs in migrants across EU/EEA countries, UK, and Switzerland. Methods: We searched Medline, Embase, Global Health, and grey literature sources (including websites of national public health organisations and agencies) for primary studies and reports on VPD cases among migrants (foreign-born individuals) in 32 European countries, published between January 2010 and April 2024. Data on demographics, VPD type, vaccination status, and outcomes were extracted. We focused on diphtheria, measles, mumps, pertussis, rubella, and tetanus. Study quality was assessed using Joanna Briggs Institute tools. Results: Fifty-seven studies met inclusion criteria, reporting 1950 VPD cases in migrants across 16 countries (2010–2024). Most studies were in Germany (n = 12), Spain (n = 11), Switzerland (n = 8), Greece (n = 6), and the UK (n = 7). Reported cases included: measles (n = 992; 50.8 %), diphtheria (n = 546; 28.0 %), pertussis (n = 267; 13.7 %), and mumps (n = 137; 7.0 %). No cases of rubella or tetanus were reported. Migrants affected mainly included asylum seekers (n = 23 studies), refugees (n = 6), labour migrants (n = 2). Six studies from Greece, Germany, and Spain accounted for 1942 cases (99.6 %). Over half of diphtheria cases (n = 307; 55.4 %) occurred in reception centres. Diphtheria primarily affected adolescents and adults (n = 10 studies), while measles cases were mostly in children. Migrants from the Eastern Mediterranean and Africa were disproportionately affected by diphtheria. Non-EU/EEA European migrants (WHO EUR), mainly from Bosnia and Herzegovina and Serbia, accounted for most measles cases (87 %), and non-European migrants were from Somalia (n = 112), Afghanistan (n = 94), Eritrea (n = 76), and Syria (n = 64). Vaccination status was unknown or unreported in over 60 % of cases. Five VPD related deaths were reported of which 4/5 were due to measles. Conclusion: Migrants are at increased risk of VPDs due to gaps in vaccination. Strengthening catch-up vaccination, particularly in adolescents and adults, and improving data collection are essential next steps.