Research investigating the implications of different degrees of migrants’ inclusivity in governments’ vaccination policies during the COVID-19 pandemic found that migrant populations have been systematically disadvantaged in COVID-19 vaccination policies, and migrants have poorer COVID related health outcomes compared to the non-migrant population. The researchers Chiara Berardi, Eun Su Lee, Heidi Wechtler, Francesco Paolucci from the University of Newcastle suggest organisation change is required and provide some policy level recommendations to improve migrants’ health and vaccination equity.

Authors: Chiara Berardi1, Eun Su Lee1, Heidi Wechtler1, Francesco Paolucci1

  1. Newcastle Business School, University of Newcastle, 409 Hunter Street, Newcastle, NSW, Australia.

Between 2020 and 2021, using a qualitative documentary analysis format which took into account pre-pandemic factors, the researchers examined the impact of COVID-19 measures, and vaccination policies on COVID-19 epidemiological outcomes in OECD countries that experienced the most extreme changes in migrant flow in 2020: Australia, Canada, Japan, South Korea and United States. The study found that migrants, faced different degrees of challenges, as their circumstances vary. However, during the pandemic, migrants with lower income were more exposed to COVID-19 due to their insecure house and job conditions. Some migrant workers live in packed dormitories or need to use public transport for work, being employed in occupations that are less likely to be done remotely.

Except for frontline workers, migrants were rarely ‘prioritized groups’ in the host countries. In Australia, temporary migrants only had an option of public vaccination sites, which had longer waiting times. Migrants faced institutional barriers to access public health systems of the host countries, as well as linguistic challenges to interpret vaccination policies and consult doctors. Barriers to access healthcare and safety measures for migrants were exacerbated by the COVID-19 pandemic. Abuse and stigma towards migrants or specific nationalities reinforced marginalization mechanisms. Migrants showed poorer COVID-19 health-related outcomes, accompanied by psychosocial and mental health issues. In Australia, foreign-born age-standardized death rate doubled that of those locally born. Similar outcomes were reported in other countries.

Ensuring equitable allocation of COVID-19 vaccine and addressing the systematic disadvantages related to migrants’ access to healthcare is critical, from a public health and human rights perspective. A failure to address those multiplicity of concerns may result in a vicious cycle for the vulnerable population at the fringes of our economy. The more inclusive and proactive the governments are in consideration of diversity of migrant populations, the better they can manage the pandemic, which leads to overall societal benefit of ensuring public health. A synergic effort from government and industry is needed to assure migrant equity in health. An intersectoral approach that includes health, migration and workplace policies should promote innovative practices and migrant inclusivity.

Policy-level recommendations:
• Inclusive discourse around healthcare and vaccination policies, and establishment of equity-based policies
• Adaptation of inclusion strategy, such as vaccination campaigns targeting migrants and refugees, for minority groups.
• Culturally sensitive knowledge, information and communication methods in vaccination campaigns, policies and programs
• Training health professionals, such as doctors and nurses, to understand cross-cultural issues that could arise in consulting patients with migrant

Organisational-level changes:
• Inclusive health and safety procedures, training, and policies around workplace
• Better support in health insurance for their migrant workers

backgrounds, and supporting healthcare providers to recruit medical interpreters.

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