{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:37:31Z","timestamp":1791218251551,"version":"4.1.0"},"reference-count":44,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,2,2]],"date-time":"2025-02-02T00:00:00Z","timestamp":1738454400000},"content-version":"unspecified","delay-in-days":32,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006389","name":"Universit\u00e9 de Gen\u00e8ve","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006389","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,1,15]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The COVID-19 pandemic has widened inequities, affecting migrant and refugee populations in vulnerable situations, who may face elevated risks of infection, constrained healthcare access and discrimination. Inclusive vaccination campaigns are recommended, but barriers persist. This study aimed to identify barriers and facilitators and estimate vaccination coverage among refugees and migrants in low- and middle-income countries, emphasising inclusive policies for effective rollout.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A mixed-method study was conducted in two phases in Ecuador, Nepal, Pakistan, the Philippines and Rwanda. Phase 1 (March\u2013May 2022) included policy analysis, in-depth interviews and focus-group discussions with 52 key informants analysed with thematic and grounded theory approaches using hybrid coding. Phase 2 (June\u2013August 2022) included a cross-sectional study among refugees and migrants in regular (MIRS) and irregular situations (MIIS) and used descriptive analysis and a COVID-19 Vaccine Equity Index (CVEI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 1378 individuals responded to the survey (43.8% MIRS, 31.2% MIIS and 25% refugees). 87% reported receiving at least one dose of the COVID-19 vaccine. The CVEI at the global level (0.824) suggested differences in complete vaccination between migrants and other residents in most of the study countries (refugees reported more access to vaccines than MIRS and MIIS). However, the qualitative phase reported delays and inequities in the early stage of the vaccination process in all countries. Overall, 64.2% of respondents perceived that government\u2019 campaigns were successful. Both the qualitative and quantitative phases identified several barriers and facilitators. The main barriers included a lack of trust in authorities, extended waiting times and distance to vaccination centres, discrimination and xenophobia, lack of identity documentation, and adverse reaction concerns. On the other hand, the primary facilitators were the widespread distribution of vaccination centres, sources and provision of information, specific campaigns for refugees and migrants, free vaccination and the motivation to protect others\u2019 health.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Despite the high coverage of COVID-19 vaccines among refugees and migrants in the study countries, the process had significant barriers. Simple vaccination registration procedures, targeted campaigns, mobile vaccination teams for hard-to-reach and vulnerable groups, and building trust in the host country authorities are pivotal for future and inclusive vaccine deployments.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-087629","type":"journal-article","created":{"date-parts":[[2025,2,2]],"date-time":"2025-02-02T20:50:37Z","timestamp":1738529437000},"page":"e087629","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Deployment and uptake of COVID-19 vaccines for refugees and migrants in regular and irregular situations: a mixed-method multicountry study"],"prefix":"10.1136","volume":"15","author":[{"given":"Pierina","family":"Benavente","sequence":"first","affiliation":[{"name":"Department of Global Public Health and Primary Care, Faculty of Medicine, Pandemic Centre, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay N","family":"Kampalath","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Children\u2019s Hospital of Philadelphia, Division of Emergency Medicine, Philadelphia, Pennsylvania, USA"},{"name":"University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moussa Lonkila","family":"Zan","sequence":"additional","affiliation":[{"name":"Institut Sup\u00e9rieur des Sciences de la Population, Ouagadougou, Centre, Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7134-7878","authenticated-orcid":false,"given":"Nguyen Toan","family":"Tran","sequence":"additional","affiliation":[{"name":"University of Geneva Faculty of Medicine, Geneve, Switzerland"},{"name":"Australian Center for Public and Population Health Research, University of Technology Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"El\u017cbieta Anna","family":"Czapka","sequence":"additional","affiliation":[{"name":"Sociology Institute, University of Gda\u0144sk Faculty of Social Sciences, Gdansk, Pomorskie, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2109-5136","authenticated-orcid":false,"given":"Seyed-Moeen","family":"Hosseinalipour","sequence":"additional","affiliation":[{"name":"Geneva Centre of Humanitarian Studies, Faculty of Medicine, University of Geneva, Geneva, Switzerland"},{"name":"Geneva Cenre of Humanitarian Studies, Faculty of Medicine, University of Geneva, Geneve, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6979-5655","authenticated-orcid":false,"given":"Enrique","family":"Teran","sequence":"additional","affiliation":[{"name":"Universidad San Francisco de Quito, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Martens","sequence":"additional","affiliation":[{"name":"Instituto de Estudios Avanzados en Desigualdades, Universidad San Francisco de Quito, Quito, Pichincha, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biraj Man","family":"Karmacharya","sequence":"additional","affiliation":[{"name":"Kathmandu University, Dhulikhel, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjali","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Public Health, Kathmandu University School of Medical Sciences, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2966-7162","authenticated-orcid":false,"given":"Jai K","family":"Das","sequence":"additional","affiliation":[{"name":"Division of Women and Child Health, Aga Khan University, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra A","family":"Padhani","sequence":"additional","affiliation":[{"name":"Institute for Global Health and Development, Aga Khan University, Karachi, Pakistan"},{"name":"School of Public Health, University of Adelaide, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente B","family":"Jurlano","sequence":"additional","affiliation":[{"name":"The Demographic Research and Development Foundation, Inc, Quezon City, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Midea M","family":"Kabamalan","sequence":"additional","affiliation":[{"name":"College of Social Sciences and Philosophy, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laetitia","family":"Nyirazinyoye","sequence":"additional","affiliation":[{"name":"School of Public Health, 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