{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T09:28:04Z","timestamp":1786354084603,"version":"build-2736575974"},"reference-count":37,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004154","name":"Mae Fah Luang University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004154","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/00mwhaw71","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background: Children of Myanmar migrants in Thailand have lower immunization coverage compared to Thai counterparts, leaving them at risk of vaccine preventable diseases. Evidence remains limited regarding immunization among Myanmar children in Chiang Rai Province, an important migration corridor between Northern Thailand and Myanmar. Objective: this study aimed to estimate the immunization status and identify its associated factors among children of Myanmar migrants in Chiang Rai province, Northern Thailand. Methods: A cross-sectional study was conducted among Myanmar migrant caregivers and their children aged under 7 years, who are residing in Chiang Rai Province, using a validated questionnaire by face-to-face interview. Descriptive statistics was used to summarize participant characteristics, while chi-square tests and binary logistic regressions were used to identify associated factors with statistical significance set at \u03b1&lt; 0.05. Results: Among 423 children, 91 children (21.5%) were found as having incomplete immunization and six factors were significantly associated with it, including lacking Thai birth registration (aOR = 9.52; 95% CI: 3.74\u201324.27), lacking child\u2019s health insurance (aOR = 14.03; 95% CI: 6.45\u201330.54), history of return migration (aOR = 19.05; 95% CI: 8.48\u201344.13), negative peer practices (aOR = 8.09, 95% CI: 1.47\u201344.54), time barrier (aOR = 4.09, 95% CI: 1.20\u201313.94) and financial barrier (aOR = 7.07, 95% CI: 1.67\u201329.91). Conclusions: A moderate prevalence of incomplete immunization was strongly associated with factors across the levels of the modified socio-ecological model: intrapersonal, interpersonal, and institutional. Interventions addressing legal access, health insurance, community outreach, healthcare system responsiveness and cross-border continuity of care are recommended.<\/jats:p>","DOI":"10.3390\/medsci14040452","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T10:24:07Z","timestamp":1785752647000},"page":"452","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated with Immunization Status Among Myanmar Migrant Children in Northern Thailand: A Community-Based Cross-Sectional Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Shin Moe","family":"Oo","sequence":"first","affiliation":[{"name":"Public Health Department, School of Health Science, Mae Fah Luang University, Mueang, Chiang Rai 57100, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8055-6812","authenticated-orcid":false,"given":"Pamornsri","family":"Inchon","sequence":"additional","affiliation":[{"name":"Public Health Department, School of Health Science, Mae Fah Luang University, Mueang, Chiang Rai 57100, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0106-9988","authenticated-orcid":false,"given":"Peeradone","family":"Srichan","sequence":"additional","affiliation":[{"name":"Public Health Department, School of Health Science, Mae Fah Luang University, Mueang, Chiang Rai 57100, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kriengkrai","family":"Prasert","sequence":"additional","affiliation":[{"name":"Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakon Nakhon Campus, Mueang, Sakon Nakhon 47000, Thailand"},{"name":"Clinical Research Center, Nakhon Phanom Hospital, Mueang, Nakhon Phanom 48000, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,2]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2026, July 20). Vaccines and Immunization. Available online: https:\/\/www.who.int\/health-topics\/vaccines-and-immunization#tab=tab_1."},{"key":"ref_2","unstructured":"World Health Organization (2020). Immunization Agenda 2030: A Global Strategy to Leave No One Behind, World Health Organization."},{"key":"ref_3","unstructured":"World Health Organization (2026, July 20). Immunization Coverage. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/immunization-coverage."},{"key":"ref_4","unstructured":"United Nations Children\u2019s Fund (UNICEF) (2026, July 20). Immunization and Conflict. Available online: https:\/\/www.unicef.org\/immunization\/immunization-and-conflict."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Hui, C., Dunn, J., Morton, R., Staub, L.P., Tran, A., Hargreaves, S., Greenaway, C., Biggs, B.A., Christensen, R., and Pottie, K. (2018). Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU\/EEA: A Systematic Review. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15102065"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.puhe.2019.04.008","article-title":"Exploring childhood immunization among undocumented migrants in Sweden-following qualitative study and the World Health Organizations Guide to Tailoring Immunization Programmes (TIP)","volume":"171","author":"Lindstrand","year":"2019","journal-title":"Public Health"},{"key":"ref_7","first-page":"114","article-title":"Uptake of Immunization and Its Determinants among Children of Migrant Population Residing in Amreli, Gujarat, India","volume":"5","author":"Savani","year":"2023","journal-title":"Pediatr. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"211","DOI":"10.15171\/ijhpm.2018.127","article-title":"The Impact of Conflict on Immunisation Coverage in 16 Countries","volume":"8","author":"Grundy","year":"2019","journal-title":"Int. J. Health Policy Manag."},{"key":"ref_9","unstructured":"World Health Organization, and United Nations Children\u2019s Fund (UNICEF) (2022). Myanmar: WHO and UNICEF Estimates of Immunization Coverage: 2021 Revision, United Nations Children\u2019s Fund (UNICEF)."},{"key":"ref_10","unstructured":"World Health Organization (2026, July 20). Thailand EPI Factsheet 2024. Available online: https:\/\/www.who.int\/publications\/i\/item\/thailand-epi-factsheet-2024."},{"key":"ref_11","unstructured":"Department of Disease Control (2024). Measles: Situation in Thailand of a Vaccinepreventable Disease."},{"key":"ref_12","unstructured":"Department of Disease Control (2024). Pertussis Can Be Prevented with a Vaccine."},{"key":"ref_13","unstructured":"United Nations Network on Migration in Thailand (2024). Thailand Migration Report 2024, United Nations Network on Migration in Thailand."},{"key":"ref_14","unstructured":"International Organization for Migration (2024). Methodology for Estimating the Size of the Myanmar Migrant Population in an Irregular Situation in Thailand, International Organization for Migration."},{"key":"ref_15","unstructured":"Chiang Rai Provincial Labor Office (2025). Chiang Rai Provincial Labor Situation Report, 2024 (January\u2013December), Chiang Rai Provincial Labor Office."},{"key":"ref_16","unstructured":"United Nations Children\u2019s Fund (UNICEF) (2026, July 20). Multiple Humanitarian Crises Endanger Children in Myanmar. Available online: https:\/\/www.unicef.org\/myanmar\/."},{"key":"ref_17","unstructured":"World Health Organization (2026, July 20). New WHO Global Evidence Review on Health and Migration Underscores How the Implementation of Inclusive Immunization Plans Is Critical for Member States to Achieve Universal Health Coverage. Available online: https:\/\/www.who.int\/news\/item\/12-07-2022-new-who-global-evidence-review-on-health-and-migration-underscores-how-the-implementation-of-inclusive-immunization-plans-is-critical-for-member-states-to-achieve-universal-health-coverage."},{"key":"ref_18","first-page":"121","article-title":"Factors Associated with Immunization Status among Myanmar Migrant Children Aged 1\u20132 Years in Tak Province, Thailand","volume":"29","author":"Prakunwisit","year":"2017","journal-title":"J. Health Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1007\/s10903-015-0294-x","article-title":"Immunization Coverage in Migrant School Children Along the Thailand-Myanmar Border","volume":"18","author":"Kaji","year":"2016","journal-title":"J. Immigr. Minor Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"528","DOI":"10.2471\/BLT.10.084244","article-title":"Barriers to immunization among children of migrant workers from Myanmar living in Tak province, Thailand","volume":"89","author":"Canavati","year":"2011","journal-title":"Bull. World Health Organ."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"49","DOI":"10.2147\/RMHP.S130442","article-title":"Evolution and complexity of government policies to protect the health of undocumented\/illegal migrants in Thailand-the unsolved challenges","volume":"10","author":"Suphanchaimat","year":"2017","journal-title":"Risk Manag. Healthc. Policy"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Chamchan, C., and Apipornchaisakul, K. (2022). Health insurance status of cross-border migrant children and the associated factors: A study in a Thai-Myanmar border area. BMC Health Serv. Res., 22.","DOI":"10.1186\/s12913-022-08681-0"},{"key":"ref_23","unstructured":"World Health Organization (2022). Behavioural and Social Drivers of Vaccination: Tools and Practical Guidance for Achieving High Uptake, World Health Organization."},{"key":"ref_24","unstructured":"World Health Organization (2022). Ensuring the Integration of Refugees and Migrants in Immunization Policies, Planning and Service Delivery Globally, World Health Organization."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Pinna, C., Kaewkungwal, J., Hattasingh, W., Swaddiwudhipong, W., Methakulchart, R., Moungsookjareoun, A., and Lawpoolsri, S. (2020). Evaluation of Immunization Services for Children of Migrant Workers Along Thailand-Myanmar Border: Compliance with Global Vaccine Action Plan (2011\u20132020). Vaccines, 8.","DOI":"10.3390\/vaccines8010068"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1177\/109019818801500401","article-title":"An ecological perspective on health promotion programs","volume":"15","author":"McLeroy","year":"1988","journal-title":"Health Educ. Q."},{"key":"ref_27","unstructured":"International Organization for Migration (2024). Overview of Myanmar Nationals in Thailand, International Organization for Migration."},{"key":"ref_28","unstructured":"Wikimedia Commons (2026, July 20). Amphoe Chiang Rai.svg. Available online: https:\/\/commons.wikimedia.org\/w\/index.php?curid=6632097."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"6598","DOI":"10.1016\/j.vaccine.2011.06.115","article-title":"Validity and reliability of a survey to identify vaccine-hesitant parents","volume":"29","author":"Opel","year":"2011","journal-title":"Vaccine"},{"key":"ref_30","first-page":"227","article-title":"Expanded Program on Immunization (EPI) for children of Myanmar migrants living in Bangkok Thailand","volume":"21","author":"Kantayaporn","year":"2013","journal-title":"J. Popul. Soc. Stud."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3026","DOI":"10.1080\/21645515.2018.1496769","article-title":"Exploring immunisation inequities among migrant and refugee children in New Zealand","volume":"14","author":"Charania","year":"2018","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s13561-017-0149-3","article-title":"Does birth under-registration reduce childhood immunization? Evidence from the Dominican Republic","volume":"7","author":"Brito","year":"2017","journal-title":"Health Econ. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Tu, P., Smith, D., Parker, T., Pejavara, K., Michener, J.L., and Lin, C. (2023). Parent-Child Vaccination Concordance and Its Relationship to Child Age, Parent Age and Education, and Perceived Social Norms. Vaccines, 11.","DOI":"10.3390\/vaccines11071210"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e006860","DOI":"10.1136\/bmjgh-2021-006860","article-title":"Parent-level barriers to uptake of childhood vaccination: A global overview of systematic reviews","volume":"6","author":"Kaufman","year":"2021","journal-title":"BMJ Glob. Health"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e061346","DOI":"10.1136\/bmjopen-2022-061346","article-title":"Association between childhood immunisation coverage and proximity to health facilities in rural settings: A cross-sectional analysis of Service Provision Assessment 2013\u20132014 facility data and Demographic and Health Survey 2015\u20132016 individual data in Malawi","volume":"12","author":"Johns","year":"2022","journal-title":"BMJ Open"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1136\/jech-2017-210296","article-title":"Socioeconomic inequalities in child vaccination in low\/middle-income countries: What accounts for the differences?","volume":"72","author":"Hajizadeh","year":"2018","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.4314\/ahs.v19i1.33","article-title":"Relationship between household wealth and childhood immunization in core-North Nigeria","volume":"19","author":"Adebowale","year":"2019","journal-title":"Afr. Health Sci."}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/4\/452\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T08:31:03Z","timestamp":1786350663000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/4\/452"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,2]]},"references-count":37,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["medsci14040452"],"URL":"https:\/\/doi.org\/10.3390\/medsci14040452","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,2]]}}}