VISTA
Research type
Research Study
Full title
Vaccine uptake and immunity screening assessments in migrant populations
IRAS ID
272480
Contact name
Manish Pareek
Contact email
Sponsor organisation
University of Leicester
Duration of Study in the UK
1 years, 4 months, 30 days
Research summary
Summary of Research
Migrants are an important group for targeted health programmes. One important public health intervention is vaccination against specific vaccine preventable diseases (VPD) such as measles. This has become especially critical recently as there have been an increasing number of outbreaks of VPDs including measles. Although data is limited, evidence from studies indicates that migrants, and especially refugees/asylum seekers, are at an increased risk of being incompletely vaccinated and therefore at risk of acquiring these infections.Assessing whether migrants are vaccinated is difficult and often inaccurate and relies on individuals remembering whether they have been previously vaccinated. Given the increase in rates of measles and other VPDs, and the fact that migrants are thought to be at increased risk of these illnesses, there is an urgent need to undertake a study to document vaccine uptake both subjectively (through reporting from the individual) and objectively through blood antibody testing.
We propose working with community partners and other organisations in Leicester with whom we have strong relationships. Working with our partners we will make individuals (aged ≥16 years and born overseas) aware of the study. Individuals interested in taking part will be provided with a simple participant information sheet and invited to an information and consent session. At this session a member of the research team will go through the study and take written informed consent. Only after written consent has been confirmed will the research team go through a simple vaccine questionnaire and offer to take a blood test to check antibody levels. Blood tests will be analysed at the Leicester Royal Infirmary to check for protection against measles, rubella and varicella (chicken-pox). At all times we will maintain absolutely strict confidentiality. We will write to the participants and their GP with their test results and recommended action.
Summary of Results
150 participants took part. One blood sample was discarded due to a labelling error and excluded from analysis resulting in a final sample of 149 participants. Results show 98% of the sample have seroprotection against chicken pox, 92% against rubella and 89.3% against measles. While seroprotection rates against varicella and rubella are close to or above the herd immunity thresholds (HIT, a point when a sufficient percentage of a population has become immune to an infection reducing risk of transmission and infection), measles was below the HIT of 95%. Seroprotection for measles was lower amongst migrants from Europe and Central Asia compared to those from Africa and the Middle East (73.7% vs 97.1%) or South Asia, East Asia and the Pacific (73.7% vs 93.4%).
We also found that migrants from Africa and the Middle East and South Asia, East Asia and Pacific regions were nearly 15 times more likely to be seroprotected against measles compared to those from Europe and Central Asia. Older migrants were more likely to have seroprotection against all three VPDs. Analysis also show that there is almost no agreement between participants’ self-reported vaccination and disease status with their laboratory assessed seroprotection status.
Discussion and Conclusion
This study provides the first data on seroprotection against measles, rubella and varicella amongst adult migrants living in the UK. Our finding that seroprotection rate for measles was below the HIT and that migrants from Europe and Central Asia (the majority of whom were from Eastern Europe) were least likely to have seroprotection against measles is in-line with previous European studies. Explanations for this observation may be found in the disturbance of health services by civil wars and low uptake of immunisation due to vaccine hesitancy. Our findings would support targeted catch-up vaccination to adult migrants, for example those coming from endemic regions/countries within Europe. Additionally, targeted public health messaging aimed at particular groups may provide an effective method of improving vaccine coverage amongst those at high risk of VPDs.REC name
London - Fulham Research Ethics Committee
REC reference
19/LO/1846
Date of REC Opinion
29 Nov 2019
REC opinion
Favourable Opinion