Evidence map›Paper›PMID 38702767›Full record

ArticleBMC medicine2024

Driving delivery and uptake of catch-up vaccination among adolescent and adult migrants in UK general practice: a mixed methods pilot study.

Alison F Crawshaw, Lucy P Goldsmith, Anna Deal, Jessica Carter, Felicity Knights, Farah Seedat, Karen Lau, Sally E Hayward, Joanna Yong, Desiree Fyle and 7 more

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In one paragraph

Article in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Alison F CrawshawMigrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
Lucy P GoldsmithPopulation Health Research Institute, St George's, University of London, London, UK.
Anna DealMigrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
Jessica CarterMigrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
Felicity KnightsMigrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
Farah SeedatMigrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
Karen LauMigrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
Sally E HaywardMigrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
Joanna YongNHS North Central London Research Network (NoCLoR) and Clinical Research Network (CRN) North Thames, London, UK.
Desiree FyleNHS North Central London Research Network (NoCLoR) and Clinical Research Network (CRN) North Thames, London, UK.
Nathaniel AsprayMigrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
Michiyo IwamiMigrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
Yusuf CiftciMigrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
Fatima WurieAddiction and Inclusion Directorate, Office for Health Improvement and Disparities, Department of Health and Social Care, 39 Victoria Street, London, SW1H 0EU, UK.
Azeem MajeedDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Alice S ForsterOur Future Health, Manchester, UK.
Sally HargreavesMigrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK. shargrea@sgul.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMigrants in the UK and Europe face vulnerability to vaccine-preventable diseases (VPDs) due to missed childhood vaccines and doses and marginalisation from health systems. Ensuring migrants receive catch-up vaccinations, including MMR, Td/IPV, MenACWY, and HPV, is essential to align them with UK and European vaccination schedules and ultimately reduce morbidity and mortality. However, recent evidence highlights poor awareness and implementation of catch-up vaccination guidelines by UK primary care staff, requiring novel approaches to strengthen the primary care pathway.

methodsThe 'Vacc on Track' study (May 2021-September 2022) aimed to measure under-vaccination rates among migrants in UK primary care and establish new referral pathways for catch-up vaccination. Participants included migrants aged 16 or older, born outside of Western Europe, North America, Australia, or New Zealand, in two London boroughs. Quantitative data on vaccination history, referral, uptake, and sociodemographic factors were collected, with practice nurses prompted to deliver catch-up vaccinations following UK guidelines. Focus group discussions and in-depth interviews with staff and migrants explored views on delivering catch-up vaccination, including barriers, facilitators, and opportunities. Data were analysed using STATA12 and NVivo 12.

resultsResults from 57 migrants presenting to study sites from 18 countries (mean age 41 [SD 7.2] years; 62% female; mean 11.3 [SD 9.1] years in UK) over a minimum of 6 months of follow-up revealed significant catch-up vaccination needs, particularly for MMR (49 [86%] required catch-up vaccination) and Td/IPV (50 [88%]). Fifty-three (93%) participants were referred for any catch-up vaccination, but completion of courses was low (6 [12%] for Td/IPV and 33 [64%] for MMR), suggesting individual and systemic barriers. Qualitative in-depth interviews (n = 39) with adult migrants highlighted the lack of systems currently in place in the UK to offer catch-up vaccination to migrants on arrival and the need for health-care provider skills and knowledge of catch-up vaccination to be improved. Focus group discussions and interviews with practice staff (n = 32) identified limited appointment/follow-up time, staff knowledge gaps, inadequate engagement routes, and low incentivisation as challenges that will need to be addressed. However, they underscored the potential of staff champions, trust-building mechanisms, and community-based approaches to strengthen catch-up vaccination uptake among migrants.

conclusionsGiven the significant catch-up vaccination needs of migrants in our sample, and the current barriers to driving uptake identified, our findings suggest it will be important to explore this public health issue further, potentially through a larger study or trial. Strengthening existing pathways, staff capacity and knowledge in primary care, alongside implementing new strategies centred on cultural competence and building trust with migrant communities will be important focus areas.

Indexed as

General PracticeTransients and MigrantsVaccinationAdolescentAdultFemaleHumansMaleMiddle AgedPilot ProjectsUnited KingdomYoung AdultCatch-up vaccinationHealth inequalitiesHealth systemsImmunisationMigrantsPrimary careTransients and migrantsVaccinationVaccine-preventable diseases

Identifiers

PMID38702767
PMCPMC11068568

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.