Open access

COVAX and the COVID-19 Vaccine for Refugees and Migrants: A Narrative Literature Review

Number of pages47
Master program titleMaster of Science in Global Health
Defense date2022-06-27

According to the United Nations, about 3.5% of the global population, or 272 million people, are migrants. Among these are an unprecedented 82 million, or approximately 1 in 30 people, who have been forcibly displaced from their homes. The ongoing Ukrainian crisis has recently compounded those figures. Despite the large global population of migrants, relatively little is known about the health needs of people “in transit,” including refugees and migrants both in regular and in irregular situations.

Populations who migrate, including refugees and migrants have experienced obstacles to get access to quality health care services. The COVID-19 pandemic has highlighted the existence of an inequity gap between the migrant and refugee populations and the general population. In high-income countries, for example, migrants were at higher risk of being infected by SARS-CoV-2 and were disproportionately represented in the fatalities. The situation is even more salient when considering refugees and migrants whose access to healthcare is constrained by fear of being deported, inability to speak the local language, lack of knowledge to navigate the local health system and social isolation.

Including migrants in vaccination campaigns has been recommended as a public health priority together with the need for more research. However, past research on immunization coverage demonstrates structural-level barriers to vaccine uptake among refugees and migrants, including disruption of health services delivery in the context of large-scale migration as well as individual-level barriers to access, such as knowledge, attitudes, and practices. Importantly for the on-going SARS-CoV-2 pandemic, the global shortage of vaccine supply and competition to secure doses in form of vaccine nationalism, has played a key role in low COVID-19 vaccination coverage among refugees and migrants.

COVAX, a multi-layered, complex Public-Private Partnership, was created under the framework of Access to COVID-19 Tools (ACT) Accelerator with one overarching goal: to ensure equitable access to COVID-19 vaccines. However, it has failed to ensure equitable access to vaccines for refugees and migrants.

Transparency and accountability issues inherent within COVAX’s structure, low representation of Civil Society Organizations and Low- and Middle- Income Countries, systemic exclusion of the United Nations High Commissioner for Refugees and International Organization for Migration from COVAX’s processes, reproduction of power in from of over-representation, failure to reach set targets, and weak allocation mechanisms for refugees and migrants are factors that have caused this failure, making COVAX unable to adhere to its principle of vaccine equity and solidarity.

  • SARS-CoV-2
  • COVID-19
  • Vaccine
  • ACT-Accelerator
  • Refugee
  • Migrant
Citation (ISO format)
HOSSEINALIPOUR, Seyed-Moeen. COVAX and the COVID-19 Vaccine for Refugees and Migrants: A Narrative Literature Review. 2022.
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Master thesis
  • PID : unige:164976

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