Health System Barriers to Child Mandatory and Optional Vaccination among Ukrainian Migrants in Poland in the Context of MMR and HPV Vaccines—A Qualitative Study

Maria Ganczak (), Paweł Kalinowski, Oskar Pasek, Łukasz Duda-Duma, Ewa Sobieraj, Jakub Goławski, Daniel Biesiada, Danielle Jansen, Johanna P. M. Vervoort, Michael Edelstein and Marta Kowalska
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Maria Ganczak: Department of Infectious Diseases, Collegium Medicum, University of Zielona Gora, 65-417 Zielona Gora, Poland
Paweł Kalinowski: Department of Hygiene and Epidemiology, Medical University of Lublin, 20-059 Lublin, Poland
Oskar Pasek: Student Research Group, Collegium Medicum, University of Zielona Gora, 65-417 Zielona Gora, Poland
Łukasz Duda-Duma: Student Research Group, Collegium Medicum, University of Zielona Gora, 65-417 Zielona Gora, Poland
Ewa Sobieraj: Student Research Group, Collegium Medicum, University of Zielona Gora, 65-417 Zielona Gora, Poland
Jakub Goławski: Student Research Group, Collegium Medicum, University of Zielona Gora, 65-417 Zielona Gora, Poland
Daniel Biesiada: Primary Care Clinic “Lancet”, 73-240 Bierzwnik, Poland
Danielle Jansen: Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands
Johanna P. M. Vervoort: Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands
Michael Edelstein: Ziv Medical Center, Safed 7404703, Israel
Marta Kowalska: Department of Hygiene and Epidemiology, Medical University of Lublin, 20-059 Lublin, Poland

IJERPH, 2022, vol. 20, issue 1, 1-20

Abstract: Background Migrants’ access to healthcare services is limited. This study aimed to identify health system barriers to vaccination, specifically HPV/MMR vaccination among children in Ukrainian economic migrants (UMs). Methods Between December 2021–March 2022, a qualitative study of UMs living in Poland was conducted. Six focus groups were held with 53 UMs aged 15–45; in-depth interviews with 12 healthcare workers (HCWs) were also performed. A thematic analysis was conducted based on the six WHO health system building blocks. Results HCWs described gaps in integrating migrant status in accessible healthcare data which impeded active management of vaccination procedures. UMs reported that the digitization of healthcare services, intensified during the COVID-19 pandemic, reduced their access to primary care. Inadequate health information systems caused problems with the provision of credible vaccine information in translated forms, and language difficulties, experienced by both UMs and HCWs; this was enhanced by a lack of professional interpreting services. Although most UMs reported vaccinating children according to the Polish schedule, the variations in schedules across countries caused concern among UMs and increased HCWs’ uncertainty about how to interpret vaccination cards, particularly in the context of possible false certificates. UMs were affected by discrimination through HCWs. HPV was deprioritized by UMs due to misconceptions about non-mandatory vaccinations; the cost was also a barrier. Conclusions The study findings have implications for migrant vaccination delivery targeting children in Poland, and other UMs receiving countries. A concerted effort is required to improve UM’s awareness of the significance of vaccinations. Barriers to healthcare access must be recognized by policymakers. Importantly, removing the cost barrier may increase the uptake of the HPV vaccine among Ukrainian migrant adolescents.

Keywords: vaccination; MMR; HPV; children; healthcare system barriers; migrants; Ukraine (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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