To be effective, COVID-19 vaccination plans must include migrants

A child vaccinated with support of IOM. Archival photo from March 2019. Photo: IOM/Andrea Empamano.

As we prepare for one of the world’s largest vaccination efforts, and on the occasion of International Migrants Day, we are coming to a critical reckoning: the need for inclusive approaches in our health-related thinking and practices has never been more urgent.

For everyone’s sake, we must ensure that the most vulnerable – including migrants, refugees, asylum seekers, internally displaced persons, and other people on the move – are not left out of our global efforts to fight back against COVID-19 and other diseases.  

Even a year after the beginning of the crisis, there continues to be tremendous suffering related to the pandemic, and it is too often those who need support and protection and assistance the most, who have the least access to it.

Currently, IOM estimates that there are nearly 272 million international migrants, in addition to 80 million forcibly displaced persons, more than two-thirds of whom are displaced within the borders of their countries due to conflict or natural disasters. Contrary to political rhetoric, most of these forcibly displaced persons live in low- or middle-income countries, which often have weaker health systems and struggle to meet the health needs of their own populations. 

The list of difficulties that migrants and forcibly displaced persons face across the world remains far too long: exclusion from health services happens through legal requirements, language barriers, prohibitive costs, and other factors. We have seen it again and again recently with COVID-19 testing and lack of access to essential health services. This is in addition to the frequently dangerous circumstances that mobile populations face before, during and after their journeys, which often place them at higher risk of falling ill. For example, they may live or work in overcrowded or unsafe conditions, have limited access to clean water and sanitation, or have disrupted continuity of care because of their relocation.  

This year we have learned the hard way that no one’s health is protected until everyone’s health is protected, and when we fail to protect everyone’s health, it can have serious, devastating impacts on all aspects of our societies, including our social, economic, and cultural fabric. Migrants have been particularly hit by the public health crisis and its consequences.

They have also been on the frontlines of the response to the pandemic, taking personal risks for everyone’s well-being, across many critical sectors: health, food, transport, research, hygiene, and others. In most high-income countries, migrants make up a large share of health workers; for example, in the United States, more than one in four physicians and surgeons are foreign-born and the OECD reports that, in the last decade, the number of foreign-born doctors and nurses in the region grew by 20 per cent. 

As IOM stands ready to support national authorities and other international organizations in the roll out of a COVID-19 vaccine, we call on Governments to count and include all migrants present in their territories – no matter their legal status – in their vaccine distribution considerations.  As health workers on the frontlines are prioritized, let’s not forget the countless migrant frontline health workers. As the elderly are prioritized, so should elderly migrants. As so on and so forth. 

The year ahead and the new tools available to fight COVID-19 are an opportunity to do better by migrants and by everyone, everywhere. As countries prepare to roll out mass vaccination campaigns, let us be reminded of the principles of universal health coverage, the duty to follow an equitable allocation process and leave no one behind. Decisions should be made based on sound, evidence-based public health rationales, in line with international prioritization recommendations. 

IOM is honoured to partner with Gavi, the Vaccine Alliance, and looks forward to working closely with the UN system, humanitarian partners and the COVAX Facility, in ensuring that vaccine allocation plans take migrants into account, including forcibly displaced persons in hard-to-reach locations and emergency settings. The Organization’s health teams have extensive experience in carrying out mass vaccination campaigns in response to outbreaks as well as routine immunization activities, for migrants and displaced populations, in collaboration with key partners, including Gavi, with whom a critical memorandum of understanding was signed on 24 November 2020. 

Today, more than ever, fairness, equity and inclusion could save thousands and thousands of lives.