Experiences of catch-up vaccination among adult migrants in the UK: An in-depth interview study

WHO's Immunization Agenda 2030 emphasises equitable access to vaccination across the life course, including migrants who may have missed childhood vaccinations due to disrupted healthcare systems or differing vaccination schedules. Uptake of adult catch-up vaccination is thought to be poor in the UK, but limited evidence exists to explain this. In-depth semi-structured interviews were carried out across two studies with different adult migrant populations on views and experiences around vaccination. Study 1 recruited those resident <10 years in the UK from a range of backgrounds (remote interviews, 09/2020-01/2022, REC2020.0058) and Study 2 (in-person, 01/2022-03/2022, REC2021.0128) engaged Congolese and Angolan migrants. Interviews were conducted in English, Lingala or French and were audio-recorded, transcribed, and analysed through qualitative content analysis in NVivo 12. 71 participants were interviewed (mean age 43.6 [SD:12.4], 69% female, mean 9.5 [SD:7] yrs in UK). Most reported having never been offered or asked about vaccination history in the UK. Participants more often reported being offered seasonal or selective vaccinations (flu [n = 20], travel-related [n = 8], pregnancy-related [pertussis, n = 7]) compared to catch-up vaccines (MMR (n = 3), DTP (n = 3)) in the UK. Generally, participants were not aware of catch-up vaccination but viewed it mostly positively. Concerns included side effects, barriers to attending primary care facilities, and vaccination fatigue. Trust was an important factor in vaccination decisions, and participants expressed varying levels of trust towards healthcare professionals’ recommendations and the NHS. There is a need to increase opportunities for catch-up vaccination in primary care by incentivisation of catch-up vaccination and education of healthcare professionals. Low trust and concerns around safety exist in some migrant groups, for which tailored information campaigns or community-led interventions could be developed. KEY MESSAGES: • There is a need to increase opportunities for catch-up vaccination in primary care. • Low trust and concerns around safety exist in some migrant groups, for which tailored information campaigns or community-led interventions could be developed.