Tactics employed by healthcare providers in Denmark to determine the vaccination needs of asylum-seeking children: a qualitative study

• Published in: BMC health services research Vol. 18; no. 1; p. 859
• Main Authors: Nakken, Cathrine S, Norredam, Marie, Skovdal, Morten
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 14.11.2018; BioMed Central; BMC
• Subjects: Adolescent; Aged; Allied Health Personnel - organization & administration; Asylum-seeking children; Care and treatment; Child; Child, Preschool; Children & youth; Denmark; Documentation; Families & family life; Female; Health care; Health Personnel - organization & administration; Health services; Healthcare workers; Humans; Immunization; Infant; Interviews; Male; Measles; Medical care needs assessment; Medical personnel; Medical screening; Methods; Middle Aged; Needs Assessment; Nurses; Parents; Professional ethics; Professional Practice - organization & administration; Public health; Qualitative Research; Referral and Consultation; Refugee children; Refugees; Refugees - statistics & numerical data; Tactics; Vaccination; Vaccines; Denmark; Europe; Germany; Tactics; Asylum-seeking children; Immunization; Vaccination; Denmark; Healthcare workers; Refugee children
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-018-3661-1

Many asylum-seekers to Denmark come from war-torn countries where conflict and insufficient health care infrastructures disrupt vaccine programmes and result in very few children and their families presenting documentation of vaccinations on their arrival in asylum-centers. There is a need to explore how healthcare providers, in the absence of vaccine documentation, determine the vaccination needs of newly arrived refugee children. To explore the tactics employed by healthcare professionals who screen and vaccinate asylum-seeking children in Denmark, we conducted semi-structured interviews between December 2015 and January 2016 with six healthcare professionals, including three doctors and three public health nurses. The interviews were digitally recorded, transcribed and subjected to a thematic network analysis. The analysis revealed that healthcare providers adopt a number of tactics to ascertain children's immunization needs. They ask into the children's vaccination history through the use of qualified interpreters; consult WHO lists of immunization programmes worldwide; draw on tacit knowledge about country vaccination programmes; consider the background of parents; err on the side of caution and revaccinate. This is one of the first studies to demonstrate the tactics employed by healthcare providers to ascertain the immunization needs of asylum-seeking children in a western receiving country. The findings suggest a need for clear guidance at a national level on how to determine the vaccination needs of asylum-seeking children, and an international effort to secure reliable immunization documentation for migrant populations, for example through virtual immunization records.