Peer-reviewed article
Low Childhood Vaccination Coverage among Ukrainian Refugees in Norway. A Nationwide, Register-Based Cohort Study, 2022–2023
Evy Therese Dvergsdal, Suzanne Campbell, Nora Dotterud Lerstad, Margrethe Greve‐Isdahl, Angela Susan Labberton et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined vaccination coverage among Ukrainian refugee children in Norway compared to the national population. Ukrainian refugee children who arrived after February 2022 had much lower vaccination coverage than Norwegian children across all age groups, ranging from 9% to 60% depending on age and vaccine type. Children born in Norway to Ukrainian refugee parents had coverage rates above 91%, similar to Norwegian children. The researchers identified gaps in catch-up vaccination access, vaccine registration systems, and possible vaccine hesitancy as key barriers.
Key points
- Ukrainian refugee children (N=8,804) had vaccination coverage of 39.5-60.5% at age 2, compared to 95.8-96.5% nationally
- 31% of Ukrainian refugee children had no vaccinations registered in the Norwegian immunisation registry
- Children born in Norway to Ukrainian refugee parents had coverage rates >91%, similar to Norwegian children
- HPV catch-up vaccination coverage among Ukrainian refugee boys was only 9%, while routine HPV vaccination coverage was 63%
- Large differences existed between routine and catch-up vaccination programs, suggesting access and registration issues
Limitations
The study cannot explain the reasons for low coverage, such as whether it reflects vaccine hesitancy, lack of access to catch-up vaccination services, missing documentation of vaccines given in Ukraine, or other barriers. The study is also limited to Ukrainian refugees in Norway and may not reflect the situation in other European countries.
Abstract
Low vaccination coverage is highlighted as a challenge in Ukraine and among Ukrainian refugees, however there is limited knowledge on coverage among Ukrainian refugees living in European countries. Individual-level data from the National Population Register for children (<20 years) with at least one parent from Ukraine were linked to the Norwegian Immunisation Registry (SYSVAK). We estimated vaccination coverage according to Norwegian Childhood Immunisation Program recommendations among 1) Ukrainian refugee children (i.e. immigrated after 01.02.2022) (N = 8,804) and 2) children born in Norway to Ukrainian refugee parent(s) (N = 224), compared to national coverage. National coverage rates were 95.8% to 96.5% (2-year-olds), 94.5% to 96.7% (9-year-olds), and 90.0% to 94.0% (16-year-olds). Corresponding rates among Ukrainian refugee children were 39.5% to 60.5%, 27.3% to 58.6%, and 9.2% to 34.3%, respectively. Coverage among Norwegian-born children of Ukrainian refugees was >91%. In all, 31% of Ukrainian refugee children had no vaccinations registered in SYSVAK. Coverage for Human Papilloma Virus (HPV) catch-up vaccination among Ukrainian refugee boys was lowest (9%), however, routine HPV vaccination coverage was 63%. Ukrainian children with a refugee background showed lower vaccination coverage than the national coverage. We found large differences between routine versus catch-up vaccination. Our findings suggest that access to catch-up vaccination, routines for retrospective registration of vaccines given outside of Norway and surveillance reporting, as well as vaccine hesitancy should all be considered when assessing childhood vaccination coverage among Ukrainian refugees. These factors should be addressed to improve vaccine uptake and surveillance in this population.