Catch-up vaccination policies for adolescent and adult migrants in LMICs

Background

Adolescent and adult migrants in LMICs are often under-immunised due to disrupted childhood vaccination and barriers to care, increasing risk of vaccine-preventable diseases. The WHO Immunization Agenda 2030 emphasises life-course vaccination and inclusion of marginalised groups in catch-up strategies (e.g. Td/Tdap, IPV, MR/MMR, HepB, HPV). While evidence from Europe shows migrants are frequently missed, it remains unclear how LMIC policies address adolescents and adults beyond child-focused programmes. We analysed catch-up and life-course vaccination policies across 136 LMICs.

Methods

Using framework analysis, we conducted a comparative review of national and subnational policies, guidance, and legal frameworks on catch-up and life-course vaccination for adolescent (10–19 years) and adult (>19 years) migrants (including refugees, asylum seekers, undocumented migrants, IDPs, and workers). Searches covered databases, grey literature, Ministry of Health websites, and international organisations (Jan 2000–Feb 2025), supplemented by consultation with national experts.

Results

Thirty-three sources (15 peer-reviewed; 18 grey literature) covered 57 LMICs. Migrant-inclusive catch-up or life-course policies for routine vaccines were rare, identified in only 9 (6.6%) of 136 LMICs. Of these, 3 were outbreak-driven, 4 relied on general schedules without migrant-specific guidance, and 2 included formal migrant entitlements. HPV (6 countries) and MR/MMR (5) were most commonly included. Only 3 countries recommended presumptive catch-up where history was unknown. In contrast, COVID-19 policies showed broader inclusion, with 57 (41.9%) LMICs documenting migrant-inclusive strategies.

Conclusions

Most LMICs lack policies ensuring access to catch-up vaccination for adolescent and adult migrants. Strengthening migrant-inclusive guidance, delivery systems, and entitlement frameworks is essential to reduce immunisation gaps.

Key messages

• Most low-and middle-income countries lack migrant-inclusive catch-up vaccination policies for adolescents and adults, leaving key populations under-immunised and vulnerable to preventable diseases.

• Clear entitlement, tailored guidance, and stronger delivery systems are urgently needed to ensure migrants can access catch-up vaccination across the life course.