Unlike their parents, especially children and adolescents are lacking the vaccines in the Expanded Program of Immunization (measles, diphtheria, pertussis, tetanus, polio, BCG) during the migration process. Intervention teams have started immunization services as a priority when Syrians under temporary protection started the border crossing into Turkey from Syria. Considering the recommendations of WHO, vaccinations for polio, measles, rubella, mumps, etc. have been started in children. After that, vaccination schemes applied to children who are citizens of Turkey, also implemented to Syrian children under temporary protection.

WHO recommends the implementation of the vaccination scheme of the country to immigrant groups. Also babies born in Turkey need similar vaccines with babies of country. Because of that newborn babies are vaccinated also with the same vaccination scheme as the babies of the country. However in this group, make vaccinations exactly whenever possible, complete the missing vaccinations and keeping electronic records are essential requirements for a correct vaccination practice without missing vaccination opportunities and without causing repeated vaccinations. It is very important for immigrants to have information about the vaccination program and vaccines to be administered in their country and to keep all vaccination records.

Referecence: https://www.aa.com.tr/tr/dunya/suriyede-bir-milyon-cocuga-kizamik-asisi-yapilacak/1304090

Expanded Programme of Immunisation, especially for children, successfully implemented in Turkey for many years. The program, which was started in 1981, has reached very high coverage rates today. Vaccination rates have exceeded the 95% target for many vaccines.

Vaccination for Syrians under temporary protection has been carried out since April 2011. This vaccination studies can be grouped under 4 headings:

-Vaccination at border crossing

-Polio Mop-up vaccination

-Miss vaccination perfection fieldworks

-Routine vaccination and monitoring

• Vaccination at Border Crossing

Since the border crossings started, the following vaccines have been given to people migrating from Syria.

OPV : Oral Poliovirus Vaccination for 0-15 years old,

MMR : Measles-Mumps-Rubella vaccination for 9 months-15 years old,

DTaP-IPV-Hib : Diptheria, Tetanus, acellular Pertussis, Inactive Poliovirus, Haemophilus Influenza Type b for under 7 years old,

DTaP-IPV : Diptheria, Tetanus, acellular Pertussis, Inactive Poliovirus for 7-12 years old,

Td : Tetanus and Diphteria for women 15-49 years old.

Reference: https://www.timeturk.com/suriyeli-cocuklar-sinirda-asilaniyor/haber-722467

• Polio Mop-up Vaccination

Similar to mop-up studies conducted within the scope of Poliomyelitis Eradication in our country, 9 rounds of vaccination studies were conducted in 18 provinces in 2013-2014-2015 for the Syrian population under temporary protection. During the campaign, 800,793 doses of OPV were administered to the group under 5 years old.

• Miss Vaccination Perfection Fieldworks

In 2017, 3 rounds of miss vaccination perfection fieldworks were conducted in February, May and November in order to vaccinate babies and children who were not vaccinated, as well as infants and children aged 0-59 months whose vaccination was started but the vaccine doses were not completed in their follow-up. Fieldworks were carried out in 20 provinces where Syrians under temporary protection are concentrated or where the ratio to the local population is 5% and above (Adana, Adıyaman, Ankara, Bursa, Diyarbakır, Batman, Gaziantep, Hatay, İstanbul, İzmir, Kahramanmaraş, Kayseri, Kilis, Kocaeli, Konya, Malatya, Mardin, Mersin, Osmaniye and Şanlıurfa). 357,925 infants or children under 5 years were vaccinated in the fieldworks. During that, all vaccines were recorded in the electronic systems.

Reference: http://www.aljazeera.com.tr/al-jazeera-ozel/turkiyede-cocuk-felci-riski

• Routine Vaccination and Monitoring

For Syrians under temporary protection in our country, routine vaccination services, in accordance with our country’s national vaccination schedule specified in EPI, are provided to 0-11 months old babies, 15-49 age group women, school age children. Detailed information on vaccination for Syrians under temporary protection can be found in the Field Guide for Completing and Accelerating Vaccines for 0-59 months under Temporary Protection (May 2017) and its annexes.

Please feel free to ask anything about migrants’ health. Also, you can comment, what is your opinion? Do you see any migrants who are in need of health care? What do you think about your country’s migrant health policies? Your comments will guide us to write new posts. Thanks for reading.

 **Cover photo by voanews.com

References

1. BICA, M.A.;Clemens, R. Vaccination policies of immigrants in the EU/EEA Member States- the measles immunization example. Eur. J. Public Health 2018, 28, 439–444.
2. DE VITO, E., Parente P.,  de Waure C., Poscia A., Ricciardi W. A review of evidence on equitable delivery, Access and utilization of immunization  services for migrants and refugees in the WHO European Region. Health Evidence Network Synthesis Report.
3. Health Evidence Network Synthesis Report. Public health aspect of migrant health ; a review of the evidence of health status for refugees and asylum seekers in the European region http://www.euro.who.int/__data/assets/pdf_file/0004/289246/WHO-HEN-Report-A5-2-Refugees_FINAL.pdf (Erişim Tarihi: 02.02.2019)
4. http://www.euro.who.int/en/countries/turkey/news/news/2018/4/who-supports-turkey-to-ensure-full-immunization-of-refugee-children (Erişim tarihi:28.02.2019)
5. https://www.unicef.org/infobycountry/Turkey_100611.html (Erişim tarihi:28.02.2019)
6. http://www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/news/news/2017/11/new-hen-report-reveals-gaps-in-protection-of-refugees-and-migrants-from-vaccine-preventable-diseases (Erişim tarihi: 28.02.2019)
7. MACDONALD, N. E. (2015). Vaccine hesitancy: Definition, scope and determinants. Vaccine. doi:10.1016/j.vaccine.2015.04.036
8. MIPATRINI, D.,STEFANELLI, P., SEVERONI, S., REZZA, G., Vaccinations in migrants and refugees: a challenge for European health systems. A systematic review of current scientific evidence Pathogens and Global Health, 2017
9. NYHAN, B., REIFLER, J., RICHEY, S., & FREED, G. L. (2014). Effective messages in vaccine promotion: a randomized trial. Pediatrics, 133(4), e835-e842
10. T. C. Sağlık Bakanlığı. Temel Sağlık Hizmetleri Gn. Md. 13.03.2009 tarih, 7941 sayılı  Genişletilmiş Bağışıklama Programı Genelgesi, 2009.
11. T. C. Sağlık Bakanlığı. Temel Sağlık Hizmetleri Gn. Md.  Aşı Sonrası İstenmeyen Etkiler (ASİE) Genelgesi, 2009.
12. World Health Organization available from: http://www.who.int/migrants/about/mh-factsheet.pdf?ua=1 (Erişim tarihi:23.10. 2018)
13. Vaccine Rejection and Hesitancy: A Review and Call to Action. Smith TC. Open Forum Infect. Dis. 2017 Summer; 4(3): ofx146
14. WHO-EURO. HEALTH EVIDENCE NETWORK SYNTHESIS REPORT .A review of evidence on equitable delivery, Access and utilization of immunization services for migrants and refugees in the WHO European Region. 2017
15. WHO-EURO. How to respond to vocal vaccine deniers in public? 2018.