The European Journal of Public Health
Volume 26, Issue 3, 1 June 2016
http://eurpub.oxfordjournals.org/content/26/3?current-issue=y

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Viewpoint
Public health needs of migrants, refugees and asylum seekers in Europe, 2015: Infectious disease aspects
Jan C. Semenza, Paloma Carrillo-Santisteve, Herve Zeller, Andreas Sandgren, Marieke J. van der Werf, Ettore Severi, Lucia Pastore Celentano, Emma Wiltshire, Jonathan E. Suk, Irina Dinca, Teymur Noori, Piotr Kramarz
DOI: http://dx.doi.org/10.1093/eurpub/ckw023 372-373 First published online: 6 April 2016
Extract
In the first 10 months of 2015 the total number of asylum applications to the European Asylum Support Office (EASO) recorded by European Union (EU) countries exceeded the 1 million mark, an unprecedented level since the establishment of the EU. Syria has been the most common country of origin of asylum applications, followed by Afghanistan and Iraq.1 However, these figures do not take unregistered migrants into account: in the same time period, 500 000 undocumented border crossing detections were recorded on the EU’s external borders, according to Frontex.2 In the light of these developments, the European Centre for Disease Prevention and Control (ECDC) assessed the public health needs of migrants or individuals that are applying for asylum or refugee status, through: (i) interviews with 14 experts from Member States and Non-Governmental Organizations with first-hand experience working with migrant populations (7–11 August 2015); (ii) a non-systematic review of available evidence (peer-reviewed publications and relevant ECDC risk assessments); and (c) an expert meeting on the prevention of infectious diseases among newly arrived migrants in the EU and European Economic Area (EEA) (12–13 November 2015).3–5
Reception system for newly arrived migrants
A recurrent theme across all the expert consultations conducted by ECDC was the need to establish a reception system for newly arrived migrants. In primary reception centres, a health assessment should be carried out immediately upon arrival. Equipping these reception areas with primary care and public health services facilitates screening, vaccination and treatment (if required) of individuals free of charge. The organisers of reception areas should consider adequately stocking them with rapid tests (e.g. for malaria) and providing instant treatment and care to patients. Such rapid interventions are the best course of action to detect and prevent onwards spread of cases of infectious disease, through the identification and management of infectious diseases with potential for …

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Infectious Diseases
Detrimental effects of introducing partial compulsory vaccination: experimental evidence
Cornelia Betsch, Robert Böhm
DOI: http://dx.doi.org/10.1093/eurpub/ckv154 378-381 First published online: 21 August 2015
Abstract
Background: During outbreaks of vaccine-preventable diseases, compulsory vaccination is sometimes discussed as a last resort to counter vaccine refusal. Besides ethical arguments, however, empirical evidence on the consequences of making selected vaccinations compulsory is lacking. Such evidence is needed to make informed public health decisions. This study therefore assesses the effect of partial compulsory vaccination on the uptake of other voluntary vaccines.
Method: A total of 297 (N) participants took part in an online experiment that simulated two sequential vaccination decisions using an incentivized behavioural vaccination game. The game framework bases on epidemiological, psychological and game-theoretical models of vaccination. Participants were randomized to the compulsory vaccination intervention (n = 144) or voluntary vaccination control group (n = 153), which determined the decision architecture of the first of two decisions. The critical second decision was voluntary for all participants. We also assessed the level of anger, vaccination attitude and perceived severity of the two diseases.
Results: Compulsory vaccination increased the level of anger among individuals with a rather negative vaccination attitude, whereas voluntary vaccination did not. This led to a decrease in vaccination uptake by 39% in the second voluntary vaccination (reactance).
Conclusion: Making only selected vaccinations compulsory can have detrimental effects on the vaccination programme by decreasing the uptake of voluntary vaccinations. As this effect occurred especially for vaccine hesitant participants, the prevalence of vaccine hesitancy within a society will influence the damage of partial compulsory vaccination.