In 2015, a group of experienced and concerned international researchers came together to collectively address a global concern on immunization access and uptake by migrant and refugee populations.  Representing Canada, New Zealand, Australia, the Netherlands and Germany, we are working towards protecting and improving the health of migrant and refugee populations through immunization and protection from vaccine preventable diseases.  Research projects are being or will be conducted in each country with a view to meeting the overall research goal across countries through an integrated multinational strategy. We call ourselves The Monarch Collaboration on the basis that the Monarch Butterfly represents the immigrant experience, as their migration cycle is longer than their life span so no one butterfly makes the entire round trip. 


To protect and improve the health of migrant and refugee populations through advancing evidence-informed research into the factors associated with immunization access and equitable uptake, and contraction of vaccine preventable diseases.

Research Objectives

  1. What can we determine about the current immunization status of migrant and refugee populations (both adults and children) based on existing data? What are the information gaps?  How could these be best addressed?
  2. What are the current policies and practices of different host countries on immunization and access to health services?  How do different practices affect migrant and refugee immunization rates?
  3. What are the factors associated with migrant and refugee decision making on immunization in different sub-populations? 
    1. What are the knowledge levels and perceptions of migrant and refugee populations on infectious disease immunity, vaccines, vaccine availability and health policies? 
    2. What are the barriers and facilitators/enablers to immunization access?
    3. What are the reasons behind migrant and refugee immunization decisions for themselves and their families?
    4. How do health care professionals, health care providers and health systems influence immunization information and access?
    5. How do different cultural, religious and other perspectives influence immunization decisions?
  4. What do health care professionals know and understand about immunizations and about the specific issues of migrant and refugee populations related to access and uptake? What do they need to improve immunization information and access?
  5. Based on this acquired knowledge and understanding, how can immunization rates be improved for immigrant populations? 
    1. What types of risk communication and information are required? How can risk communication strategies be effectively targeted for different populations and scenarios?  
    2. What policies and practices optimize immunization access and uptake?
    3. What policies and risk communication strategies need to be adopted at regional, national and global level s(e.g. the World Health Organization) to address this important issue nationally and transnationally?