Improving the Health of Immigrant and Refugee Women and Children through Immunization

Significance and Impact
Recent outbreaks of vaccine preventable diseases have underscored the urgent need to improve immunization rates in Canada and internationally to reduce adverse health impacts and achieve herd immunity targets. Concurrently, increasing globalization is resulting in escalating levels of population mobility and immigration, including unprecedented numbers of refugees. Immigrants and refugees are often particularly susceptible to vaccine preventable diseases because they may be lacking adequate immunization and may be more vulnerable to disease. Immunization is particularly important for women of reproductive age, as women are particularly vulnerable when pregnant.  Mothers also usually make immunization decision for their children. More than one-third of new immigrants and refugees in Canada (particularly women) are estimated to be susceptible to measles, mumps and/or rubella, and rates of hospitalization for vaccine preventable diseases are significantly higher for these populations than in the native-born population. However, information on the immunization status of immigrant and refugee populations in Canada, and the factors that influence immunization decision-making in these groups, is generally limited. Immunization is one of the most successful and effective means of improving the health of immigrants and refugees, and protecting the health of residents of their host countries.

Research Goals
The goal of this research is to protect and improve the health of immigrant and refugee women of reproductive age and their children through an empirically grounded understanding of the factors associated with immunization access and uptake, thus facilitating higher immunization rates. A secondary goal is to develop means of identifying the current immunization status of immigrant populations.

The research will involve: 1) focus groups with different populations of immigrant/refugee women of reproductive age (including mothers) across Canada to determine their knowledge and decision-making processes on immunization for themselves and their children; 2) development of targeted messages in different languages and formats to be tested for effectiveness through further focus groups; and 3) a feasibility study on linking administrative databases on immigrants/refugees and immunization to determine immunization status of these populations. The research is being conducted under the auspices of an international collaboration investigating this issue globally.

Research Team
An exceptionally experienced and committed team of Canadian and international researchers has been assembled for this collaboration, representing the range of diverse disciplinary perspectives and experience required to address this complex research area.  The team also consists of a variety of appropriate Principal Knowledge Users and Collaborators, including government decision-makers, health organizations and community organizations, who will facilitate the development of research and uptake of results into policy and practice.  The research team members are:

Canadian Research Team

  • Cindy Jardine (Nominated Principal Applicant), University of the Fraser Valley

  • S. Michelle Driedger (Principal Applicant), University of Manitoba

  • Shelley Canning (Principal Applicant), University of the Fraser Valley

  • Chuck Hui (Principal Applicant), University of Ottawa

  • Stephanie Kowal (Co-Applicant), University of Alberta

  • Alan Katz (Co-Applicant), University of Manitoba

  • Tony Barozzino (Co-Applicant), University of Toronto

  • Chris Greenaway (Co-Applicant), McGill University

  • Kevin Pottie (Co-Applicant), University of Ottawa

International Research Team

  • Nikki Turner (Principal Applicant), University of Auckland

  • Lesley Gray (Principal Applicant), Otago University

  • Anita Heywood (Principal Applicant), University of New South Wales

  • Frederic Bouder (Principal Applicant), Maastricht University

  • Barbara Rath (Principal Applicant), Vienna Vaccine Safety Initiative

  • Nadia Charania (Co-Applicant), Auckland University of Technology

Knowledge Users and Collaborators

  • Tim Hilderman (Knowledge User), Manitoba Health, Seniors and Active Living

  • Margaret Haworth-Brockman (Knowledge User), National Collaborating Centre for Infectious Disease

  • Kumanan Wilson (Knowledge User), University of Ottawa

  • Lucie Marisa Bucci (Collaborator), Immunize Canada

  • Susan Smith (Collaborator), Alberta Health

  • Yvonne Chui (Collaborator), Multicultural Health Brokers Cooperative

  • Louisa Taylor, Refugee 613

Funded by the Canadian Institutes of Health Research (CIHR) under the Improved Immunization Coverage Initiative (IM2-151604)