For millions of refugees and asylum seekers around the world, death may seem more merciful than what they have to endure before, during, and after migration, especially during a pandemic that has crippled even the strongest of countries.
When we talk about health equity and disparity, we mostly think about unequal distribution of and access to healthcare services. Many citizens of developed countries generally have access to preventive healthcare screenings. By contrast, refugees, asylum seekers, and undocumented immigrants generally have limited or no access to healthcare due to the lack of health insurance, fear of using healthcare benefits that might negatively impact their immigration status, or cultural barriers and discrimination.
Governments have exploited the pandemic to implement restrictive immigration policies. The United States issued blanket entry bans and expelled thousands of asylum seekers and unaccompanied children despite protests from public health leaders to respect humanitarian laws. Moreover, structural racism is happening widely around the world over vaccine access, vaccine branding, and even vaccine manufacturing sites. For example, millions of people from low- and middle-income countries who received vaccines of the same recipe, but which were manufactured outside of the U.K. or Europe, are barred from entering Europe.
On the one hand, developed countries have superfluous vaccines, many of which are on the verge of expiring due to vaccine hesitancy fueled by conspiracies propagated on social media. On the other hand, people in developing countries are signing up months in advance to receive their first shot of any vaccine that comes their way.
The majority of displaced individuals live in low-income countries that have received only 0.2 percent of COVID vaccines and which are struggling to secure enough vaccines for their own citizens. Many foreign migrants in developed countries serve as front-line workers, yet they face barriers to getting vaccinated.
Domestic healthcare workers and populations at-most risk were prioritized in the recommended vaccine allocation mechanisms. Foreign-born migrants, asylum seekers, and refugees make a significant portion of at-risk populations due to the inherent housing situations in detention and refugee camps and because many of them suffer from co-morbidities and are unable to maintain social distancing or public health measures. Instead of developing inclusive vaccine rollout frameworks, we witnessed solitary confinement of asylum seekers in detention centers in the United States, evictions of asylum seekers in England during the second COVID-19 wave, evictions from tent cities of pandemic refugees in Brazil, halting of rescue missions in the Mediterranean, and increased xenophobia everywhere.
What does it take to change?
Let’s take the selfish route. None of us can be completely safe if any group or nation is left behind. To achieve herd immunity, vaccine access should be a basic right. We all eagerly want our lives back. That can only happen with herd immunity. Creativity in developing and enforcing immigration policies should be rooted in humanitarianism and empathy, not xenophobia and nationalism. After all, we all depend on one another in various ways, especially to stay healthy.
As individuals, what can we do?
Building immigrant-citizen collaborations in high-income countries to advocate for the rights of those who have no voice or are fearful of repercussions is one way to improve vaccine equity, especially among forcibly displaced populations. This can be in the form of working with nongovernmental organizations, voicing concerns to Congress about sharing superfluous vaccines with other countries, eliminating unnecessary visa exclusions, and investing in humanitarian border operations, and engaging in community outreach programs to empower displaced individuals by compiling reliable and accessible resources about their eligibility for healthcare benefits, including vaccines.
Working together we can make a difference.