Deployment of COVID-19 Vaccines for Refugees and Migrants in Nepal.

Background The needs and determinants of COVID-19 vaccination uptake and coverage among refugees, migrants in regular situations (MIRS), and migrants in irregular situations (MIIS) remain undocumented. This hinders advocacy toward inclusive vaccination policies and ultimately undermines effective vaccine rollout. Objective To estimate vaccination coverage and produce evidence on the barriers and facilitators to COVID-19 vaccination for refugees and migrants in Nepal. Method Mixed-method study was conducted in Koshi, Bagmati and Gandaki provinces of Nepal. In total, 210 household surveys were conducted among the refugees and migrants, and eight key informant interviews were conducted locally among Nepal's major stakeholders of COVID-19 vaccination. Result A total of 210 participants were included in this study: 101 refugees, 66 MIRS, and 43 MIIS. Among them, 52.9% (111/210) were fully vaccinated with two or more COVID-19 doses, 43.3% (91/210) were partially vaccinated with one dose, and 3.8% (8/210) were unvaccinated. Inclusive vaccination policies were an enabling factor for wide access to COVID-19 vaccines among refugees and migrants. The availability of vaccines free of cost, timely information on vaccinations, and multiple vaccination centers facilitated COVID-19 vaccine uptake. However, barriers like requirement of identity documents, safety misconceptions, fear of side effects, and language challenges hindered access. Conclusion This study highlights the overlooked issue of vaccination uptake among refugees and migrants, emphasizing the lack of data on their needs and determinants. This gap hinders inclusive vaccination policies and rollout effectiveness. Tailored strategies are crucial to address their specific needs, alongside ongoing research and advocacy for inclusive policies and targeted interventions to overcome barriers.