High coverage of polio immunization program in refugees resettling in Denmark. A cross-sectional study of polio serology in newly arrived refugees

ABSTRACT

Objectives: Wild poliovirus (WPV) infection has been eliminated in Europe through mass immunization. Resettling refugees may lack immunity and importing WPV through refugees continues to cause concerns.

Method: We performed a cross-sectional study to establish the prevalence of poliovirus immunity in children and adult refugees resettling in Aarhus, Denmark. Immunity was evaluated by antibody response for serotypes 1, 2, and 3.

Results: The participants in this study counted a total of 475 children and adult refugees aged between 6 months and 76 years and 59% were males. The survey was conducted between 2014 and 2016. Among the refugees, 72% were from Syria, and the rest from Eritrea, Congo, Lebanon, Somalia, Afghanistan, Iran, Iraq, Ethiopia, and Columbia. In the cohort, 27 lacked antibodies against a least one serotype. None of the participants lacked antibodies against all three polio types. Originating from The Horn of Africa, age between 20 and 30 and male gender was associated with lack of immunity.

Conclusion: The study found a complete WPV immunity in 94% of recently resettled refugees in Denmark. This study demonstrates a high coverage of the polio immunization program. However, ensuring poliovirus immunity among refugees remains a priority until polio has been eradicated worldwide.

KEYWORDS:

• Polio
• vaccination
• immunization
• refugee
• migrant health

Author contribution statements

Anne Mette Hvass and Christian Wejse came up with the original idea for the project. Anne Mette Hvass has seen most of the patients for health screenings, working as a M.D. with Aarhus Municipality. Christian Wejse verified the analytical methods. Anne Mette Hvass wrote the manuscript with support from Christian Wejse. All statistical analysis was done by Anne Mette Hvass with supervision from Christian Wejse. Both authors discussed the results and contributed to the final manuscript.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This article was funded by the Aarhus Municipality Department of Social Medicine, Aarhus University Ph.D. grant, The Kerrn-Jespersen Foundation and The “Folkesundhed I Midten” Foundation