Immunization Challenges with Migrant Children

A global effort to provide immunizations to children throughout the world has been a priority for decades. Many children are properly immunized in their homelands through reliable health agencies and international charities. However, due to the fragile nature of vaccines, there are challenges that accompany the process of transport and administration in developing countries. Vaccines and sterile equipment are often difficult to deliver in rough terrain. It may be impossible for families with young children to travel to the immunization site due to poor road conditions. Temperature controls often vary during lengthy trips and cause discrepancies in viral effectiveness. In addition, there are often insufficient skilled health care workers in the field to administer the vaccines.

Migrant children from developing countries may have been partially immunized previously, but certain variables may have interfered with the administration, timeliness, and effectiveness of the vaccines. Titers can be drawn to identify antibody status. Furthermore, multiple research studies (CDC and WHO) suggest that immunizations are safe to be repeated. The live viruses of polio and MMR need to be re-administered due to unreliable temperature controls at immunization facilities.

Health care workers have a distinct challenge when attempting to determine the current immunization status of newly arrived migrant families. An initial physical assessment is completed for all individuals who pass through a border station. Gross assessments are completed to determine health status and contagion. Immunization status is evaluated during this assessment to coincide with underlying disease processes. Immunization planning and education are generally initiated at the time of arrival, and a plan is developed for the ongoing schedule of vaccines.

Immunization Challenges with Migrant Children

Download All Files for This Teaching Strategy

Learning Objectives

Students will:

  • Identify challenges with immunizations in developing countries
  • Develop a catch-up vaccination plan for a migrant child

Learner Pre-Work

Read Evaluating and Updating Immunizations during the Domestic Medical Examination for Newly Arrived Refugees and answer the following questions:

  • What are barriers to identifying which vaccines a migrant may have had in his or her home country?
  • List three potential reasons for revaccination of a migrant child.

Suggested Learning Activities

1.  Review the Ashkir Yusef case study about a 14-year-old male from Somalia. 2.  Lead a classroom discussion on challenges with immunizations with developing countries.
  • Using the Ashkir Yesef case study as a guide, review the communication, cultural, and educational barriers that the health care worker will encounter.
  • What are the solutions to assist migrant families to comply with US regulations for immunization and disease prevention?
  • What concerns might parents have in knowing that their children will need all required vaccines again because the paperwork was lost in transit?

Suggested Reading

Asuman, D., Godfred Achah, C., & Enemark, U. (2018). Inequalities in child immunization coverage in Ghana: Evidence from a decomposition analysis. Health Economics Review.

Centers for Disease Control and Prevention. (2019, January). Preparing for questions parents may ask about vaccines. Retrieved from

Fatima, M. (2018, Dec. 18). Cooling in developing countries. The Borgen Project Blog.

Malande, O.O., Munube, D., Afaayo R. N.,, Annet K, Bodo B Bakainaga A, … Musyoki A. M. (2019). Barriers to effective uptake and provision of immunization in a rural district in Uganda. PLoS ONE, 14(2), e0212270. doi:10.1371/journal.pone.0212270

WHO Fact Sheet on Immunization Coverage -

Author Information

Jennifer Ware, MSN, RN
University of Texas at El Paso
El Paso, Texas