Expanded program on immunization and COVID-19 vaccination in migrant children under 12 years old at the Eastern Economic Corridor (EEC): Chonburi, Rayong and Chachoengsao provinces

Abstract

Despite Thailand's efforts to provide protection for migrant children, including birth registration and vaccination, many migrant children still lack documentation. They are not covered by health insurance. This puts them at risk of vaccine-preventable diseases. Moreover, the current system fails to reach migrant children who are not registered as dependents of migrant workers or who live outside the system. This study aimed to expanded program on immunization and COVID-19 vaccination in migrant children under 12 years old at the Eastern Economic Corridor (EEC): Chonburi, Rayong and Chachoengsao Provinces. The objectives were to determine the coverage of basic and COVID-19 vaccination in migrant children under 12 years old. Also, Identify the barriers to accessing basic and COVID-19 vaccination services in this population. A cross-sectional descriptive study was conducted using a questionnaire and data collection form. The parents were interviewed. Data were collected from October,1 2022 to September, 30 2023. Data were analyzed using frequency, percentage, mean, standard deviation, and Pearson's Chi-square test.

                A total of 445 parents of migrant children under 12 years old were interviewed. The coverage of BCG and HB vaccines at birth exceeded the target in all three provinces (96.9% and 95.5%, respectively). The coverage of DTP–HB3, OPV3, and IPV was 90.1%, 88.8%, and 81.0%, respectively, while the coverage of MMR1 was 87.0%, which was below the target of 95%. Only Rayong province was higher the target for MMR1 coverage (96.8%). For children aged 2-3 years, the coverage of DTP4, OPV4, and LAJE2 vaccines was 72.6%, 71.6%, and 64.4%, respectively, which was below the target in all three provinces. For children aged 3-4 years, the coverage of MMR2 and LAJE vaccines was 67.4% and 64.4%, respectively, which was below the target for both vaccines. The coverage of COVID-19 vaccine in migrant children under 12 years old was low, with only 25.4% having received the vaccine. Factors affecting access to vaccination services: Personal factors (e.g., travel costs, lack of time, forgetting the vaccination schedule, and lack of awareness about the need for vaccination) were found to be associated with access to basic vaccination services (p-value < 0.05). Additionally, service factors, such as lack of health insurance coverage and distance to vaccination facilities, were also found to be associated with access to basic vaccination services (p-value < 0.05).

            This study found that migrant children under 12 years old in the three provinces had not received complete vaccinations according to the recommended schedule. Especially, the first and second doses of the MMR vaccine were below the target for both times. The coverage of OPV3, IPV,DTP4, OPV4, and LAJE2 vaccines was below the target and the COVID-19 vaccine was below the target too. However, the factors such as travel costs, moving of residence, lack of health insurance coverage, service and distance to vaccination facilities are part of the reason access to basic vaccination services is lower than the target. Therefore, relevant agencies, especially those in the public health sector, should accelerate public relations efforts and conduct outreach activities to ensure that this group of children has greater access to vaccination services. Local administrative organizations should also be encouraged to support vaccination services to prevent vaccine-preventable diseases from spreading to Thai children in the future.