As countries around the world strive to vaccinate their populations against the coronavirus and its deadly Variants, one group was largely excluded from the conversation: 26 million Refugees.
In the search for herd immunity, experts say to include refugees in national vaccination efforts critical to end the pandemic. Yet refugees, most of whom have escaped Conflicts or persecution in their home countries are absent from more than a third of the countries' national vaccination plans. Turkey hosts the largest refugee population 3.6 million people but has not said whether they will be included in the national rollout. Pakistan also has no home 1.4 million refugees.
At first glance, coronavirus doesn't appear to be that big of a problem with refugee populations. About a year after the pandemic began, the number of cases appears to be among refugees lower than originally predicted experts. A possible explanation? In terms of demographics, refugees are relatively young – roughly half are under the age of 18, according to the United Nations High Commissioner for Refugees (UNHCR). Camps also tend to be fair isolated from urban areas where the virus can spread more freely.
But there is also little data and it is possible that cases are not sufficiently reported: Since refugees are not tested regularly due to capacity and supply bottlenecks, It is unclear how the virus is spreading in their population. "We're shooting in the dark to find out how refugees are affected," said Paul Spiegel, director of the Johns Hopkins Center for Humanitarian Health. "We just don't know."
In a broader sense, refugee populations face several major hurdles that could complicate global efforts to contain the virus.
Many of the methods commonly used to mitigate virus transmission, such as social distancing and wearing face masks, include: heavy– even impossible – to implement among refugees, especially in overcrowded camps and settlements. In these conditions, they are "like sedentary ducks to the spread of COVID," said Annie Sparrow, special adviser to the director general of the World Health Organization.
Refugees could also refrain from reporting cases to avoid discrimination or potential stigmas, especially after they are mistakenly accused of transmitting the coronavirus at the start of the pandemic. "There is a chance that we may actually miss hospital stays and / or deaths because they don't want us to know," said Spiegel.
There is also the problem of the variants that have turned up in South Africa, the United Kingdom, and Brazil. The lack of information among refugees has raised concerns about how these spread deadly and higher transmissible variants will affect their communities. Since many countries with large refugee populations are unable to perform the genetic sequencing required to detect the variants, it cannot be confirmed how far they have or are already spreading. This is worrying as some variants appear to reduce the effectiveness of vaccines.
And then there is the simple question of access to the vaccines. U.N. Secretary General António Guterres has conjured up Countries to make vaccines available to "all people" and to view their diffusion as a "global public good," but not all nations have heeded his appeal. According to the UNHCR only 51 out of 90 countries or 57 percent from countries with national vaccination plans have announced that they will include refugees. It remains to be seen whether they will keep their promises; so far, Jordan was one of the few countries that has started vaccinating its refugee population.
"Mentioning (refugees) and actually giving (the vaccine) are two different things," said Spiegel.
Another complication is the fact that most refugees live on low to middle incomes countries, many of whom have difficulty acquiring vaccines in a highly competitive global marketplace where rich countries– only 16 percent of the world's population – have secured 60 percent of the world's total supply. Countries in need can get them through COVID-19 Vaccines Global Access (COVAX), a global vaccination efforts that is working to at least provide free vaccines 20 percent COVAX has also created a last resort to ensure the world's most vulnerable people are protected Emergency buffer That saves 5 percent of the cans for humanitarian purposes.
"It doesn't matter if you are a citizen or a refugee from a public health pandemic – a virus will definitely infect you," said Hazem Rihawi, senior program manager with the American Relief Coalition for Syria.
Even if the vaccines are available, people have to get the shots. Misinformation about vaccines, however, poses another challenge. Just as misinformation has hampered vaccination efforts in the United States – almost one third of US troops have rejected the vaccines, a trend reflected in the US population – it has also plagued refugees, many of whom fear becoming test subjects for possible experiments or sterilizations.
"We need to work with them to make sure they actually want to receive the vaccine when it becomes available," said Spiegel.
All of these barriers are important as achieving herd immunity is the best way to protect yourself from ongoing disruption from the pandemic. Despite all these efforts, experts do not expect the majority of refugees to receive vaccines anytime soon. To reach Herd immunity requires at least antibodies 70 percent from people. But with the first delivery of COVAX 3.3 percent Of the populations of the participating countries – and most of the admissions intended for frontline health workers – it will take years for vulnerable groups to achieve herd immunity.
"There is no way we are anywhere near (herd immunity) or we will be close for the next two to three years," said Mesfin Teklu Tessema, head of the International Rescue Committee's health unit. Thanks to the new variants, the herd immunity threshold could be even higher, he noted.
The impact is not only limited to overcrowded camps or displaced persons, but also to the global fight over COVID-19.
"The stakes are enormous," said Mike Woodman, a senior public health officer at UNHCR. "If you don't make sure everyone gets the vaccine, we won't control the pandemic (and the effects will be felt by everyone."