‘Filling in the Gaps’- Catch-up immunisations for asylum seekers and refugees

When asylum seekers and refugees arrive here in Melbourne, they often have not had access to the same immunisations that others born and raised here might have.

Especially as an adult, it is often presumed that you are fully immunised – but this is not always the case, and it is not always the focus of general GP consultations. Asylum seekers and refugees are a particularly vulnerable group in our society, and many have come from countries overseas where there is a high prevalence of certain diseases. Though they are often forgotten, the Cabrini Asylum Seeker and Refugee Health Hub’s Immunisation Program ensures that new arrivals can be on par with the general public when it comes to being vaccinated, and are not left out of the health system.

The Cabrini Outreach Asylum Seeker and Refugee Health Hub (CASRHH)’s Immunisation Program began in 2016, when the Hub opened. As many asylum seekers and refugees are not eligible for Medicare, this free program benefits them substantially as they already face a huge barrier when it comes to accessing primary health care in Australia. Whenever a new asylum seeker or refugee presents at the Hub, our nurses meet with them to undergo a full refugee health screening assessment. Through talking with the client and asking about their immunisation status, a ‘catch-up schedule’ is created to gain an understanding of what vaccinations they need. This involves interpreters, the translation of vaccination records, and the type of sleuthing that other healthcare services are not always equipped for.

“Using interpreters with our clients allows us to develop trusting relationships. It makes a world of difference for them. This means clients feel safe to ask questions and discuss fears or hesitancy they may have surrounding certain vaccines. It’s a great opportunity to promote the importance of immunisations which can often encourage others from our client’s families and communities to show interest in getting themselves immunised.” - Hannah Juhrmann, Refugee Practice Nurse
Hannah, a practice nurse, vaccinating an asylum seeker client at the Cabrini Asylum Seeker and Refugee Health Hub

Hannah, a practice nurse, vaccinating an asylum seeker client at the Cabrini Asylum Seeker and Refugee Health Hub

If the client has no prior documents about their immunisation status, then the catch-up process is usually commenced from scratch. The nurses do a full screening of Hepatitis B, to check for any past exposure, current infection or surface antibodies. This allows them to see whether the client requires any further tests, treatment or catch-up Hepatitis B immunisation. They offer a full catch-up schedule for adults which includes Polio, Diphtheria, Tetanus, Pertussis (whooping cough), Measles, Mumps, Rubella, Varicella (chicken pox), as well as Hepatitis B. They also provide Influenza, Meningococcal ACWY, Gardasil, Pneumococcal and Herpes Zoster Vaccine for adults who are eligible. All parents of children who were born overseas are also strongly encouraged to complete a full immunisation catch-up schedule which differs to an adult schedule. On average, it takes about 3-6 months for adults to catch up. Fortunately, this allows the time and opportunity not only to check in with the client monthly for their health needs, but to build rapport.

“Offering this service to our asylum seeker and refugee clients leaves them feeling extremely happy and grateful afterwards. There is extremely little hesitance – if only from needle phobia – and it makes them feel like they are on the same level as others in the community. As nurses, it is a privilege to provide the service, and it is lovely that clients are so open and trusting with us.”  - Maymun Mohamud, Refugee Practice Nurse

While the peaks of COVID-19 posed a challenge in bringing clients in for their injections, our team of nurses and doctors worked hard to re-arrange the catch-up schedules whilst wisely weighing up the risks of bringing their clients into the Brunswick clinic. During World Immunisation Week, we want to thank them for the dedication and remarkable service that they continue to provide. As we begin to witness the COVID-19 vaccine roll-out throughout Australia, we are further reminded as to why free and accessible vaccinations are so important.