Coronavirus vaccine shortage: world’s refugees pushed to the back of the pack

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Salimullah, a Rohingya refugee, lives in the Indian capital of New Delhi since 2013 when he fled the violence in Myanmar. Stateless and now homeless after a fire razed his camp, the 35-year-old lives in a tent with up to 10 other people at a time.

Before the pandemic, he ran a small business selling groceries in a shack. But it was shut down during India’s hard lockdown that lasted for months, and its savings were gone. He and his family survived on food donations, but he must return to work soon, despite the risk of having COVID-19[female[feminine and infect others.

Although some refugees in India have started to be vaccinated, no one in their camp has received a vaccine. Just over 7% of India’s population is fully vaccinated and vaccine shortages have plagued the nation of nearly 1.4 billion people.

A Rohingya activist distributes new clothes to refugees at a refugee camp along the banks of the Yamuna River on the southeast border of New Delhi, India's sprawling capital, on July 1.
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A Rohingya activist distributes new clothes to refugees at a refugee camp along the banks of the Yamuna River on the southeast border of New Delhi, India’s sprawling capital, on July 1.
(PA)

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“The disease does not discriminate. If we are infected, so will the people be,” said Salimullah.

It wasn’t supposed to be like that.

For months, the World Health Organization has urged countries to prioritize immunizing refugees, placing them in the second priority group for those at risk, alongside those with serious health problems.

This is because refugees inevitably live in conditions of overcrowding where the virus can spread more easily, with limited access to the most basic health care or even clean water, said Sajjad Malik, director of the Resilience and Solutions Division of the United Nations Refugee Agency.

“They are really going through difficult situations,” he said.

More than 160 countries have included refugees in their plans, but these have been shattered by supply shortages. According to the WHO, some 85% of vaccines were administered by rich countries. In contrast, 85% of the 26 million refugees worldwide live in developing countries struggling to immunize even the most vulnerable, according to the United Nations refugee agency.

Some countries, such as Bangladesh, have placed their hopes in COVAX, the global initiative for vaccine equity. In February, he changed his initial vaccination plan to include nearly a million Rohingya refugees in overcrowded camps on the country’s border with Myanmar. But so far he has only received 100,620 doses – less than 1% of his allocated injections – of COVAX, leaving Rohingya refugees without.

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Children play the role of Salimullah, 35, a Rohingya refugee who steps out of his tent in a refugee camp along the banks of the Yamuna River on the southeastern border of New Delhi on July 1.  (AP)

Children play the role of Salimullah, 35, a Rohingya refugee who steps out of his tent in a refugee camp along the banks of the Yamuna River on the southeastern border of New Delhi on July 1. (AP)

COVAX has not only weakened in Bangladesh. Globally, the initiative delivered less than 8% of the 2 billion doses of vaccine it had promised by the end of the year.

Even in countries where vaccination of refugees has started, supply remains a problem. In Uganda’s Bidi Bidi camp, less than 2% of 200,000 refugees received a single injection of the AstraZeneca vaccine, with second doses rare after India stopped exporting them after its own cases exploded.

Other obstacles, ranging from language barriers to misinformation about vaccines, compound the problem. Thomas Maliamungu, a South Sudanese refugee and teacher in Bidi Bidi, said he overcame his fears to get his first shot only after it became mandatory for teachers.

“According to rumors on the pitch, I never wanted one,” he said.

Some countries, such as India, initially required documents such as passports or other government IDs, which many refugees do not have to get vaccinated. Online registration was also a barrier for many people without internet access.

India started vaccinating people in January. Four months later, the documentation requirements were relaxed. The Chin community in New Delhi, a Christian minority who fled violence in Myanmar, began shooting at them in June. By this time, the monstrous wave of India had already ravaged their overcrowded encampment, entire families were falling ill and dying.

With the city’s health system collapsing, refugees struggled to get a hospital bed and private hospitals charged around $ 4,000 for a few days, James Fanai, chairman of the Chin Refugee Committee, told Delhi. “Getting oxygen was almost impossible,” he said.

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Registration initiatives, such as volunteers going to camps to help refugees register for vaccines, have sometimes failed, said Miriam Alía Prieto, immunization and epidemic response advisor for Doctors Without Borders.

“Many are not in camps but are living with relatives,” she said, noting refugee populations in Jordan and Lebanon.

Due to the transient nature of some refugee populations, some countries in Europe are turning to the use of the single injection Johnson & Johnson vaccine for refugees. Prieto said Spain is awaiting the arrival of these vaccines. Greece started a campaign in early June for those living in migrant camps and shelters using Johnson & Johnson photos.

Refugees are being shot at in EU countries, but the situation is worse in other parts of the continent, said Frido Herinckx, COVID-19 operations manager at the regional office of the International Federation of the Red Cross and the Red Crescent for Europe. For example, only 1.5% of Armenians and 4.2% of Ukrainians are fully vaccinated.

In some countries, such as Montenegro, the fear of being arrested or deported remains an obstacle and, he said, Red Cross volunteers accompany migrants, including refugees, to help them get away with it. vaccinate while ensuring that they are not stopped afterwards.

“So (it’s) to keep this firewall between (…) the border guards and the health service,” he said.

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But even as the supply of vaccines increases, there is the question of liability – the question of who is responsible in the rare event of serious side effects from the vaccine.

Humanitarian organizations can request to distribute vaccines under the humanitarian buffer – an emergency mechanism put in place by COVAX as a last resort. But it also means accepting responsibility for any serious side effects.

Prieto said Doctors Without Borders wanted to try to get vaccines from manufacturers but did not want to take responsibility for it. Many vaccine manufacturers have refused to sign agreements for vaccines or ship them without this stipulation.

Another obstacle, she said, is that sometimes a WHO-approved vaccine is not yet authorized by the host country, creating a mismatch between which vaccines are available and which can be used.

“We are in this strange phase where a drug is approved, but no one wants to take responsibility for it,” she said.

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As the virus continues to spread, the difficulties encountered in vaccinating refugee populations around the world could spell disaster for host communities.

“The virus doesn’t distinguish between a national and a refugee. So if you don’t protect and save your refugee population, it becomes a public health problem,” Malik said.

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