The COVID-19 vaccines and undocumented migrants in Belgium

As part of our efforts to monitor access to the COVID-19 vaccines for undocumented migrants in Europe, we’re speaking with national-level advocates about the situation in their countries. In this blog, we’re looking at the situation in Brussels, Belgium, with the help of various national level actors. It is not meant to offer an exhaustive picture of the legal and practical context in Belgium. Please get in touch at info@picum.org if you have information you’d like to share, and follow our Twitter page @PICUM_post to get more recent updates.

What does the Belgian vaccination strategy say about undocumented migrants?

In March 2021, the Belgian Federal Health Minister confirmed in Parliament that the COVID-19 vaccine would be available to all undocumented migrants. Then, in April, the Secretary of State of Asylum and Migration, Sammy Mahdi, confirmed again that undocumented migrants in Belgium would be able to get vaccinated. Secretary Mahdi also stated that police would not be involved in the vaccination process. Since these declarations, the Brussels-Capital region has come up with various strategies to implement its vaccination campaign to include undocumented migrants and other groups facing social exclusion.

What is the approach in Brussels?

One aspect of the vaccination strategy in Brussels is to use mobile teams, or “Mobivax”, to administer the Johnson & Johnson vaccine – which can be given in a single dose – to undocumented migrants and others facing barriers to vaccination in the region. Mobile vaccination teams began vaccinating homeless and undocumented people on 19 May.

Why mobile teams?

The use of mobile teams facilitates the vaccination of people who may be unable to reach vaccination centres by themselves. This can be because of  different reasons, such as physical or mental illness, or reluctance to venture to centres for fear of encountering the police and, for undocumented people, the risk of immigration enforcement. In this way, the use of mobile teams can alleviate vaccine hesitancy amongst undocumented migrants and increase their uptake of the vaccine. Among the sites the mobile teams will prioritise will be accommodation centres for homeless people and informal centres or “squats”.

The mobile teams are being coordinated by a consortium of organisations including Médecins du Monde, Médecins Sans Frontières, the Red Cross, and the Samusocial (which runs shelters and provides related medical care), all of which have been collaborating closely with the government since the beginning of the pandemic to devise strategies to reach people who face barriers to getting vaccinated. Each Mobivax team includes two cultural mediators to facilitate dialogue with the target group.

Why use a single-dose vaccine?

Using the Johnson & Johnson single-dose vaccine is more conducive to reaching people who do not have a fixed address, which otherwise greatly complicates the administering of a second dose. Factoring in those without permanent housing is especially important given the relatively large numbers of people living in precarious residence in Belgium: in 2015, it was estimated that there were between 85,000 and 160,000 people in precarious housing, and estimates show that around 50% of people experiencing homelessness in Brussels are undocumented.

While the merits of using mobile teams are clear, they should be paired with other measures, such as making vaccination centres better equipped and more accessible.

How can undocumented migrants register?

To register for a COVID-19 vaccine in Belgium, a person must provide their national number (numéro bis).  While this number is visible on one’s official national registration card, it is also possible to get the bis number without having a national card, and without any immigration consequences. You only need to provide basic information, and it is usually used for people who do not have citizenship but can access health care and social security. The bis number is also easy for GPs and local authorities to create.

That being said, there is a need for greater awareness about the existence of the bis number and the avenue to vaccination it creates. And in practice the bis number is not always straightforward for undocumented people to obtain, especially, for example if they are homeless. For those who cannot register online, registration can be carried out either through the GP, or anonymously by phone for those without a doctor. After receiving the jab, a document will be issued showing proof of vaccination.

What still needs to be done?

There is an agreement between the federal government and the regions that data obtained by the health care services will not be shared with the immigration authorities for the purpose of immigration control or otherwise used for reasons not related to public health. However, some NGOs have called for clear and binding policy frameworks formalising this and for better communication and awareness-raising around this issue by NGOs and government.

Cover: Adobe Stock – MEDIAIMAG