“No one is safe until everyone is safe”

On 10 July, Commission President Ursula von der Leyen announced in a statement that the EU had received enough vaccine doses to vaccinate 70% of its adult population. She also acknowledged that the virus “is not yet defeated” and that now “member states must do everything to increase vaccinations”, adding “nly then will we be safe.”

This echoes the mantra of the World Health Organisation (WHO) and other international bodies over the last several months that “none of us will be safe until everyone is safe” – a simple statement of the need for solidarity and equity to be at the heart of our collective response to the pandemic, at both the global and national levels.

What about people with irregular residence status?

International and regional public health and human rights bodies have, since the end of 2020, been vocal about the need for inclusive and equitable vaccination schemes, as a matter of public health, fairness and human rights; and have published guidelines about how to achieve this for people with irregular migration status, who have long faced major barriers to accessing health care. Click here for a more detailed picture of existing recommendations.

In Europe, vaccine strategies vary considerably, with wide variation in governments’ approaches to inclusion of undocumented people. Despite important gaps, promising practices have emerged in several countries to promote access by undocumented people and others facing various forms of systemic exclusion to COVID-19 vaccines. Below is an overview of some of those promising practices.

1. Proactive measures to address legal, practical barriers to access. The United Kingdom announced in February that all UK residents could access the vaccine for free, regardless of their migration status, with only a requirement (for those without a national health number) to register with a general practitioner. This was reflected in official national guidelines. Access has, however, been hampered by fears linked to the “hostile environment” and the fact that most GPs refuse to register undocumented patients because they cannot provide documentation, such as a valid residence permit, even if this is not required by law.
2. NGOs, community-based organisations actively involved by governments in the definition of strategies. In Belgium, the federal government was receptive to the concerns of non-governmental and community-based organisations and collaborated with them from early on in the development of its strategy and approach; and the Brussels region has worked proactively with local organisations to craft practical solutions for ensuring that undocumented people and others facing exclusion can get the vaccinated, including through mobilisation of mobile clinics.
3. Clear instructions from governments and health authorities about entitlements and how to ensure undocumented people get COVID-related care. In Spain, the federal vaccination strategy explicitly mentions undocumented migrants and other marginalised populations as groups to be vaccinated. It doesn’t, however, detail how to reach them. While there are examples of inclusive approaches in some regions, non-governmental organisations have been pushing for clear guidelines from the Ministry of Health to the regions to address inconsistencies in practices that lead to exclusion.
4. Clear commitment and communications that personal data will not be shared with immigration authorities or otherwise used for purposes not related to public health. In Ireland, the Minister of Health stated clearly that there would be no immigration consequences for people coming forward to be vaccinated, and encouraged undocumented people to do so. During the lockdowns in 2020, Ireland had already announced that undocumented people could access COVID19-related care without risk of data sharing with immigration authorities – and that they would be included in the country’s Pandemic Protection Program for workers who lost their jobs. In Germany, the Munich municipality confirmed in writing that there would be no immigration checks on undocumented people who would try to access the vaccines.
5. Straightforward and flexible procedures, with limited documentation requirements. Portugal published a COVID-19 vaccination registration website where undocumented people can book their vaccinations, and which is adapted to be less burdensome in terms of the information that must be provided (address, birth date, phone number and nationality). According to official figures from June, more than 19000 undocumented migrants had registered via the website, often with assistance from local NGOs.
6. Communications campaigns tailored to the needs of diverse groups. Because undocumented people generally do not have access to mainstream health systems, they often also do not have ready access to health-related information. They may also have limited access to online sources of information. So it’s essential that information about the pandemic and about the COVID-19 vaccine – its safety and efficacy, who is eligible to receive it and how – is tailored to address these barriers, and made available and accessible in multiple languages to promote awareness and understanding, address vaccine hesitancy.

The COVID-19 vaccination strategies are spotlighting pre-existing gaps and inequities in national health systems across countries in Europe, and at least in some cases tensions between immigration control and public health and equity imperatives. Some countries have been proactive in trying to fill gaps in the context of the pandemic and vaccination programs, in particular. This is a key moment to think not only about a more equitable pandemic response, but sustained and systematic efforts to repair the cracks in our health systems, and to prioritise need over status in defining and implementing rights to care.

Cover: Adobe Stock – bernardbodo

International and regional public health and human rights bodies have, since the end of 2020, been vocal about the need for inclusive and equitable vaccination schemes, as a matter of public health, fairness and human rights; and have published guidelines about how to achieve this for people with irregular migration status, who have long faced major barriers in accessing health care.

For instance:

According to World Health Organisation (WHO) guidance from June 2021, “Striving for equity in vaccine access should be a guiding principle for all countries to adequately protect groups experiencing greater burden from COVID-19 disease irrespective of legal status including refugees, asylum seekers, internally displaced persons (IDPs), migrants, stateless persons, as well as people living in areas under the control of any non-state armed group.”

International human rights experts have highlighted that: “In the context of establishing criteria for vaccines prioritization, attention must be given to those migrants who are most exposed and vulnerable to the SARS-COV-2 due social determinants of health, such as migrants in irregular situations, low-income migrants, migrants living in camps or unsafe conditions, in immigration detention, migrants in transit.”

The International Organisation for Migration (IOM) has documented seven main barriers to migrants’ access to COVID-19 vaccines including administrative or policy barriers, informational barriers and mistrust, and fear of arrest or deportation. In December 2020, the IOM had called for full inclusion of migrants, regardless of status, in national vaccination strategies.

The European Centres for Disease Control and Prevention (ECDC) devoted a report to increasing uptake of the COVID-19 vaccines among migrants, noting that “onsideration needs to be given to ensuring equitable access to and uptake of testing for COVID-19, and for COVID-19 vaccines, particularly in migrants excluded from, or facing barriers to accessing health systems”, noting the “urgent need to share models of good practice and lessons learned from across the Region.” Moreover, “or migrants who face barriers and exclusion from mainstream health systems – including undocumented migrants, asylum seekers/refugees, and those residing in camps and detention facilities – mechanisms will be required to ensure they are meaningfully included in national response plans to reduce transmission. »

For an overview of international and regional guidelines on inclusive responses to the COVID-19 pandemic, click here.

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. This interview was conducted in July 2021 with Lefteris Papagiannakis of Solidarity Now to discuss the situation in Greece. It is not meant to offer an exhaustive picture of the legal and practical context in Greece. 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 Greek vaccination strategy say about undocumented migrants?

The Greek vaccination strategy says nothing about undocumented migrants. This is something we, and other NGOs, try to raise every time we meet with public health officials, but the political environment is very hostile. There’s like an allergy to talking about undocumented migrants.

How does the mainstream booking system work? Is that accessible to undocumented migrants?

To register for your COVID-19 vaccine, you need a social security number. This is needed whether you book it online, at citizens’ services centres or pharmacies. EU citizens and refugees can access a temporary social security number, but many may not have it in practice for bureaucratic reasons. For undocumented migrants, such a number is not available.

Greece has a large migrant population who live in so-called refugee camps. Is anything being done to reach those people?

Vaccinations against COVID-19 have started in main camps in mainland, but they don’t reach everyone. For instance, people who get a second rejection of their asylum claim are not given the vaccine.

A lot depends on the person’s residence status, which is a complex matter in Greece, and especially inside the camps it can change from one day to the other.

Are there any risks of immigration enforcement as a result of people trying to access the vaccines?

We don’t have a formalised ban against public services sharing personal data with immigration authorities. So it can happen that undocumented patients get reported. But this is almost a non-issue in the case of the COVID-19 vaccines, as undocumented people aren’t even able to book their shot.

Update from September 2021:

Since July, the Greek government has established and convened meetings of working groups to discuss access to the COVID-19 vaccines for undocumented migrants in the country. Despite this positive step, no practical measures have been implemented to address persisting challenges.

Registration still requires having a social security number, and so remains problematic. Under a circular issued in May, undocumented people with documents from their country of origin can use them to register for a social security number to book and get their vaccination. But some do not have even these documents – and for many who do, they are fearful of registering because of possible immigration consequences.

Furthermore, specific groups of undocumented migrants face different challenges, depending on if they live in the “camps” on the islands or mainland; in the city, where many work in the hospitality sector, or as domestic workers, or vendors; or in more remote regions on farms doing seasonal work.

Humanitarian organisation INTERSOS has launched the campaign “Vaccines for All” to open up access to COVID-19 vaccines for undocumented people in Greece. The campaign calls for the removal of existing barriers to vaccinations, including simplified registration, and a clear statement from the government that everyone in Greece can be vaccinated, without fear of immigration consequences. It also aims to raise awareness and build trust among migrant communities around the vaccination. The campaign is joined by the Greek Forum of Migrants and the Greek Forum of Refugees as implementing partners.

Update from November 2021:

On 2 October 2021, the Greek government published Law 4839/2021, which includes a provision making it possible for undocumented people and stateless persons in Greece to obtain a provisional social security number (PAMKA) so that they can register for COVID-19 vaccination.

The law (Article 32) law indicates that undocumented migrants will not be deported if they seek access to the vaccination process. Undocumented migrants will be issued a PAMKA exclusively for the COVID-19 vaccination, the receipt of the relevant certificate and for receiving COVID-19 self-tests.

The law (Article 31) foresees that NGOs and municipalities will have a role in the delivery of the COVID-19 vaccines. But the practical implementation has to be detailed in a future joint ministerial decision from the Ministers of Health, Digital Governance, Labour and Social Affairs, and Migration and Asylum.

The measure has been welcomed by advocates as a positive step towards addressing systemic barriers faced by undocumented people in getting the COVID -19 vaccines in Greece, although there is frustration that the inter-ministerial decision needed to implement the law has yet to be agreed. In the meantime, migrants’ rights organisations are rolling out community-based initiatives to inform migrants in Greece of their rights, to address their questions about the vaccine and to encourage strong uptake when it becomes available.

Humanitarian organisation INTERSOS continues the campaign “Vaccines for All” for the COVID-19 vaccines for undocumented people in Greece, including updating the website Vaccines for All daily with information and latest news on vaccination against COVID-19, translated into different languages. The campaign is joined by the Greek Forum of Migrants and the Greek Forum of Refugees as implementing partners.

Cover: Christophe Meneboeuf – http://www.pixinn.net

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. This interview was conducted in June 2021 with Magda Faltová of Migrace to discuss the situation in the Czech Republic. It is not meant to offer an exhaustive picture of the legal and practical context in the Czech Republic. 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 Czech vaccination strategy say about undocumented people?

The Czech vaccination strategy  doesn’t say anything about undocumented migrants unfortunately. As the vaccination campaign stands now, only people with public health insurance, and – as of 11 June – regularly residing migrants with private health insurance, are able to access the COVID-19 vaccines.

So the mainstream booking system isn’t accessible for undocumented people?

The mainstream booking system provides two main avenues to register: neither is accessible for this population because of the data they require.

The first one is an online portal, which requires a national ID number or a passport number that is already registered in the national database, and then a public health insurance number.

The second avenue is through GPs, who can administer the vaccines themselves. However, to get the vaccine, you would still need to provide a national ID and public health insurance number at the doctor’s office.

Even if you somehow managed to book your vaccine, staff at the vaccination centre would still check your ID and public health insurance card.

Is anything being done for undocumented people?

On 30 June, the Ministry of Health sent a letter to regional authorities stating that they can also vaccinate migrants without health insurance. But nothing was said as to how to practically organise this or how to reach this group.

What’s more, the regions don’t want to pay for the administration of the vaccines to this population. So now authorities at different levels are discussing how to cover these costs.

The Prague Municipality is currently piloting a scheme where local social services administer the vaccines to people without health insurance.

If vaccines at some point become practically available for undocumented migrants too, would they risk facing immigration checks?

In theory, the mainstream booking system doesn’t transfer data to the immigration authorities. But it’s unclear what happens with the vaccination certificates, which are needed for people to access a whole range of services and places in the Czech Republic, and which is administered by the Ministry of Health. And it’s unclear what impact the new EU Green Pass will have on the processing of data of vaccinated people.

Our concern is that the Ministry of Interiors won’t hesitate to use such data, should it be stored somewhere.

Cover: Adobe Stock – JackF

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

This blog post was co-authored by Laetitia Van der Vennet, Advocacy Officer at PICUM, and Jennifer Zuppiroli, Advocacy Officer at Save the Children Spain.On Friday 11 June 2021, PICUM and Save the Children Spain co-organised the webinar “Growing up undocumented in Europe” which brought together speakers from Migrant Rights Centre Ireland, Platform Minors in Exile (Belgium), Save the Children Italy, Save the Children Spain, the European Commission, and the Council of Europe. Below you can find the conclusions of the event, including links to the presentations given and a recording of the event at the bottom of the page. The full programme is available here.Across Europe, undocumented children face legal and practical barriers to pursuing an education, getting the health care they need, and having a decent and stable home. However, as the representative from the Council of Europe pointed out, international bodies stress the importance of treating undocumented children as children only.

This struggle to access their basic rights impacts every aspect of undocumented children’s lives. The impact of the stress, fear and lack of perspective for the future cannot be underestimated. As a society, we cannot look away when we hear how children and youth are not fully recognized as citizens in our societies. We cannot look away from the fact that they are unable to imagine or plan their future because of their residence status. Young activists from across Europe are doing amazing work to lift the voices of undocumented children and youth. For instance, Young, Paperless and Powerful have long been campaigning to make their voices heard in Ireland. Knowing that after a decade of collective campaigning, the Irish government will be regularising undocumented children, families and adults is equally heart-warming and heart-wrenching. Heart-wrenching because people who have lived in Ireland for years but have only recently lost their residence status risk falling between the cracks.

We also note the difficulties to come to specific figures on the number of undocumented children across Europe. No reliable regional estimate exists, but some trustworthy national-level estimates do. For instance, between 190,000 and 241,000 undocumented children are estimated to have been living in the UK in early 2017, and nearly 147,000 undocumented people younger than 19 were living in Spain according to 2019 municipal censuses which Save the Children and PorCausa Foundation consulted. Approximately half of them were younger than ten years old and about 55,000 children were younger than five. Good data is necessary to develop effective and targeted public policies that respond to the needs of undocumented children and their families, and we hope to see more good-quality national estimates in the future.

This lack of data is worrying because institutions and legislation at EU and member state-level can, and do, make the difference for undocumented children and their families. We heard several examples of this: the prohibition to deport undocumented children in Italy and their right to stay, measures taken by Spain to avoid Venezuela nationals who seek protection but who do not fulfil the criteria of the Geneva Convention from becoming undocumented or the newly announced regularisation programme that offers the chance to regularise to children and their families after three years in Ireland. We also got to know two laws that benefit unaccompanied children, specifically: the Italian Zampa law adopted in 2017, and the procedure to identify a durable solution for unaccompanied children in Belgium. The first strengthens the protection of unaccompanied children arriving in Italy and simplifies the issuing of a residence permit to those unaccompanied children who do not seek asylum, while the latter has the guardian propose a durable solution in the best interests of the child to the Belgian Immigration Office.

These national-level residence schemes are important, as children and their parents migrate for many reasons (not only fleeing from war), many children are born on EU soil to undocumented parents, and these procedures provide complementary pathways for stay based on children’s rights and needs. As explained by the European Commission, the Return Directive explicitly grants member states the freedom to provide an “autonomous residence permit or other authorisation offering a right to stay for compassionate, humanitarian or other reasons” to any undocumented person on their territory. And, in line with international law and guidance, countries should find a durable solution that is in the child’s best interests and serves their long-term wellbeing.

We did hear many limitations as well – the Belgian procedure simply lapses once the child turns 18, for example, and the now-adult must then try to regularise their status another way or be deported. The 18^th birthday represents a difficult transition because the child loses the protection and support they enjoyed as children, and service providers are often unable to extend the support they provided. Transition into undocumented adulthood results in exclusion and seeing your classmates build their dreams while you are stuck. The impact on mental health cannot be underestimated, and the years it can take before the young person can regularise their stay can never be regained. Durable solutions must be found before a child turns 18, and children supported in their transition into adulthood.

Even in the most polarized context, a child does not cease to be a child. All other considerations, whether they be administrative, political or concern migration management, are less important than that fact.

Cover image: rawpixel

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. This interview was conducted in June 2021 with Marco Paggi, lawyer at Associazione Studi Giuridici sull’Immigrazione (ASGI) to discuss the situation in Italy. It is not meant to offer an exhaustive picture of the legal and practical context in Italy. 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 Italian vaccination strategy say about undocumented migrants?

The Italian vaccination strategy doesn’t mention undocumented migrants explicitly. But the Italian Immigration Act (Testo Unico sull’Immigrazione) explicitly guarantees access to the vaccines as part of preventive public health care campaigns to all people living in Italy, including irregular migrants, besides any other urgent or essential health care. And the Italian Medicines Agency (Agenzia Italiana del Farmaco, AIFA) released guidelines which make clear that undocumented people are entitled to the COVID-19 vaccines.

So, all good?

Not really. The online booking platforms, which are managed by Italy’s twenty regions, in most cases still require information and documents which are unavailable to most undocumented migrants. In some regions, for instance, users have to enter their social security number (codice fiscale), which is only available for regularly residing people.

As part of a coalition of NGOs that advocates for access to health care for migrants in Italy (Tavolo Immigrazione e Salute), we have written to the Ministry of Health to ask for clear instructions for the regions to open up their online booking platforms, but we haven’t got any response from the national government yet.

Are there any good examples at the regional level?

Yes, in Apulia, Campania, Sicily and Veneto, for instance, undocumented migrants, both EU  and non-EU nationals, can book their vaccines online. Lombardy has recently opened the registration for undocumented non-EU nationals, while it’s unclear if irregular EU nationals can access the registration too. More regions are opening up their online booking platforms to this population, including most recently Friuli Venezia Giulia and Tuscany.

How do they do this?

Where access to the platforms is possible, undocumented migrants only have to enter their STP (Straniero Temporaneamente Presente, or Temporarily Present Foreigner) card number, which is provided to any undocumented migrant who approaches local health authorities, which also conduct some administrative services. There’s also a specific number, the ENI (Europeo Non Iscritto, or Non-Registered European) number, which is provided to those European citizens who live in Italy but cannot be registered with a local municipality because they lack the administrative requirements to do so. They too can book their vaccine online, but only where the platform allows them to enter their ENI number.

Are these online booking platforms the only way for an undocumented migrant to access the COVID-19 vaccines in Italy?

There are some local initiatives which aim at reaching out to undocumented people to vaccinate them. For instance, the Rome administration, in cooperation with local NGOs, has set up special vaccination facilities. The Veneto region asked local health authorities to agree with local NGOs – as has already happened in some provinces – ways of providing direct access to vaccines for irregular foreigners or those without a health card.

But staff is largely made up of volunteers, and these initiatives depend on the availability of specific vaccines. Most of them rely on the Johnson & Johnson vaccine, because it only requires one dose and is therefore easier to administer logistically. But when the use of this vaccine was suspended because of concerns around its side-effects, these initiatives were stopped too as a result.

The initiatives implemented so far cover only part of the national territory and remain difficult to implement effectively. Yet they’re still crucial to reach some undocumented groups who wouldn’t be able to access the online booking systems.

Do you have a specific group in mind?

Well, for instance the farmworkers who work in the fields all across Italy, who often live in informal settlements. Many of them may have a residence permit and STP card issued in a province far away from where they work, which makes access to local health facilities more challenging.  Others don’t even have an STP number, because they may not be aware of it and never requested one, and so wouldn’t be able to book their vaccine even if the online platform allowed them to. For this group, NGO initiatives may be the only way to effectively access a COVID-19 vaccine.

Are there any concerns around potential immigration checks if an undocumented person tries to access the COVID-19 vaccines?

No. The law is very clear in this sense. Article 35 of the Immigration Act (Testo Unico sull’Immigrazione) forbids any data sharing with police and judicial authorities. Indeed, the STP number is released to any undocumented migrant so they can access public health care safely.

Cover: Christopher Czermak – Unsplash

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. This interview was conducted in June 2021 with Zuzana Stevulova of Human Rights League to discuss the situation in Slovakia. It is not meant to offer an exhaustive picture of the legal and practical context in Slovakia. 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 Slovak vaccination strategy say about undocumented migrants?

The Slovak vaccination strategy doesn’t say anything about undocumented migrants. And there haven’t been any official statements from public authorities on the vaccination of this group. Indeed, since having public health insurance is a condition for getting the vaccine, even some documented migrants are excluded, if they are covered by private (rather than public) health insurance.

So nothing is being done for the vaccination of undocumented migrants?

In early April, an amendment clarified that the Ministry of Health can expand access to the vaccines for groups of foreigners just by publishing a note. They haven’t done so yet, and it’s unlikely that they would include undocumented migrants.

Bratislava and other regions are currently operating special mobile teams to vaccinate people who are homeless and people living in socially excluded settlements (mostly inhabited by Roma people). These teams use the single-dose vaccine, Johnson & Johnson. In principle, undocumented people could benefit from this – but they don’t tend to be in touch with organisations working with the homeless (or Roma people). Most undocumented people living in Slovakia are not homeless, but rather seasonal workers who live in often low-cost accommodation provided by their employers.

How does the booking system work? Could undocumented people access it?

The mainstream booking system happens through a specific website, which is only available in Slovak. To register, you need a social security number (birth registration number) and a registered address. You also need to select your health insurance, which can be either public, or EU health insurance (for EU residents registered for residence in Slovakia).

This information is generally not available for undocumented migrants. Those who used to reside regularly and therefore had a social security number might be able to register with the old number, since the online portal doesn’t control the validity of the data provided. But this is highly hypothetical.

Let’s assume an undocumented person is able to register through their old social security number. What will happen at the vaccination point?

At the vaccination centre, you need to show your health insurance card and ID card, which is yet another barrier for undocumented people. Whether staff will actually verify its validity, that depends on the centre.

Are there any concerns regarding possible immigration checks if an undocumented person tries to book their COVID-19 vaccine?

Well, the starting point is that access to the mainstream booking system is not an option for undocumented migrants in Slovakia, because of the information that is required. The online portal isn’t connected to other public databases, and it’s unlikely that a vaccination centre would call immigration authorities in case an undocumented person tries to get their vaccine, but we don’t have a clear and formalised firewall that would prevent public services from sharing personal data with immigration authorities.

Cover: Martin Katler – Unsplash

On Monday 14 June 2021, the EPSCO Council unanimously adopted the Council Recommendation establishing a European Child Guarantee. In a clear signal to both children and governments, the Council’s text states that all children in need must be able to benefit from the Child Guarantee actions, irrespective of their migration status. This momentous step forward cannot be underestimated, as activities supporting undocumented people have long been excluded from EU funding in the past. But with member states now tasked with developing national Child Guarantee action plans, national governments and civil society must make sure that undocumented children in need can and will benefit in practice.

Opening up access to key services

According to the Council Recommendation, undocumented children and children in migration who are “at risk of poverty or social exclusion” should have effective and free access to high-quality early childhood education and care (ECEC), education and school-based activities, at least one healthy meal each school day and healthcare. They should also have effective access to healthy nutrition and adequate housing.

As shown in PICUM research, all of these areas of life are rife with difficulties and exclusion for undocumented children and families. Undocumented children and families often live in cramped, unhealthy housing, need to overcome financial or administrative barriers to go to school, are excluded from early childhood education and care, may not be eating healthy because of a tight family budget and, depending on where they live, may only be able to benefit from emergency health care.

The Council Recommendation sets a precedent because with it, member states commit to prioritising children’s needs over their residence status. For children in migration, and especially undocumented children, this recognition is hard-won and far from self-evident. As was made clear in the child guarantee feasibility study, undocumented children face more barriers than other migrant children when accessing the services targeted by the Child Guarantee.

The Child Guarantee could also open the door for undocumented children and families to receive benefits connected to accessing ECEC, education, school-based activities, healthcare and one healthy meal per school day because ‘free access’ is to be understood as services being “provided free of charge, either by organising and providing such services or by adequate benefits to cover the costs or the charges of the services, or in such a way that financial circumstances will not pose an obstacle to equal access.”   

Prioritising children’s needs over their residence status

The European Child Guarantee is part of a broader trend by the EU institutions to prioritise people’s needs over residence status in its social policies. For instance, the EU Strategy on the Rights of the Child (2021-2025) clarifies that all children are targets of the strategy and Commission representatives have confirmed that that includes undocumented children. The EU Action Plan on Integration and Inclusion (2021-2027), too, differs from its predecessor, the 2016 Action Plan on the integration of third-country nationals, by not limiting its scope to regularly-residing people. The European Pillar of Social Rights Action Plan, of which the EU Child Guarantee is a deliverable, also sets the goal of lifting at least 5 million children out of poverty by 2030. This recent trend of inclusive policies is very positive, and we hope it will continue.

However, we see a very different trend in Europe’s approach towards migration. Both at member state and EU-level, the trend towards more detention and fewer safeguards for children and adults continues to gather support. Most concerningly, the 2020 Migration and Asylum Pact does not adequately safeguard or protect children even though key European and global institutions have recognized that migrant children are highly vulnerable members of our society and their best interests overrides migration management considerations.

This contradiction of recognizing a child’s needs and rights over their residence status in one policy field while not doing so in another is not sustainable. Especially when we know that undocumented children’s vulnerability and social exclusion is partly caused by their residence status, restrictive migration policies and the lack of options to regularise their stay. If the proposed Migration and Asylum Pact will prevent migrants from accessing in-country residence procedures, set up a return sponsorship scheme that rips undocumented families from their support networks to drop them in an unknown country, or cause trauma and additional vulnerability through the widespread use of detention – children will not be set up for success. Nor will the proposed Migration and Asylum Pact create the necessary preconditions for a successful integration policy because it erodes migrants’ resilience and trust in the system.

Leveraging EU funds to tackle child poverty and exclusion

Because the Child Guarantee activities would complement existing national-level actions and funding, several EU funds will be financing its implementation. After months of negotiations, the European Parliament, Council and Commission, agreed that member states will earmark an “appropriate amount” of the European Social Fund Plus (ESF+) to tackle child poverty and exclusion, and member states with an above-average number of children living at risk of poverty or social exclusion earmarking at least 5%. For the 2021-2027 financing period, these countries are Bulgaria, Cyprus, Greece, Ireland, Italy, Lithuania, Luxemburg, Malta, Romania, Spain and Sweden.

It will soon become clear how committed member states are to lifting children out of poverty. A clear indicator will be seeing what member states consider an “appropriate amount” and whether they target more difficult-to-reach populations, like undocumented children and families.

Going beyond the recommended actions

Member states should understand the recommended activities listed in the Council Recommendation as a first step. For instance, regarding access to healthcare, the Council only recommends to member states that they facilitate early detection and treatment of diseases and developmental problems; implement accessible health promotion and disease prevention programmes targeting children in need and their families; and provide targeted rehabilitation and habilitation services for children with disabilities. It is evident that these do not, alone, equate to effective and free access to health care for children in need. That is why member states must go beyond what is recommended by the Commission or the Council and consider the effective needs of children and what hampers them from enjoying these services.

Member states should immediately appoint a national Child Guarantee Coordinator. Member states now have until March 2022 to present national actions plans that are adapted to national, regional and local circumstances, and identify children in need and the barriers they face in accessing and taking-up the services above.

Member states cannot do this alone, however. Because they are often invisible, there is a lack of understanding of the barriers undocumented children and families face, what they need and even how many undocumented children are living in specific country. It is up to civil society, specialists and migrant-led organisations to assist member states in developing national action plans that target and effectively benefit undocumented children. And it is up to member states to ensure they are consulted and involved in the drafting of the plans.

As PICUM, we are glad to see the route taken by this Commission and the Council with their recognition that children’s interests are primordial – including when children have irregular migration status. We hope that the national action plans will reflect the intent of the Parliament, the Commission and the EPSCO council and ensure that undocumented children can fulfil their potential.

Employment, Social Policy, Health and Consumer Affairs Council (EPSCO)

A.o. by the European Court of Human Rights in Mubilanzila Mayeka and Kaniki Mitunga v. Belgium and Tarakhel v. Switzerland.

The UN Committee on the Rights of the Child, underlined that “non rights-based arguments such as, those relating to general migration control, cannot override best interests considerations.” in General Comment no. 6, Treatment of unaccompanied and separated children outside their country of origin

Cover: Unsplash – Mi Pham 

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. This interview was conducted in April 2021 with Janine Wildschut of Dokters van de Wereld to discuss the situation in the Netherlands. It is not meant to offer an exhaustive picture of the legal and practical context in the Netherlands. 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 Dutch vaccination strategy say about undocumented migrants?

The strategy explicitly mentions undocumented migrants as one target group for the vaccination campaign. In terms of priority, they come after age, medical and professional categories, and are included in the group of homeless people.

What do you make of this?

It’s good that the strategy mentions undocumented migrants explicitly, and this was the result of advocacy early-on carried out by civil society organisations. But we also pointed out that undocumented migrants should also be prioritised based on their age and medical conditions, and not come after age and medical categories, as if those didn’t apply to them. In addition, not all undocumented people are homeless, and so they wouldn’t be reached through outreach in the shelters for homeless people.

So how can undocumented migrants get their COVID-19 vaccine in the Netherlands practically?

There are three main avenues. The first one is the one outlined in the vaccination strategy, that is in the shelters for homeless people. The Ministry of Health, in cooperation with civil society, has organised vans with medical teams who administer the jabs in the shelters, or other facilities managed by civil society. This process started at the beginning of June.

At Doctors of the World, we’ve been able to administer the vaccines to some undocumented migrants before this process started. But this only happened because we were able to convince local doctors, on a case-by-case basis, that these people were old enough or sick enough to be vaccinated according to the age and medical priority groups. And then only because spare doses were available.

What about the other two avenues for undocumented migrants to get vaccinated?

The second avenue is by phone. Anyone can call a public number to book their vaccination, when they are part of the priority group whose turn it is. If you don’t have a national registration number, the operator will just insert a string of 9s. Not all operators are aware of this policy, but this is what’s in the regulations.

The third avenue is through the GPs, who can help patients with a medical condition to book their vaccination. To register with a GP, you’d normally need health insurance, which includes your national registration number: this is not available to undocumented migrants, but the GP can still accept them as patients and later be reimbursed through the national health service. Because this process is quite bureaucratic, though, it really depends on the individual GP and whether or not they’ll accept an undocumented person.

Are there any risks of immigration checks when undocumented migrants try to get the vaccine?

In the Netherlands, there’s a clear duty of confidentiality for all medical staff, and privacy regulations would apply too. We haven’t heard of any case of data sharing, but fears over immigration enforcement are obviously still present among the undocumented community.

Cover: Michal Soukup – Unsplash

EU countries should do better to protect undocumented migrant workers’ rights under existing EU rules. This is what the EU Fundamental Rights Agency found in their latest report. The research finds major gaps in the implementation of the Employers Sanctions’ Directive when it comes to enabling exploited workers to get justice, nearly ten years since it came into force on 20 July 2011. It highlights the need to improve complaints systems, access to compensation and residence permits, and ensure labour inspectorates focus on protecting workers and not immigration law. This research echoes the experiences of our members.

This issue is not new. The European Commission’s (EC) own website summarises two main findings from its first evaluation report of the Employers’ Sanctions Directive from 2014: there are differences in the severity of the punishment in different EU countries, and there is room for improvement in all areas offering protection to irregular migrants.

Nonetheless, the EU has done little to encourage such improvements so far, and rather has pursued policies focused on stepping up detention and deportation that run at odds with fundamental rights. Only one evaluation report of the Employers’ Sanctions Directive was published in 2014, and the European Commission has since remained silent regarding undocumented workers’ labour rights.

Later this year, an evaluation report from the European Commission is finally expected, together with a political direction regarding the future of the policy.

While organisations representing workers have, and continue to, express concerns around the Directive, PICUM recognises and regularly uses its provisions that explicitly reaffirm undocumented workers’ labour rights.

A major focus has been the provisions in the Directive that require EU Member States to ensure there are effective mechanisms and procedures through which third-country nationals working irregularly may lodge complaints against their employers, introduce a claim and eventually enforce a judgement for any outstanding remuneration. Effective complaints mechanisms enable the exercise of a full range of rights of undocumented workers – as persons, workers or as victims of crime – stemming from various legislation.

Crucially, in order for the complaints mechanisms and legal procedures to be effective, they have to be accessible without risk of immigration enforcement.

However, labour inspection authorities have for the most part been tasked with checking work permits of workers, in order for sanctions to be imposed on employers in the case of irregular employment – in line with the ‘Employers Sanctions Directive’. While there are a number of important examples where it is not the case, in most European countries, undocumented workers risk immigration enforcement as a result of these checks. The FRA found that labour inspectorates share irregular migrants’ personal data with police or immigration authorities in 20 out of 25 EU countries bound by the Directive. There is a lack of safeguards to ensure this data is not used for immigration enforcement. Labour inspectors also frequently carry out inspections accompanied by police who directly carry out immigration checks.

This completely undermines the purpose of labour inspections (and the ILO Labour Inspection Convention), and access to labour rights for undocumented workers. The risk of deportation for most people with precarious or irregular status is equivalent to losing everything, being uprooted from your life, repeat victimisation and exposure to significant hardship and risk of harm.

This situation also enables the immigration system to be used as a tool for exploitation. Workers threatened with deportation are liable to accept poor pay and conditions. Deported undocumented workers can easily be replaced by others and the gains made through systematically under-paying workers and not declaring work make it financially worth the risk of sanctions. Authorities also face significant barriers to imposing sanctions without the evidence and engagement of workers.

As one of our members said: “While the Labour Inspectorate struggles with sanctions against employers, the Foreign Police is very effective and quick with sanctions against workers.”

By holding employers accountable for due wages, taxes and social security, the financial implications for them would be much more significant. And fundamentally, the complaints mechanisms would serve the state, public purse and social security system, the labour market and workers.

A crucial issue at stake is whether or not the EU will recognise this in its forthcoming report. We hope the European Commission will finally take a stand and clarify to member state authorities that the Employers’ Sanctions Directive requires complaints mechanisms and procedures to be effective, and therefore due safeguards must be put in place to enable engagement and access to remedy for workers, who should not face immigration enforcement as a result.

Information gathered or otherwise obtained by labour inspection authorities should be used to initiate procedures against employers for due social security, taxes, wages and sanctions, and where applicable to support workers to access relevant residence permit procedures, but not used to initiate immigration enforcement against workers.

Find out more in our submission to the European Commission’s consultation on Directive (June 2021).

According to the law, a report on its implementation is due every three years.

Likewise our analysis from April 2015, found extremely limited implementation of any of the protective elements in four EU countries. In 2017, we looked deeper into the situation in Belgium and the Czech Republic and found worker complaints mechanisms inadequate, inaccessible and ineffective, with only one known case across the two countries in which a worker had been able to claim unpaid wages in line with the provisions of the Directive.

This directive does not apply to all EU countries – Denmark and Ireland opted out.

Cover: Unsplash – Zhipeng Ya

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. This interview was conducted in June 2021 with Maria Lapa of Amnesty International Portugal to discuss the situation in Portugal. It is not meant to offer an exhaustive picture of the legal and practical context in the Portugal. 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 Portuguese vaccination strategy say about undocumented migrants?

The Portuguese vaccination strategy doesn’t really mention undocumented migrants, but it does say that access to the vaccines is “universal”, meaning that it will be available to anyone who lives in Portugal. Access to health care is anyways possible for undocumented migrants under national law.

Public officials also announced that they’re working on a specific plan to identify and vaccinate undocumented migrants. In addition, the Ministry of Health created a dedicated registration platform to let undocumented people book their vaccine.

Can you tell us more about this platform?

Sure. Essentially, it’s a website where undocumented people can book their vaccination against COVID-19. The website, in Portuguese and in English, is adapted to them in terms of the data that they’re required to provide. On this website, people only need to provide their address, birth date, phone number and nationality. Civil society organizations seem to be playing an important role in helping migrants sign up to the platform.

According to official figures from June 2021, more than 19000 undocumented migrants have signed up.

Who manages the data provided in the platform?

The data is managed by the National Health Authority, which oversees the vaccination process. In the platform, they state that the data will be shared with the relevant entities and only for the purpose of the vaccination.

Where are undocumented migrants vaccinated? And are they required any specific documents at the vaccination point?

Undocumented migrants can go to the same vaccination centres as everyone else. It’s unclear what documents they’d need to provide, but since all vaccinations are pre-scheduled, my guess is that there would be a list for this population.

Are there any practical barriers for undocumented people to get the vaccine?

Yes, the coordinator of the vaccination task force has admitted that it’s been hard to identify migrants for the vaccination process. He also said that as long as the person is identified “they have every right to be vaccinated” because “the pandemic doesn’t choose nationality, race or age”. So it’s good to see these kind of positive statements from the coordinator, but I think that the success of this initiative will depend a lot on the ability of civil society organisations to reach out to migrant communities and convince them to trust the process enough to agree to sign up for vaccination

Cover: Unsplash – André Lergier