For undocumented people, the pandemic and related lockdown measures have exacerbated pre-existing conditions of social exclusion and deprivation.
Undocumented people are at high risk of getting COVID-19, especially if they are homeless or living in cramped, precarious conditions where physical distancing is hard to impossible. Some lost their jobs because of the pandemic, while many had to keep working – frequently in sectors that have become indispensable – often without adequate protection. Being undocumented means they are unlikely to qualify for non-emergency health care or for social or income protection schemes that are keeping others hit hard by the pandemic afloat.
As COVID-19 vaccination campaigns are starting to roll out across Europe, it is crucial that undocumented people are included.
In December 2020, the International Organisation on Migration issued a statement highlighting that, to be effective, COVID-19 vaccination plans must include migrants, and calling on governments to include all migrants present in their territories, regardless of their migration status, in their vaccine deployment plans.
At the end of 2020, the European Centre for Disease Prevention and Control also released two reports that consider migrants in relation to the COVID-19 vaccination campaigns. The first classifies “migrants and refugees” as potential target groups for the vaccination campaigns; the second advises that consideration should be given to settings with “little ability to physical distance” including migrant centres, crowded housing and homeless shelters.
In October 2020, the European Commission issued a Communication on vaccine preparedness, which includes “communities unable to physically distance” (such as “refugee camps”) and “vulnerable socioeconomic groups and other groups at higher risk” (such as “socially deprived communities to be defined according to national circumstances”) as “possible priority groups” for vaccines deployment. According to the communication:
”Member States will need to make decisions on which groups should have priority access to the COVID-19 vaccines so as to save as many lives as possible. These decisions should be driven by two criteria: to protect the most vulnerable groups and individuals, and to slow down and eventually stop the spread of the disease.”
Besides making the vaccines available to undocumented people on paper, countries need to make sure they get the vaccines in practice. What does this mean? As the IOM’s Director of Migrant Health has noted: ”As frontline health workers are prioritised, let’s not forget the countless migrant frontline health workers. As the elderly are prioritised, so should elderly migrants.” Similarly, efforts to reach people who are homeless or who are uninsured must reach, within these groups, people who are undocumented. Outreach plans need to account for the fact that for undocumented people, like others in situations of social vulnerability, financial hardship and administrative hurdles present real barriers to accessing mainstream care. More than that, the criminalisation of undocumented status means that many will avoid contact with government bodies, even if they are unwell or think they are sick.
It is, then, critical that the deployment of any COVID-19 vaccine to groups that include people who are undocumented or have insecure status has to be done in close cooperation with trusted community-based organisations that have a history of working with and providing services to them, and with the collaboration and direct involvement of individuals from these communities themselves. There must be clear assurances that any information informally or formally obtained about a person’s residence status in the course of providing care will not be used against them, to prompt immigration proceedings. And the absence of formal documentation cannot be a barrier to signing up for or getting a vaccine (or testing, for that matter).
Including undocumented people in national vaccination campaigns is not a luxury: it is necessary to ensure the success of vaccination programs, and ultimately getting the pandemic under control. But measures limited to opening up access to the vaccine are not enough. To ensure society’s resilience to similar shocks in the future, and to address the glaring cracks in our health and social welfare systems that have been exposed, governments need to adopt measures to remove systemic barriers to primary health care for all their residents, regardless of status, and ensure they are not forgotten and left to struggle alone when the next pandemic hits.
The European Commission has urged a recovery that builds resilience, that does not happen at the cost of ”the poorest people” – that ”will have to be inclusive and fair.” For this, Europe’s social policies must be disconnected from its restrictive migration policies so that all children, workers, families, individuals can get the services they need, without discrimination – in the context of this wretched pandemic, and beyond. The pandemic has shown us that this is the right thing to do, and the smart thing to do, for everyone.
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