Development of a country specific flow chart to the effective vaccination of migrants in Italy.

S Scarso, M L Russo, G Marchetti, G Mancini, A Bellini, M Sabato, C Ferrari, M Marceca, S Declich

European Journal of Public Health, Volume 33, Issue Supplement_2, October 2023

Published: 24 October 2023



Achieving universal health coverage (UHC) is a key priority for promoting health equity. However, migrants face significant barriers to accessing health services, including vaccination. Within the “Access To Vaccination for Newly Arrived Migrants”(AcToVax4NAM) project (Grant No. 101018349, 3° EU Health Programme), this study aims to develop Italian country-specific action-oriented flow chart to overcome system barriers to the effective vaccination of newly arrived migrants (NAM).


Taking advances from AcToVax4NAM’s prior research on vaccination barriers and solutions related to NAM immunization, Italian Professionals for Health (PfH) were engaged in participatory activities to ensure context-specific and relevant flow charts. The stakeholders invited were professionals working in Local Health Authorities (LHA), Non-Governmental Organizations and Universities. Two Focus Groups (FGs) were organized in order to validate and finalize the flow chart.


A total of 29 PfH participated in the two FGs. The Italian country-specific flow chart resulted in a comprehensive approach to addressing barriers to effective vaccination of NAM in LHA. The flow chart includes steps such as entitlement, reachability, adherence, achievement and evaluation which are critical to ensuring vaccination coverage among migrants. A total of 58 tools also provides practical resources to support PfH in implementing the flow chart and addressing system barriers. Further evaluation of the impact of this flow chart on vaccination coverage and health outcomes is needed to assess their effectiveness and inform future efforts to improve health equity.


The development of Italian country-specific flow charts represents an important step towards achieving UHC and reducing health inequity among migrants. This flow chart and the tools identified to address the barriers have the potential to be a powerful support resources for equitable and guaranteed vaccination for NAM.

Key messages

• The Italian country-specific flow chart by addressing barriers to effective vaccination of NAM have the potential to significantly improve the health of migrants by reducing health inequity.

• The AcToVax4NAM’s approach to creating context-specific flow charts ensures health equity for newly arrived migrants and their access to necessary vaccinations, promoting optimal health outcomes.

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