Catch-up and life-course vaccination policies for adult and adolescent migrants in low-and-middle income countries: A policy analysis.

Publication date: May 22, 2026

Adolescent and adult migrants in low- and middle-income countries (LMICs) are often under-immunised because of disrupted vaccination in childhood and barriers to care, increasing the risk of vaccine-preventable diseases. WHO’s Immunization Agenda 2030 strengthens calls for life-course immunisation and inclusion of marginalised groups in catch-up initiatives (including Td/Tdap, IPV, MR/MMR, HepB, HPV). Despite evidence from Europe that migrants are frequently missed, it is unclear how far LMIC policies include adolescents and adults beyond child-focused programmes. We analysed catch-up and life-course vaccination policies, operational guidance, laws and frameworks across 136 LMICs. Using framework analysis, we conducted a comparative policy analysis of national and subnational policies, operational guidance, laws and frameworks on catch-up and life-course vaccination for adolescents (10-19 years) and/or adults (>19 years) migrants (including refugees, undocumented migrants, asylum seekers, Internally Displaced Person (IDPs) and migrants workers) across LMICs. We did systematic database and grey-literature searches including and Ministry of Health websites, key international organisations (Jan 2000-Feb 2025), and contacted health ministries and national experts to locate unpublished policies and guidelines. 33 policy and guidance sources met the inclusion criteria (15 peer-reviewed; 18 grey literature), reporting vaccination policies for migrants across 57 LMICs. Evidence clustered into two policy domains, routine vaccinations and COVID-19. We found that migrant-inclusive catch-up or life-course vaccination policies for routine vaccines were rare, identified in only 9 (6. 6%) of 136 LMICs. 3 (33. 3%) of these countries focused on outbreak-responsive or ad hoc provisions only, 4 (44. 4%) applied general national immunisation schedules with opportunistic catch-up to migrants (but without migrant-specific operational guidance), and 2 (22. 2%) recognised migrant entitlement through formal policy frameworks or structured partnerships. Policies targeted both adolescents and adults in 9 (6. 6%) of 136 LMICs, and refugees in 9 (6. 6%) LMICs, while other migrant groups were less consistently specified. Vaccines most commonly appearing in guidelines for adolescent and adult migrants in LMICs were HPV in 6 (4. 4% of 136 LMICs) and MR/MMR in 5 (3. 7%), followed by OCV and HepB in 3 (2. 2%) countries each. Polio, tetanus and typhoid were also included in rare cases. Where vaccination history was uncertain, only 3 (33. 3%) countries explicitly recommended presumptive catch-up vaccination. For COVID-19, vaccination policies demostrated broad migrant inclusion: 57 (41. 9%) of 136 LMICs documented migrant-inclusive policies or rollout targeting adolescents and/or adult migrants through national deployment plans or emergency strategies. Most LMICs lack policies ensuring adolescent and adult migrants access catch-up and life-course vaccination, despite ample evidence that these are under-immunised populations. Governments should clarify entitlements, adopt migrant-inclusive guidance, and strengthen delivery and monitoring systems to reach people who miss vaccines, doses, and boosters in origin countries or during transit, and who face barriers to care.

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Original Article