Barriers to immunization among children of migrant workers from Myanmar living in Tak province, Thailand

An estimated 2.7 million children die annually from vaccine-preventable diseases.1 Immunization is one of the most effective existing strategies for preventing illness in children and it is widely seen as a beneficial, low-cost investment.2 The World Health Organization’s Expanded Programme on Immunization (EPI) is the first component of An essential public health package, a set of recommendations to improve child health at a low cost.3 Despite this, the implementation of immunization programmes varies greatly across different communities4 and approximately 34 million children worldwide do not have access to any immunization services.4,5

Thailand is one of the most successful and stable economies in south-east Asia and draws tens of thousands of migrant workers from Myanmar each year. More than 2 million people from Myanmar live and work, predominantly illegally, in Thailand.6 Illegal migrants represent a significant public health issue. It is estimated that only 10% of migrants are legally registered in Thailand and most do not use the Thai health services; as a result, children of migrant workers rarely receive immunizations.7 The Thai Government maintains immunization records for all Thai children but not for migrant children living on the Myanmar border. The Thai district health authorities attributed this to difficulties completing immunization courses due to the mobile nature of these communities.