A new beginning for refugee children settling in the United States may be delayed if their vaccination status prevents them from starting school. Refugees are invited to live in the United States by the federal government due factors such as war, environmental disasters, or political, religious, or ethnic persecution in their home countries. Although refugees in the United States are eligible immediately for the Medicaid program to ensure access to health care, lack of vaccine education and difficulty navigating the health system can stall their vaccine uptake.
St. Louis Children’s Hospital’s mobile health unit helps refugees overcome those barriers and others by bringing immunizations to where they live and providing education in their languages.
When the hospital’s Healthy Kids Express began operating in 2000, it brought immunizations to families at the International Institute of St. Louis, an immigration service and information hub. Now, children receive vaccinations in one of the hospital’s facilities located near neighborhoods where many refugee families settle. The program is available to children eligible for the federal Vaccines For Children program.
Removing barriers to vaccination
Kim Ewing, a registered nurse who works with Healthy Kids Express, said most parents are open to vaccinating their children once they understand what’s offered and its protection. However, language barriers often stand in the way. The Healthy Kids Express team works with interpreters to communicate with families and educate them on the importance of vaccination.
“There’s definitely an educational component there,” Ewing said. “We’ve developed our own script where we ask each parent and patient about allergies and past medical procedures. Then, we ask if they know what immunizations are and what they do.”
Ewing said the team has created printed resources in six of the most common languages so every parent can understand how vaccines work and the importance of getting children immunized. The handouts include potential side effects, what to expect in the hours or days after the immunization, and emergency contacts in the case of a reaction. The team also uses certified medical interpreters and a virtual interpreter via tablet during immunization visits.
Transcending vaccinations
Although the Healthy Kids Express team focuses on vaccination efforts, they see vaccinations as a first step for a family to receive care. For example, when a mother brought her children in for vaccinations, she expressed concern about her son’s abdominal distress. The nurse sent a message to a provider where the family had received care previously and determined the child should be brought to the emergency room. Ultimately, the child was admitted to the hospital for care. Without this intervention, the boy's condition could have had life-altering consequences.
Crystal Nelson, community health manager, said her unit regularly organizes food boxes, referrals for dental services, and distribution of toys and other items for the children they are helping.
“Our focus is to get them immunized, and we're just lucky that we have other resources that we're able to offer the families,” Nelson said. “We can get them in school, and that's our priority.”
