311 Health equity challenges for forced migrants in the COVID-19 pandemic: an MD-PhD thesis

Abstract OP 31: Refugees and Asylum Seekers 6, B207 (FCSH), September 5, 2025, 09:00 - 10:00 Background The COVID-19 pandemic exacerbated pre-existing health inequities, particularly among forced migrants who often face barriers to healthcare access and lack representation in health policy. This thesis examines health equity challenges faced by population in vulnerable situations in the canton of Vaud, Switzerland during the pandemic, focusing on risk factors, attitudes, and experiences. Methods This MD-PhD thesis is composed of five studies with different methodology including systematic review of the literature, quantitative surveys, seroepidemiologic data, and semi-structured qualitative interviews. It aimed to identify risk factors associated with higher COVID-19 prevalence among forced migrants, understand their attitudes and awareness regarding prevention guidelines, assess pandemic-related experiences and concerns, and evaluate the implementation of COVID-19 vaccination programs for undocumented migrants. Results Findings revealed higher infection rates linked to living conditions and low health literacy. Poor knowledge of health recommendations correlated with language barriers and community center living. Asylum seekers residing in community centers reported more sleep disorders compared to those in private accommodations. Individuals with lower educational backgrounds expressed greater fear for their lives. Denied asylum applicants were more likely to believe COVID-19 rumors. The study also demonstrated that specific vaccination programs for undocumented migrants were crucial for ensuring equitable healthcare provision during the pandemic. Conclusion The thesis emphasizes the need for tailored public health interventions addressing the unique challenges faced by forced migrants. Recommendations include relocating migrants from high-density facilities to private accommodations, adapting health communication to be linguistically and culturally appropriate, implementing targeted vaccination programs, and proactively addressing mental health. By integrating health equity considerations into comprehensive public health policies, healthcare systems can work towards more equitable care provision for vulnerable populations, particularly during crises like the COVID-19 pandemic.