Access to COVID-19 vaccination for displaced Venezuelans in Latin America: a rapid scoping review

Abstract

Background: Venezuelan migration is the second largest international displacement in contemporary history. Yet, amid global calls for the inclusion of migrants and refugees in COVID-19 vaccination priority groups, little is known about how Latin American countries are prioritising COVID-19 vaccination for Venezuelans. This rapid scoping review addresses this gap, taking up a Latin American Social Medicine approach to assess the region's sociopolitical context and explore the extent to which Venezuelan migrants are considered in COVID-19 vaccination strategies in Latin America. Methods: We conducted a three-phased rapid scoping review assessing peer-reviewed literature, gray literature, and government documents addressing COVID-19 vaccine access for displaced Venezuelans in Latin America. Documents published in English, Spanish, or Portuguese between January 2020 and June 2021 were included. Peer-reviewed literature search yielded 142 results and 13 articles included in the analysis; Gray literature screening resulted in 68 publications for full-text review and 37 were included; and official Ministry of Health policies in Argentina, Brazil, Chile, Colombia, Ecuador, and Peru were reviewed in-depth. Screening and data extraction used a combination of online platforms (Covidence, Google Forms, Zotero, and Excel) and the team met twice weekly to review, compare, discuss, analyse, and interpret data across a 6-week period. Findings: Findings from country-level policies revealed a heterogeneous and shifting policy landscape amid the COVID-19 pandemic, which strongly juxtaposed calls for a rights-based, social justice approach to COVID-19 vaccination evidenced in the peer-reviewed and gray literature. For example, under extreme resource constraints resulting from a chronically underfunded health system and mass Venezuelan migration. Colombia's vaccination plan excluded migrants with irregular migration status. Countries prioritised COVID-19 vaccines to certain “at-risk” groups defined by individual epidemiological factors rather than social vulnerability, limiting vaccine access for displaced Venezuelans in the region. Country-level policies differentiated, at times arbitrarily, between refugees, irregular migrants, and regular migrants, with important implications for vaccine access. While international right to health legislation prohibits discrimination based on migration status and urges states to refrain from denying access to preventive health services, these results suggest the need for further guidance on terminology to better contend with migrants' social vulnerabilities. Interpretation: COVID-19 is rapidly evolving and there is an urgent need for rights-based approaches to vaccination that consider sociopolitical contexts, especially impacts of mass migration. Findings underscore the need to better integrate Venezuelan migrants into vaccination strategies, not only as a matter of social justice, but a pragmatic public health strategy. Funding: Funding provided by the Canadian Social Sciences and Humanities Research Council Insight Development Grant.