Serological Vulnerability and Active Infection Detection Among Recently Arrived Migrants in Spain: Results from a Targeted Screening Program.

Abstract

Background: Newly arrived migrants are at increased risk for vaccine-preventable and communicable diseases due to low immunization coverage, poor access to healthcare, and challenging migration trajectories. This study describes the implementation and outcomes of a one-stop public health intervention focused on serological screening and accelerated vaccination in recently arrived migrants in Galicia, Spain.

Methods: We conducted a cross-sectional descriptive study in July and August 2024 involving 335 adult migrants from sub-Saharan Africa with irregular administrative status and asylum applications. A centralized mobile health unit provided point-of-care screening for immunity against measles, mumps, rubella, varicella, and hepatitis A, alongside testing for active infections, including hepatitis B and syphilis. Sociodemographic and clinical data were collected, and individuals were offered vaccination according to an accelerated immunization schedule.

Results: Of 336 migrant adults invited to participate in the study, only 1 individual declined to participate (participation rate: 99.7%). Therefore, 335 migrants were assessed. A significant proportion of participants were susceptible to at least one vaccine-preventable disease, particularly hepatitis B (36.4%, 95% CI 31.3-41.6), measles (22.7%, 95% CI 18.2-27.2), and varicella (16.4%, 95% CI 12.5-20.4). Active infections were detected in 12.9% (95% CI 9.3-16.4) of individuals, including hepatitis B (9.9%, 95% CI 6.7-13.0) and syphilis (3.0%, 95% CI 1.2-4.8). The intervention allowed for timely vaccination and linkage to care, minimizing dependence on passive healthcare access.

Conclusions: This study highlights substantial immunization gaps and the presence of undiagnosed infections in vulnerable migrant populations. Centralized and culturally adapted screening programs, combined with accelerated vaccination strategies, are feasible and effective. These findings support the integration of structured protocols into national health systems to ensure equity, reduce transmission risk, and align with WHO and ECDC public health frameworks.