Since October, aid organization Samusocial de Paris has been offering COVID-19 vaccinations twice a week to homeless people, mainly migrants, at Porte de la Villette, in northern Paris. The organization has to face many challenges dealing with this mobile population with little access to the internet and which does not always speak French. InfoMigrants spoke with Maëlle Prioux, head of health projects at Samusocial and Samy Rasli, coordinator of public health actions at Samusocial.
InfoMigrants : How many migrants have been vaccinated since you have started giving out the vaccine at Porte de la Villette?
Maëlle Prioux: "Every day, we have 56 doses of the vaccination to give out. On average, we use about 40 doses.
From October 13 to December 16, we gave 547 doses to 335 people. Of these, 261 were a first dose, 156 a second and 74 a third.
The number of first-dose injections is higher for two reasons. We see a lot of newcomers who were unable to get vaccinated on the road to exile, but also because some received a vaccine that is not recognized by the European Union."
Samy Rasli: "In addition, other migrants can no longer find their document relating to their vaccination schedule. In these cases, we offer serology tests to adjust the number of doses needed according to the presence or absence of antibodies in the blood.
Of the 270 tests performed, 34% came back positive. This means that one-third of the population we receive has developed antibodies, either from having contracted Covid-19 or from having been already vaccinated."
IM: How are migrants referred to your facility?
MP: "We work a lot with the partners of Samusocial de Paris, such as 115, Doctors Without Borders (MSF), the Red Cross or even the associations managing the reception centers. They send us people who want to be vaccinated.
We have also done outreach work in lodgements to tell migrants about this vaccination program and to set up appointments."
IM: Do you also vaccinate minors in the Porte de la Villette facility?
MP: "Yes, we vaccinate unaccompanied minors aged between 12 and 18. At present, under-16s cannot be vaccinated without the authorization of an adult, which simplifies the procedure.
For the others, they can choose a guardian of their choice. It has already happened, for example, that a young person presents himself with a member of France terre d'asile, who serves as his reference."
IM: Are some migrants reluctant to be vaccinated?
SR: "They are no more reluctant than the general population. We find the same apprehensions among migrants.
As in the rest of the country, there was also a renewed interest in the vaccine pass. Migrants will need it to travel, for example, by train for long-distance journeys, to honor their administrative appointments. So, since the beginning of the year, the Porte de la Villette structure has been running at full capacity."
IM: What challenges do you face in vaccinating the migrant population?
SR: "There are many administrative difficulties, such as the impossibility of making an appointment on the Doctolib website due to a lack of Internet connection, or because of the language barrier. All this complicates their access to vaccination."
MP: "The second injection can also be a problem. It is a population on the move, migrants are not necessarily in the same place between the first and second dose. It is therefore sometimes difficult for us in our structure to follow up. And they don't always have a phone that would allow us to reach them for their second appointment.
In addition, the number of boosters becomes more complex as people's administrative status changes. To put it simply, a person who receives his or her first dose and who have not received their rights under the health insurance system obtains a provisional number for his or her vaccine.
If the person's rights are then provided at the time of the second injection, this number may not be found because there is no link between the provisional file and the health insurance. This can be a complex process for caregivers who cannot find the provisional number. This can make it difficult to administer the second dose."
SR: "It also happens that vaccination centers refuse people without a carte vitale [health insurance card] or CMU [complementary health insurance, ed. note]. Legally, it is open to everyone but some caregivers are not aware of this or simply do not want to do it.
The absence of a "carte vitale" can sometimes be an obstacle to accessing traditional structures. Two thirds of the people who come to Porte de la Villette have not received their medical rights, for the AME [Aide médicale d'État] for example".
IM: Can the vaccination pass requirements complicate the daily life of migrants?
SR: "The pass requirements can make it difficult to travel. It is less of an issue for leisure or cultural places, because the majority do not frequent them.
Another consideration, though is the fact that the vaccination pass is one more document migrants need to keep safe, when they already have to keep so many of them for their administrative appointments."
***Practical information: The Samusocial de Paris vaccinates every Wednesday and Thursday from 10am at Porte de la Villette, at the Restos du cœur food distribution.