The New York Academy of Medicine

This article, published in the Journal of Urban Health is on "HTR" (hard-to-reach) populations and the need to develop plans to reach them with influenza immunisation in the event of an influenza pandemic. According to the authors, most pandemic preparedness plans do not currently address how to vaccinate HTR populations, including undocumented immigrants, substance users, the homeless, homebound elderly, and minorities. These groups frequently have poor access to immunisation services, difficulties in negotiating the health care system, system, financial constraints, and/or lack of education - all of which can lead to misconceptions about vaccine risks and benefits, and lack of clear, strong recommendations from health care providers. "In the United States there are an estimated 11.5-12 million undocumented immigrants, 1.5 million IV drug users (in 96 large urban areas), and 744,000 homeless persons."

The study recommends involving communities and participants from the HTR populations in designing immunisation distribution services, and in developing and pilot testing educational materials that are community based and culturally sensitive. The research also emphasises access to vaccination sites by increasing the number of unconventional sites, for example urban needle exchange programmes. Researchers suggest that neighbourhood locations associated with trust and familiarity include pharmacies, grocery stores, public schools, daycare centres, churches, migrant worksites, soup kitchens, homeless shelters, gathering places for day labourers, community-based clinics, and senior centres. The study concludes that immunizing HTR populations is of public health importance.”

This article is available through subscription to Journal of Urban Health: 2007;84(4):615-631 or for purchase at the web address below at a cost of $US32.