Over the past few years, there has been a lot more talk about refugees in the media. A refugee is someone who has been forced to leave their home country because of poor conditions, including war, hostility (persecution), and violence. [1] Refugees fear desperately for their safety, and cannot return home for reasons related to their race or nationality, religion, political or social orientations/opinions. [1] According to the United Nations Refugee Agency, “war and ethnic, tribal and religious violence are leading causes of refugees fleeing their countries.” [1] Countries in crisis often experience citizens fleeing for fear of their safety—most of us are the most familiar with the stories of refugees from Syria, South Sudan and Iraq. [1]

In recent years we have heard of the spread of disease—pandemics—from one country to another, worldwide. Some examples include the Zika virus, H1N1, and seasonal flu. [2] The Centers for Disease Control and Prevention (CDC) helps to prevent the spread of diseases to the United States from refugees and immigrants by ensuring all persons seeking entrance to the United States undergo a required medical examination to be admissible for entry into the United States. [3] This public health measure includes both refugees and immigrants from outside the US, as well as those seeking asylum (protection) in the US before refugee status is granted. [3] Individuals with a communicable disease may be denied entry or have to wait until they are healthy—as well, vaccinations and immunizations must be up to date and records provided. [3] Physical and mental health, risk to others, and drug use are all factors that may change a person’s admissibility status. [3]

Most refugees have the chance for better health once they are in a country where their safety is not being threatened. Healthcare is a human right, and one that they may not have access to in the country they are fleeing.

The gravity of their situations means that asylum seekers want to do their best to meet entry requirements: this includes being vaccinated for all vaccine preventable diseases outlined by the CDC—mumps, measles, rubella (MMR vaccine); polio; diphtheria, tetanus, pertussis (whooping cough) (DTAP vaccine); Flu strain B, seasonal influenza (flu); rotavirus, hepatitis A and B (“Twinrix” vaccine), meningitis (Meningocococcal disease), varicella and pneumonia. [3.1] Lacking these vaccines or being infected with a disease that has public health significance may be cause for denial or delay of entry to the United States. These diseases/infections include tuberculosis, syphilis, gonorrhea, or leprosy, or any disease currently in the “quarantinable diseases” category (most of which are vaccine preventable), and/or any disease currently a public health threat or emergency determined by the World Health Organization (for example, smallpox and SARS). [3.1]

Some may ask if these diseases are vaccine preventable, why must refugees be free of them before entry? For medical reasons, some people are unable to be vaccinated against certain diseases—while the school of thought is changing, often people with egg allergies have been told to avoid vaccine due to potential allergic reaction, but this is one example of a susceptible group who could be harmed by introduction of diseases eradicated in North America by immigrants. If you have an egg allergy, it is important to wear a medical ID bracelet for anaphylaxis or a food allergy medical ID.

The issue of health and refugees is complex, and this barely touches the surface. However, it is important to remember that refugees who are admitted (as well as those who have already sought asylum prior to application) are thoroughly screened during the admission process. Dire circumstances in their home countries mean that access to treatment is limited—both physical and mental health issues (such as Post Traumatic Stress Disorder) can affect refugees, most of which are treatable upon resettlement. [4]

The key things to remember are that governments of developed nations like the US and Canada do all they can to decrease public health and safety risk when accepting refugees, and that many health threats to refugees are ones that are eradicated in developed nations—they are preventable, treatable, and education of both refugees and the public can further decrease perceived public or personal heath risks.