Letter to the Editor
The Russo-Ukrainian war crisis and vaccination of Ukrainian refugees as an urgent need
Crisis bélica ruso-ucraniana y vacunación de los refugiados ucranianos como necesidad urgente
a Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
b Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
c Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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This mortality and morbidity burdens are further intensified when people are forced to migrate, have limited access to safe food and water and are have to dwell in overcrowded environments during military conflicts. Through wars, millions of refugees are forced to flee causing a huge influx of population to neighboring territories. These migratory movements pose serious public health challenges.<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a> In the actual context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic with more than 531 million confirmed cases as well as 6.3 million deaths in the worldwide due June 2022, makes this challenge even more difficult to manage. There is no certain therapeutic regimen for SARS-CoV-2 infection and vaccination remains as the only measure available to control the current status of the COVID-19 pandemic. Unfortunately, the Russia-Ukraine war initiated on February 24, 2022 is causing a serious challenge for both countries and their neighbor territories. The recent Russian invasion has forced Ukrainian people to flee from their country and migrate to other European neighbors i.e. Poland, Romania, Russia, Hungary, Moldova, Slovakia, and Belarus.<a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a></p><p id="p0010" class="elsevierStylePara elsevierViewall">By February 2022, the Ukraine ministry of health had registered 5.04 million confirmed COVID-19 cases and 112,459 deaths attributed to SARS-CoV-2 infection. Mass vaccination was also initiated on February 24, 2021 in Ukraine at the same day as the invasion a year before.<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> However, only 34% of the Ukrainian population have been fully-vaccination against COVID-19.<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a> Efflux of Ukrainian refugees could increase the risk of COVID-19 infection and even emergence of new SARS-CoV-2 variants throughout the European countries.<a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a> Ukraine has lower SARS CoV-2 vaccination rates than neighboring countries e.g. Hungary (63.6%) and Poland (59.3%). High efflux of Ukrainian refugees during short span can aggravate health problem in these territories. Ukraine citizens as well as intermingled refugees could be asymptomatic carriers of SARSCoV-2 that may possibly transmitted to other European residents. Poland's healthcare services warning regarding possibility of further increasing trend of SARS-CoV-2 in Poland (34.5% vs. 59.3% vaccine coverage) or even overstretched due to large influx of Ukrainian refugees during short time span.<a class="elsevierStyleCrossRefs" href="#bb0025"><span class="elsevierStyleSup">5–7</span></a> In addition, outbreaks of polio and measles are very likely due to inappropriate vaccine coverage that be 82% (2 doses of measles vaccine) as well as 50% (polio vaccine) in several oblasts such as Kharkiv, where massive population are fleeing after the military conflict.<a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a> The European Centre for Disease Prevention and Control (ECDC) also notes that other concerns regarding Ukraine's population including (second highest number of tuberculosis cases in Europe), HIV (the second-highest prevalence of HIV/TB coinfection in the World Health Organization European Region), and seasonal flu in Ukraine.<a class="elsevierStyleCrossRef" href="#bb0040"><span class="elsevierStyleSup">8</span></a><span class="elsevierStyleSup">,</span><a class="elsevierStyleCrossRef" href="#bb0045"><span class="elsevierStyleSup">9</span></a> It also announced that traumatic wounds infected by multi-drug resistant organism during the invasion of Ukraine that could be transmitted in other European territories.<a class="elsevierStyleCrossRef" href="#bb0050"><span class="elsevierStyleSup">10</span></a> In summary, the recent Russo-Ukrainian war has raised concern about preventive measures about COVID-19 pandemic. Thus, resorting to refugee shelters, mass vaccination of Ukrainian refugees, impose restrictions on gatherings, movement and business operations, the wearing of face masking, obligation to perform COVID-19 test and undergo quarantine in Polish-Ukrainian border can curb a possible increase in COVID-19 cases in other European countries. In all and with special concern for the surge of new SARS-CoV-2 variants, as well as better management of the current situation, these actions should be undertaken as soon as possible.</p><span id="s0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0005">Conflict of interest</span><p id="p0015" class="elsevierStylePara elsevierViewall">There is no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "s0005" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-06-07" "fechaAceptado" => "2022-06-10" "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." 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