BACKGROUND: The COVID-19 pandemic has prompted considerable changes in delivery of UK primary care, including rapid digitalisation, yet the impact upon marginalised migrant groups is unknown .
AIM: To understand the impact of the COVID-19 pandemic on migrants and their access to primary healthcare, and implications for COVID-19 vaccine roll out .
SETTING: Primary care professionals, administrative staff, and migrants (foreign born ;> 18 years; <10 years in UK), were recruited in three phases using purposive, convenience and snowball sampling from urban, suburban and rural settings .
METHODS: In-depth semi-structured interviews were conducted by telephone . Data were analysed iteratively, informed by thematic analysis .
RESULTS : 64 clinicians were recruited in Phase 1 (25 GPs , 15 nurses , 7 HCAs , 1 Pharmacist); Phase 2 comprised 16 administrative staff; and Phase 3 , 17 migrants (88% asylum seekers; 65% female; mean time in UK 4 years). Digitalisation has amplified existing inequalities in access to healthcare for many migrants due to lack of digital literacy and access to technology, compounded by language barriers and challenges building trust . Participants highlighted challenges registering and accessing healthcare due to physical closure of surgeries . Migrants reported specific beliefs around COVID-19 and COVID-19 vaccines, from acceptance to mistrust, often influenced by misinformation . Innovative opportunities suggested included translated digital health advice using text templates and YouTube .
CONCLUSION: Migrants risk digital exclusion and may need targeted support to access services . Solutions are urgently needed to address vaccine hesitancy and barriers to vaccination in marginalised groups (including migrants) to ensure equitable uptake of the COVID-19 vaccine.