Nearly 90,000 of the Afghans who were displaced by the Taliban takeover of Kabul reached the United States through Operation Allies Welcome (OAW) Response. OAW was an initiative that coordinated efforts across the federal government and its many partners. As resettled Afghans began arriving in 2021–during the COVID-19 pandemic–resettlement agencies collaborated with federal agencies, healthcare systems, public health professionals, social service providers, and community-based organizations to provide assistance.

Nearly 90,000 Afghans who were displaced by the Taliban takeover of Kabul came to the United States through Operation Allies Welcome (OAW) Response. Launched in 2021, OAW was a coordinated interagency initiative that mobilized federal government offices, national non-profit organizations, state and local resettlement agencies, private businesses, and other stakeholders to resettle and support Afghan newcomers.

Many people from Afghanistan have arrived to the United States through Operation Allies Welcome (OAW) Response. Amid the ongoing COVID-19 pandemic, resettlement agencies around the country had to work rapidly with federal partners, health systems, public health practitioners, social service, and community-based organizations to support newly arrived Afghans.

Estimates suggest that 20% of displaced and migrating women have experienced some form of sexual violence. This overall prevalence speaks to the historical and collective effects of conflict and forced migration and suggests urgent action is needed to support the needs of survivors, particularly in communities of refuge.

Starting in August 2021, the Food and Drug Administration began approving pediatric COVID-19 vaccines, starting with ages 16 and up, and approving other age groups throughout 2021 and 2022.  As of May 2023, the CDC reports that the proportion of children under-the-age of 18 who have completed their COVID-19 primary series continues to lag behind adults, with less than 20% obtaining bivalent boosters.

Many newly resettled Afghans in the United States came through Operation Allies Welcome (OAW) Response , a coordinated interagency effort to resettle over 75,000 Afghans displaced by the Taliban takeover of Kabul in August 2021. In the midst of the ongoing COVID-19 pandemic, resettlement agencies around the country had to work rapidly with federal partners, health systems, public health practitioners, social service and community-based organizations to support newly arrived Afghans.

The COVID-19 pandemic has disproportionately impacted refugee, migrant, and immigrant (RIM) communities. This crisis is shaped by various social, economic, and cultural factors, including religious practices, which can significantly influence RIM community responses to the pandemic and acceptance of vital health services such as vaccines.

Using multiple touch points in vaccine outreach through reminder systems, such as phone calls, letters, and text messages, can significantly increase vaccine uptake. Several studies have demonstrated the positive impact of these reminder systems on vaccination rates.

Over 75,000 of the Afghans who were displaced when the Taliban took control of Kabul were resettled in the United States through Operation Allies Welcome (OAW) Response. OAW was organized in 2021 as a coordinated effort across federal government offices, national non-profit organizations, state and local resettlement agencies, private businesses, and other stakeholders to resettle and support Afghan newcomers.

Organizations that work with refugee, immigrant, and migrant (RIM) communities often face numerous linguistic and cultural challenges when communicating with these communities. These communication gaps were made more apparent during the COVID-19 pandemic across non-English speaking and limited English proficient (LEP) communities. 

More than 75,000 of the Afghans who were displaced as the Taliban took control of Kabul have found refuge in the United States through Operation Allies Welcome (OAW) Response. Established in 2021, OAW coordinated efforts among multiple federal, state, and local agencies to resettle and support Afghan newcomers.

Many newly resettled Afghans in the United States came through Operation Allies Welcome (OAW) Response , a coordinated interagency effort to resettle over 75,000 Afghans displaced by the Taliban takeover of Kabul in August 2021. In the midst of the ongoing COVID-19 pandemic, resettlement agencies around the country had to work rapidly with federal partners, health systems, public health practitioners, social service and community-based organizations to support newly arrived Afghans.

As the pandemic reaches three years, the public has wearied of COVID-19 and may not feel motivated to engage with important health messaging. At the same time, without proper precautions COVID-19 can still cause significant illness and even death. To continue engaging people, the International Rescue Committee (IRC) has adapted its approach to discussing COVID-19 with clients by mainstreaming the conversation and inserting it into contextually appropriate conversation entry points.

For many refugee, immigrant, and migrant (RIM) community members, navigating the complex U.S. healthcare system is challenging, even in normal times. During the COVID-19 pandemic, existing inequities in health and access to health care have been compounded by inadequate or insufficient COVID-19 information in languages other than English.

Many refugee, immigrant, and migrant (RIM) community members experience significant cultural, linguistic, and logistical barriers to accessing health information and healthcare, including accurate information about COVID-19, COVID-19 vaccines, and vaccination opportunities.

Many refugee, immigrant, and migrant (RIM) community members experience significant cultural, linguistic, and logistical barriers to accessing health information and healthcare, including accurate information about COVID-19, COVID-19 vaccines, and vaccination opportunities. 

Over-the-counter (OTC) medicines are a broad category of medicines that people can buy without a prescription from a healthcare provider. These are often recommended to safely treat or provide symptom relief for common health issues, including COVID-19. For refugee, immigrant, and migrant (RIM) communities, the lack of translated resources for how to use OTC medicines, including potential drug interactions, can present a significant safety risk.

COVID-19 has disproportionately affected refugee, immigrant, and migrant (RIM) communities and highlighted health inequities that often stem from a lack of trust and understanding between RIM communities and public health or healthcare agencies. Community health boards can serve as an effective strategy to build capacity within a community as well as provide community members with a trusted resource for health information and guidance.

Refugee, immigrant, and migrant (RIM) community members have experienced significant obstacles to accessing consistent and free COVID-testing. Community members face a lack of walk-up and/or trusted testing sites, limited (and fluctuating) cost-free testing supplies and a lack of culturally and linguistically appropriate testing resources on-site. Testing is a critical tool in the mitigation of COVID-19, particularly during surges.

Many refugee, immigrant, and migrant (RIM) community members experience significant cultural, linguistic, and logistical barriers to COVID-19 vaccination. Accessing the COVID-19 vaccine presents several challenges, including digital literacy, transportation, and navigating unfamiliar vaccination sites. When eligible children and their adult relatives have opportunities to get vaccinated at pediatric clinics and children’s hospitals, some of the barriers to vaccinating the whole family are reduced.

Building vaccine confidence takes time and trust. Client-facing staff and others working directly with community members seeking to dispel fear, misinformation, and disinformation will usually need to engage and explore people's hesitancy before sharing accurate information. One helpful way to do this is using some of the techniques found in Motivational Interviewing.

The COVID-19 pandemic continues to have a disproportionate impact on refugee, immigrant, and migrant (RIM) communities. To slow the spread of COVID-19 in RIM communities, health departments and community-based organizations (CBOs) are developing innovative approaches that encourage youth to wear a mask and get vaccinated not only for themselves, but also for others.

The availability of accurate COVID-19 information that is culturally and linguistically relevant is essential to keeping communities safe. Messages change rapidly and some health departments may face challenges with developing health messaging that reaches all communities, particularly refugees, immigrants, and migrants (RIM). 

Many refugee, immigrant, and migrant (RIM) community members experience significant barriers to getting accurate information about the COVID-19 vaccine, as well as the vaccine itself. At clinics and mass vaccination events, the challenge of navigating a large and confusing site with unfamiliar staff can be intimidating.

Effective community-led COVID-19 responses are built on approaches that give space for communities to identify problems, explore solutions, and draw up action plans to address community needs. Yet, traditional research methods do not commonly reflect community voices, and perspectives. Often community members are not meaningfully engaged in the research process.

Youth and young adults continue to have low COVID-19 vaccination rates across the US. Engaging youth is vital in the next stage of vaccine promotion and for reaching herd immunity.

Many people from refugee, immigrant, and migrant (RIM) communities experience significant logistical barriers to COVID-19 vaccination. Some vaccine campaigns rely on internet-based registration and utilize locations that accommodate large numbers of people for vaccine administration. This strategy may be ineffective for many RIM communities due to linguistic limitations, unreliable internet access and overall internet navigation barriers. Community members may not have reliable internet access or be familiar with the internet.

Social media is a primary source of information for much of the US public, especially youth and young adults. This includes people in refugee, immigrant and migrant (RIM) communities who may not utilize traditional media sources that are not published in their language.

Immunization rates are lower among refugee, immigrant, and migrant (RIM) communities due to factors that include limited culturally and linguistically appropriate information, knowledge and beliefs about a disease and vaccine, and challenges accessing healthcare (related to cost, transportation, medical system complexity/unfamiliarity, lack of welcoming environment, etc.). Vaccine hesitancy is a significant hurdle to ending the COVID-19 pandemic and getting back to

In the COVID-19 response, partnerships are essential to reaching refugee, immigrant, and migrant (RIM) communities, maximizing resources, reducing duplicating efforts, and improving the delivery of services and resources. The requirement in most of the U.S., that a person must visit a medical facility to receive medical services, is a large barrier for many individuals and communities, particularly for preventive health care such as immunizations.

As COVID-19 continues to disproportionately impact refugee, immigrant, and migrant (RIM) communities, it is vital that linguistically and culturally appropriate messaging created by and from the community is accessible. Recognizing the need to reach individuals with real-time, tailored messaging about COVID-19, the International Rescue Committee (IRC) in Boise is creating hyperlocal, rapidly produced videos.

In the COVID-19 response, some vaccination sites are challenged to vaccinate large numbers of refugee, immigrant, and migrant (RIM) community members due to misconceptions surrounding the COVID-19 vaccine, language barriers, confusion about the registration and administration process, and awareness of existing services. Ensuring access to accurate vaccine facts and information about vaccination sites and the process is critical for these communities.

A key component of COVID-19 vaccine hesitancy is misinformation and disinformation about vaccine safety that is combined with fear and uncertainty about side effects. Hearing from known and trusted people about their vaccine experience is useful in decreasing fear and increasing acceptance.

The availability of accurate COVID-19 information that is culturally- and linguistically relevant is essential to keeping communities safe. Refugee, immigrant, and migrant (RIM) communities experience numerous challenges to successful COVID-19 vaccination, many of which stem from a different understanding of COVID-19 and vaccines, especially as it applies within their community, as well as a well-founded lack of trust in governmental organizations and systems.

To respond effectively to COVID-19 and to longstanding health inequities made worse by the pandemic, it is essential to leverage community strengths and trusted community networks.

Refugee, immigrant, and migrant (RIM) communities experience numerous challenges to successful vaccination efforts, many of which stem from concerns about COVID-19 and vaccines, especially as it applies within their community, as well as a well-founded lack of trust in governmental organizations and systems. Common questions from RIM communities about the COVID-19 vaccine include:

COVID-19 vaccines are becoming more widely available in the United States. As vaccine allocation includes a larger proportion of the population, understanding and overcoming challenges to vaccination experienced by different communities is essential to ensuring equitable vaccine implementation.

COVID-19 continues to have a disproportionate impact on refugee, immigrant, and migrant (RIM) communities. While health providers may be keen to develop initiatives to reach these communities, doing so without engagement of the communities may result in efforts that are ineffective or even harmful. One-off attempts at community engagement (e.g.

Many refugee, immigrant and migrant (RIM) community members experience significant logistical barriers to COVID-19 vaccination. As vaccine allocation and expanded eligibility increases across the United States, many vaccine campaigns rely on internet-based registration and utilize locations that accommodate large numbers of people for vaccine administration. This strategy can be ineffective for many RIM communities due to a variety of factors.

In the COVID-19 response, partnerships are essential to reach underserved communities, maximize resources, reduce duplication of efforts, and improve the delivery of culturally- and linguistically-appropriate services and resources. It is essential to draw on community strengths and trusted community networks to respond effectively to COVID-19 and to longstanding health inequities made worse by the pandemic. Collaboration allows limited federal, state, and local resources to be targeted and allocated to areas that need the resources most.

Many refugee, immigrant, and migrant (RIM) community members experience significant cultural, linguistic, and logistical barriers to COVID-19 vaccination. Accessing the COVID-19 vaccine presents several challenges, including digital literacy, transportation, and navigating unfamiliar vaccination sites. But even more importantly, before a community member seeks out a COVID-19 vaccine, there may remain lingering questions and concerns regarding the COVID-19 vaccine.

In the COVID-19 response, partnerships are essential to reach underserved communities, maximize resources, reduce duplicating efforts, and improve the delivery of services and resources. Refugee resettlement agencies and local health departments work independently and collaboratively to ensure that the people and communities they serve are healthy.

Case investigation and contact tracing (CICT) is an important tool for controlling the spread of COVID-19. Sara Alert is a tool for local health departments to support their CICT efforts in mitigating the spread of COVID-19 in their communities. 

Effective COVID-19 response among refugee, immigrant, and migrant (RIM) populations requires relationships with communities. Each community’s success in achieving measurable and timely health outcomes is oftentimes based on the social determinants of health of the particular community. Ensuring health equity within RIM communities builds healthier and more resilient communities; this can be a challenge, particularly for certain communities disproportionately affected by COVID-19. 

Many community members have questions regarding COVID-19 vaccines. In particular, organizations that work in the community and often serve as information hubs have a specific need to ensure that their staff have up-to-date information about COVID-19 vaccines that they feel comfortable sharing. The program creates virtual platforms for community engagement and information sharing as well as a resource hub program that addresses information gaps. 

In the COVID-19 response, health departments across the country are challenged with knowing how to reach refugee, immigrant, and migrant (RIM) communities and assess their specific needs. There may be difficulty in beginning to build relationships with a community. Health departments must build trust with RIM communities to ensure useful work can be accomplished. Identifying community partners is the first step to establish connections and create rapport within the RIM community.

To reach communities that are most impacted by inequities during the COVID-19 pandemic, it is essential to integrate considerations for these communities of focus into all aspects of the response efforts. When equity work is sequestered to one area of the response, there are often siloes in the work and equity considerations can become reactive instead of proactive.

In the COVID-19 pandemic, additional mental wellness challenges are being placed on refugee, immigrant, and migrant (RIM) community members due to increased stigma, isolation, financial stressors, and existing traumas from resettlement. Ensuring equitable barrier-free access to mental health support and resources is especially critical for RIM communities to mitigate the disproportionate impact of COVID-19 on this population and prevent further trauma.

Refugee, immigrant, and migrant (RIM) communities experience numerous challenges to successful vaccination, many of which stem from a different understanding of COVID-19 and vaccines, especially as it applies within their own community, as well as a well-founded lack of trust in governmental organizations and systems.

Many refugee, immigrant and migrant (RIM) community members experience significant logistical barriers to COVID-19 vaccination. As vaccine allocation in the United States includes increasing numbers of people, many vaccine campaigns rely on internet-based registration, and utilize locations that can accommodate large numbers of people for vaccine administration. This strategy can be ineffective for many RIM communities due to a variety of factors.

Effective COVID-19 response among refugee, immigrant, and migrant (RIM) populations requires relationships with communities. There may be some challenges in figuring out where to start when building or enhancing relationships with communities. One consideration for health departments includes engaging with the consulates or population-specific business organizations of RIM communities in your area.

Data collection and management can be challenging in a rapidly evolving infectious disease outbreak such as COVID-19. Data is often collected by various individuals in different formats in the early stages of investigation. Effective data organization and access is essential to COVID-19 response activities, including case investigation and contact tracing. 

In coordinating an effective COVID-19 response, partnerships with existing community groups are essential for reaching underserved communities and improving the delivery of services, resources, and information. Youth groups can be especially effective outreach partners, helping to provide door-to-door information, distributing resources and empowering the youth in the community to be active participants in emergency health response.

In the COVID-19 response, partnerships are essential to reaching refugee, immigrant, and migrant (RIM) communities, maximizing resources, reducing duplicative efforts, and improving the delivery of services and resources. Collaboration allows limited federal, state, and local resources to be targeted and allocated to areas that need the resources most. Likewise, it is also essential to provide information and services via channels that community members actively use and trust.

Many community members turn to local, trusted sources to get information about COVID-19 and COVID-19 vaccines. For refugee, immigrant, and migrant (RIM) communities, local media outlets that are linguistically and culturally concordant are essential conduits for the most up-to-date COVID-19 information and guidance.

Refugees can receive more and better services when the people who support them have access to complete and accurate information on their healthcare needs. However, this may be challenging as health departments work to reach more refugees in their case investigation and contact tracing (CICT) efforts.

Effective COVID-19 response among refugee, immigrant, and migrant (RIM) communities requires relationships with communities. Lack of information in the community can foster distrust with the health department, lead to hesitancy to cooperate with case investigators and contact tracers, and potentially worsen health outcomes. There may be some difficulty in knowing where to start when building or strengthening relationships with a community.

The availability of accurate COVID-19 information that is culturally- and linguistically-appropriate is essential to keeping communities safe. Likewise, it is also important to provide information via channels that community members actively use and trust.  

In the COVID-19 response, partnerships are essential to reach underserved communities, maximize resources, reduce duplication of efforts, and improve the delivery of culturally- and linguistically-appropriate services and resources. Community Health Workers (CHWs), community-based organizations (CBOs), and local health departments (LHDs) share goals to improve community health, particularly among disproportionately impacted populations.

In the COVID-19 response, partnerships are essential to reach refugee, immigrant, and migrant (RIM) communities, maximize resources, reduce duplicating efforts, and improve the delivery of services and resources.

COVID-19 vaccines are becoming more widely available in the United States. As vaccine allocation includes a larger proportion of the population, understanding and overcoming challenges to vaccination experienced by different communities is essential to ensuring equitable vaccine implementation.

The availability of accurate COVID-19 information that is culturally and linguistically appropriate is essential to keeping communities safe. However, there are currently many communication challenges for refugee, immigrant, and migrant (RIM) communities. Language barriers, time restraints, and having patients isolated from their families has resulted in a communication gap between patients, families, and health providers.

Over the last two years, many refugee, immigrant and migrant (RIM) community members have faced major logistical challenges to getting the COVID-19 vaccine.  Although COVID-19 vaccines are now more widely available in the United States, mainstream vaccination campaigns have mostly relied on internet-based registration and large sites for mass vaccination, which can be ineffective for RIM communities for various reasons.

In the COVID-19 response, partnerships are essential to reach underserved communities, maximize resources, reduce duplicating efforts, and improve the delivery of services and resources. Federally-Qualified Health Centers (FQHCs) and local health departments (LHDs) share goals to improve community health, particularly among disproportionately impacted populations. Collaboration allows limited federal, state, and local resources to be targeted and allocated to areas that need the resources most.

In the COVID-19 response, some sites are challenged when it comes to offering and vaccinating significant numbers of refugee, immigrant, and migrant (RIM) community members at mainstream vaccination sites due to transportation barriers, language access issues, and challenges regarding stigma. This challenge exists for both administering the COVID-19 vaccine and routine vaccinations, especially in the pediatric population.

Refugee, immigrant, and migrant (RIM) community members face several challenges to accessing COVID-19 testing services due to transportation barriers; difficulty using online registration platforms; and inability to use drive-through testing services if they do not have a car. Furthermore, COVID-19 educational resources may not be translated into RIM languages at traditional COVID-19 testing sites and different elements of the testing process may feel unfamiliar or be challenging to navigate. 

The availability of accurate COVID-19 information that is culturally and linguistically appropriate is essential to keeping communities safe. Likewise, it is also vital to provide information via channels that community members actively use and trust.

The case investigation and contract tracing (CICT) process may involve several potential challenges when attempting to reach refugee, immigrant, and migrant (RIM) communities. Case investigators and contact tracers may be unable to reach or engage RIM community members during the initial phone call due to interpretation challenges, mistrust of answering an unknown phone number, or uncertainty/fear about what is being done with the information gathered.

In the COVID-19 public health response, some sites report low attempts to follow-up and low response rates within refugee, immigrant, and migrant (RIM) communities. This leads to inaccurate data for case investigators and contact tracers. Likewise, it is also essential to provide information and services via channels that community members actively use and trust.

Some health departments experience challenges reaching some refugee, immigrant, and migrant (RIM) communities during case investigation and contact tracing (CICT) due to limited numbers of professional interpreters or bilingual CICT staff.

Some multilingual case investigation and contact tracing (CICT) staff have encountered unique challenges when using standard scripts for CICT, particularly when encountering situations with cases or contacts not covered by the script. These situations pose not only communication barriers but may be particularly difficult or stressful for CICT staff.

Immunization rates are lower among refugee, immigrant and migrant (RIM) communities due, in part, to challenges accessing healthcare services. The requirement in most of the U.S., that a person must visit a medical facility to receive medical services, is a large barrier for many individuals and communities, particularly for preventive health care such as immunizations. This is due to many factors which include cost (e.g. time away from work), transportation, and complexity of navigating a medical system for appointments, especially if your primary language is not English.

Immunization rates are lower among refugee, immigrant and migrant (RIM) communities due to factors which include cultural and linguistic diversity, knowledge and beliefs about a disease and vaccine, and challenges accessing healthcare (related to cost, transportation, medical system complexity/unfamiliarity, lack of welcoming environment, etc.). This challenge is expected to persist as the COVID-19 vaccine becomes increasingly available.

State and local health departments (SLHD) may work with community-based organizations (CBOs), resettlement agencies, and faith-based organizations to reach refugee, immigrant, and migrant (RIM) communities. However, in order to more effectively address the health needs of incoming refugee arrivals, SLHD should partner with State Refugee Health Coordinators to better assess refugee health needs as part of a comprehensive and effective COVID-19 public health response. 

The availability of accurate COVID-19 information that is culturally and linguistically relevant is essential to keeping communities safe. Messages change rapidly and some health departments may face challenges with developing health messaging that reaches all communities, particularly refugees, immigrants, and migrants (RIM). 

It is essential to draw on community strengths and trusted community networks to respond effectively to COVID-19 and to longstanding health inequities made worse by the COVID-19 pandemic.

During and beyond the pandemic, providing accurate COVID-19 information, support, and resources that are culturally and linguistically appropriate and specific to RIM communities remains essential to keeping communities safe.

COVID-19 continues to impact and further disenfranchise many communities, including immigrants, migrants, the elderly, and others. The needs of these communities are complex and solutions require many stakeholders and partners. 

Reaching populations that are most impacted by COVID-19 with resources and education is critical, particularly for refugees, immigrants, and migrants (RIM), communities of color, American Indian communities, and LGBTQ+ communities. Trusted messengers and tailored outreach are especially essential to a successful partnership with these communities due to distrust of government, ongoing and historical trauma, and linguistic needs.

Health departments are working quickly to implement plans for COVID-19 vaccine roll-out. As news and messaging around COVID-19 vaccines unfolds rapidly, some communities may have questions and concerns about what to expect. 

The availability of accurate COVID-19 and other public health related information that is culturally and linguistically relevant is essential to keeping communities safe. Messages change rapidly, and some health departments may face challenges with developing health messaging that reaches all communities, particularly refugees, immigrants, and migrants.

The availability of accurate COVID-19 information that is culturally- and linguistically-appropriate is essential to keeping communities safe. Likewise, it is also important to provide information via channels that community members actively use and trust.  

In the COVID-19 response, some sites are reporting challenges in reaching large numbers of refugee, immigrant, and migrant (RIM) community members to disseminate consistent health messaging and awareness of existing services.