Ireland Has Done Comparatively Well with Policies on Vaccinating Undocumented People, Europe-wide Report Finds

Alexandre Henrique de Paula, an undocumented man in Clonsilla, didn’t watch, listen or read the news to find out how he could access the Covid-19 vaccine.

“As my English is in progress. I just asked the people I was around,” said de Paula. Meaning his sister and friends, he says.

When de Paula’s turn to be vaccinated came around, his sister Renata booked him an appointment, and de Paula showed up. It was easy, he said.

If he had turned to Irish government announcements, he may have found them hard to decipher and to work out whether they applied to undocumented residents of Ireland like him.

Overall, Ireland has scored relatively high on metrics such as making identification and residency requirements clear, providing access to marginalised groups, and guaranteeing privacy, says a scorecard by Lighthouse Reports, an investigative nonprofit newsroom working with Europe’s leading media.

But it did fall short on policy transparency in general and the transparency of the language used about equal access for undocumented migrants, the collated data suggests.

According to a recent press release, the Department of Justice estimates that there may be about 17,000 undocumented people living in Ireland.

The Uptake

Figures aren’t available for how many undocumented people in Ireland have been vaccinated and how many have sat it out.

Central Statistics Office (CSO) data suggests that some migrant groups have been more hesitant about getting the vaccine than others.

From 1 January to 10 September 2021, vaccine uptake was much lower among those living in Ireland who are citizens of countries that joined the European Union after 2004, such as Poland or Lithuania, the CSO figures show.

Those EU citizens wouldn’t be undocumented. But it does indicate how uptake varies among different groups.

Neil Bruton, campaign development worker at the Migrants Rights Centre Ireland (MRCI), says that he thinks a large number of those who are undocumented have been vaccinated, based on MRCI’s interactions throughout the pandemic.

When the pandemic struck, the Health Service Executive (HSE) put up information firewalls to stop data swaps between itself and immigration authorities, to encourage undocumented people to get vaccinated.

When booking online, people needed a PPS number, which some people who are undocumented don’t have. But there were ways around that, said Bruton.

Undocumented people just had to phone centres rather than book online, he said. MRCI helped many with that, said Bruton.

A HSE spokesperson said the HSE hasn’t recorded the number of people who booked an appointment by phone.

De Paula relied on a letter from the Department of Justice that says his application to get legal status is being processed, when he went to get his jab, to help him explain why he had no PPS number.

“My passport and the letter from the minister,” says de Paula.

His status isn’t hidden anymore. Gardaí outed him in October 2020, when investigating a robbery at a car dealership near the carwash where he works. They dropped by to check IDs, he says.

Clear Messages

While undocumented people could access the vaccine, thanks to the firewall and a way around needing a PPS number, they had to know that.

A HSE spokesperson said that it has publicised that there isn’t a need for a PPS number to get jabbed.

Bruton said that MRCI filled communication gaps and deciphered and simplified government messages. “We were delighted to, but I suppose we would have liked a bit more support on that.”

The Irish government didn’t explicitly mention the undocumented – or other groups like those who are homeless or prisoners– in itsnational vaccination policy document. Instead, it talked in more general terms about “all residents”.

Lighthouse Reports evaluated whether the language used in national vaccine strategies could still be easily “interpreted as including undocumented populations”, with phrases like, “everyone in the country or regardless of migration status”, and Ireland didn’t use that language in documents.

Ireland did score higher that average among the 18 European countries it looked at, when it came to how public officials addressed undocumented populations in public statements.

Its scorecard cited Minister of Health Stephen Donnelly saying that, “It is important that undocumented migrants are encouraged and facilitated to take-up the Covid-19 vaccine.”

But De Paula, and another Brazilian undocumented man who asked not to be named because his status wasn’t known to the government, say they don’t recognise themselves in the government’s healthcare communications.

Said Bruton of MRCI: “It’s very important for someone to say, ‘They are talking about me there.’ Rather than, ‘Oh they’re talking about somebody else,’ in order to establish trust.”

A Department of Health spokesperson said they couldn’t find any internal guidelines or HSE policies expressly about vaccinating undocumented people, in response to a Freedom of Information Act request.

They couldn’t find any emails between the department and the HSE discussing the matter either, says the response.

Bruton says leaving out the word “undocumented” from conversations around pandemic measures and healthcare isn’t helpful. “We would like to see specific message for undocumented people in simple clear language across all media.”

A HSE spokesperson said, in response to a query about why it chose to avoid using the term “undocumented” in the national vaccination policy, that questions about the Government of Ireland’s communication campaigns weren’t relevant to them.

“The HSE has ongoing and targeted communications to support increased uptake of both the COVID-19 primary vaccine and the Booster dose of COVID-19 vaccine,” they said.

Which Languages?

Bruton says that translating inclusive healthcare messages into various languages is also crucial. “So that people can be really sure about the meaning of announcements.”

In the Lighthouse Reports analysis, Ireland scored well above average among European countries for developing official policies for minority communities.

A spokesperson for the HSE said that its vaccine information material is available in 27 languages, both online and in print.

It has commissioned multi-lingual video messaging company Translate Ireland to produce a series of videos in an array of languages too, the spokesperson said.

Graham Clifford, CEO of Translate Ireland, says he set up the venture from a corner of his bedroom last year out of sheer necessity.

Not long into the health crisis, he and his wife, who is a GP, realised that language barriers were stopping asylum-seekers who they knew from accessing Covid-related information.

“So, I was on to the HSE saying, what are you doing? Or what’s the plan for communication? And of course, there was no plan,” he said.

Then, he says, there was an outbreak in a meat factory near where they live, and around 200 workers, a large number of them young Brazilians, tested positive for the virus in one day.

“Public health started ringing us up saying, what do we do? Because we’d done a few videos,” said Clifford.

The HSE commissioned Clifford to do more videos, in more languages. Their videos are now available in 46tongues, presented by health professionals, he said.

But the video missives haven’t reached their full potential because the HSE doesn’t impactfully distribute them, said Clifford.

“The big problem is that we break our back making the videos, get them all ready, send them to HSE, the HSE takes weeks and then they might put them up on their website,” he says. “And they sit on the website, they’re not shared.”

The HSE spokesperson said it has recently uploaded Translate Ireland’s multi-lingual Covid-19 video messages to encourage pregnant women to get jabs onto its YouTube channel.

They said it has run multilingual Covid-19 information campaigns including on the radio in 10 languages, including Punjabi, Urdu, and Russian.

They have also run ads in newspapers in Ireland that publish in different languages, like the Russian-language Nasha Gazeta, said the spokesperson.** **

Bruton says healthcare messages for undocumented people should be short and jargon-free and spread through lots of different media, whether radio, television or signs on the street.

Most of the government’s communications around vaccine access, Bruton said, were “you know, part of a longer department press release, or a Twitter statement”.

Or maybe a line in the HSE guidelines, which an undocumented person might not even know exist.

A Bigger Picture

Bruton says the pandemic has cracked open a public conversation around the needs of vulnerable people, like those who are undocumented, and it’s worth acknowledging that the government listened.

Undocumented people have been able to access the pandemic unemployment payment (PUP), he said.

“I mean, in practice it proved quite difficult, but at least there was a firewall between the Department of Social Protection and immigration,” he says.

The firewalls helped to dampen fear in accessing the vaccine and job supports, he said. “And we think it should also be in place for things like reporting a crime.”

A HSE spokesperson did not directly respond to a query asking if it’s going to keep the firewalls in place for healthcare beyond the pandemic.

Covid vaccinations, meanwhile, are just one healthcare intervention that those who are undocumented have had to work out how to access and whether they can access it safely.

De Paula has had trouble getting treatment for his son’s skin condition, he says. General practitioners who can help refer him to a specialist ask for the child’s PPS number, he says.

But his son is, like de Paula, undocumented. He doesn’t have one.

Private clinics don’t ask for the PPS number, he says. “But they only give ointments – €70 each visit,” he says, and the creams don’t help much.

Overall, it’s been harder to access healthcare for his child without a PPS number than for him or his wife, he says. “I don’t know why.”

Earlier this month, the Department of Justice announced an amnesty scheme for undocumented people.

The scheme, slated to open in January, is open to applications from those who’ve been living and working here without immigration papers for more than four years, or three years if they have children. It also includes asylum seekers who have waited for a decision for** **more than two years.

It is expected to cost €700 for families and €550 for single people to apply, and be free for asylum seekers. (Migration support non-profits like Nasc have already set upfundraisers to help with the costs).

The Justice Department is yet to release the policy document with detailed information on the scheme. It’s unclear if the pandemic prompted the government to fast-track it.

The scheme means thousands could be able to access healthcare without fear or bureaucratic barriers. But some won’t make the cut.

One Brazilian man in Dublin recently worked out that he doesn’t qualify, he says. He’ll be four years living paperless in March, rather than January, so he falls short, he said.

When he first heard word of the scheme was ecstatic, he says, dreaming of how – once he had his papers – he could set up his own business, selling his home-baked cakes.

“It makes me feel so sad and depressed,” he said. It “makes no sense at all”.

De Paula’s phone lit up with messages from other Brazilian friends in Dublin when the scheme was announced, he says.

But de Paula had been forced to turn himself in and apply outside of the scheme. That makes him nervous, he said.

In the past, more undocumented people who’d turned themselves in gotserved with deportation orders than granted status, according to official figures.

In 2019, for example, the Justice Department issued 1,245 deportation orders, compared to the 245 letters of permission to remain.

Inside a two-story house in Clonsilla, de Paula continues to lament that his application is not part of the mass amnesty. “The scheme would be better,” he said, pursing his lips.