Background:
Provide equitable access to vaccination for all migrants, regardless of their nationality and migration status is essential to making progress towards universal health coverage. Access to Vaccination for Newly Arrived Migrants (AcToVx4NAM) is a project (Grant n 101018349, 3rd EU Health Programme) that aims at improving the vaccine literacy of the health system and making access to vaccinations for migrants more equitable and guaranteed.

Methods:
Qualitative research has been carried out to identify barriers of italian vaccination system and possible solutions to overcome them. Focus groups and interviews were conducted with 17 professionals: vaccination planning experts, health, social professionals engaged in the topic of migrant vaccination. The results were analyzed using a thematic analysis linked to the framework produced by the project, which divided the vaccination process into five conceptual hubs: entitlement, reachability, adherence, achievement and evaluation.

Results:
In Italy, migrants are entitled to vaccinations, regardless of their legal status. Nevertheless, some differences in age, gender and migratory route directly influence the interception of migrants by Italian vaccination system. The compulsory vaccines for schooling and the pathways of the reception system are key opportunities offering the recommended vaccinations. Beyond these, the capability of the vaccination offer to reach migrants is very limited. The main strategies, that can be adopted to improve the vaccination offer, are the transversal promotion of vaccinations by all those who encounter migrants; building relationships of trust between service providers and the target population, especially through partnerships with NGO active on the issue

Conclusion:
Vaccinations should be a multi-step process of protecting and promoting individual and community health, not just a single vaccine shot. Multi-sectoral alliances with a multiplestakeholders are needed.. Moreover, it seems that are not migrants who hard to reach, but the vaccination system that is unable to reach them.