Article type
Abstract
Background:
The prison population, for its low social distancing, high and constant turnover, and prevalence of migrants, should be a pivotal target of vaccination campaigns. Vaccination coverage among people living in prison (PLPs) is low, likely because of sub-optimal access to healthcare services and inadequate vaccine and general health literacy. In the prison setting, vaccination is still challenging due to vaccine hesitancy, distrust of the institutions of PLPs, and allocative choices.
Objectives:
The study aims to explore determinants of vaccine hesitancy in the prison population and assess the impact of a co-design educational intervention.
Methods:
In the RISE-Vac project, funded by the European Commission, we conducted a cross-sectional observational study in 13 prisons across 4 European countries with 847 prisoners and 755 staff, using surveys to examine vaccine hesitancy, health literacy, vaccine refusal history, and demographics. Exploratory factor analysis was used to extract three independent components of vaccine hesitancy. Logistic regression and linear regression were applied to assess associations among different components. All analyses were adjusted for socio-demographic variables.
A co-designed intervention to increase awareness about prison health in PLPs and custodial staff will be implemented in February-April 2024. The same parameters will be measured in the same population in March-June 2024 to assess the effectiveness of the intervention by comparing pre- and post-intervention results.
Results:
We identified three independent components of vaccine hesitancy explaining 49% of the total variance: Mistrust, Concern, and Conspiracy. All the components were associated with previous vaccine refusal and presented good internal consistency. Young participants presented the highest levels of vaccine hesitancy; migrant people living in prison had lower levels of Mistrust and a higher level of Concern; all three factors were lower among participants with the highest degree of academic education. Mistrust and Concern were inversely associated with vaccine literacy, while all three subscales were inversely associated with general health literacy.
Post-intervention results are being collected and will be analyzed and available for the conference.
Conclusions:
Our study identifies the reasons behind vaccine hesitancy in prisons and creates interventions to improve vaccination rates, addressing a significant public health concern.
The prison population, for its low social distancing, high and constant turnover, and prevalence of migrants, should be a pivotal target of vaccination campaigns. Vaccination coverage among people living in prison (PLPs) is low, likely because of sub-optimal access to healthcare services and inadequate vaccine and general health literacy. In the prison setting, vaccination is still challenging due to vaccine hesitancy, distrust of the institutions of PLPs, and allocative choices.
Objectives:
The study aims to explore determinants of vaccine hesitancy in the prison population and assess the impact of a co-design educational intervention.
Methods:
In the RISE-Vac project, funded by the European Commission, we conducted a cross-sectional observational study in 13 prisons across 4 European countries with 847 prisoners and 755 staff, using surveys to examine vaccine hesitancy, health literacy, vaccine refusal history, and demographics. Exploratory factor analysis was used to extract three independent components of vaccine hesitancy. Logistic regression and linear regression were applied to assess associations among different components. All analyses were adjusted for socio-demographic variables.
A co-designed intervention to increase awareness about prison health in PLPs and custodial staff will be implemented in February-April 2024. The same parameters will be measured in the same population in March-June 2024 to assess the effectiveness of the intervention by comparing pre- and post-intervention results.
Results:
We identified three independent components of vaccine hesitancy explaining 49% of the total variance: Mistrust, Concern, and Conspiracy. All the components were associated with previous vaccine refusal and presented good internal consistency. Young participants presented the highest levels of vaccine hesitancy; migrant people living in prison had lower levels of Mistrust and a higher level of Concern; all three factors were lower among participants with the highest degree of academic education. Mistrust and Concern were inversely associated with vaccine literacy, while all three subscales were inversely associated with general health literacy.
Post-intervention results are being collected and will be analyzed and available for the conference.
Conclusions:
Our study identifies the reasons behind vaccine hesitancy in prisons and creates interventions to improve vaccination rates, addressing a significant public health concern.