COVID-19 vaccination in the Federal Bureau of Prisons, December 2020—April 2021

Abstract

Objectives To describe COVID-19 vaccine distribution operations in United States Federal Bureau of Prisons (BOP) institutions and offices from December 16, 2020—April 14, 2021, report vaccination coverage among staff and incarcerated people, and identify factors associated with vaccination acceptance among incarcerated people. Methods The BOP COVID-19 vaccination plan and implementation timeline are described. Descriptive statistics and vaccination coverage were calculated for the BOP incarcerated population using data from the BOP electronic medical record. Coverage among staff was calculated using data from the Centers for Disease Control and Prevention Vaccination Administration Management System. Vaccination coverage in the BOP versus the overall United States adult population was compared by state/territory. Univariate and multivariable logistic regression models were developed to identify demographic, health-related, and institution-level factors associated with vaccination acceptance among incarcerated people, using hierarchical linear modeling to account for institution-level clustering. Results By April 14, 2021, BOP had offered COVID-19 vaccination to 37,870 (100%) staff and 88,173/126,413 (69.8%) incarcerated people, with acceptance rates of 50.2% and 64.2%, respectively. At the time of analysis, vaccination coverage in BOP was comparable to coverage in the overall adult population in the states and territories where BOP institutions and offices are located. Among incarcerated people, factors associated with lower vaccination acceptance included younger age, female sex, non-Hispanic Black and Asian race/ethnicity, and having few underlying medical conditions; factors associated with higher acceptance included having a prior SARS-CoV-2 infection, being born outside the United States, and being assigned to a Federal Detention Center. Conclusions Early COVID-19 vaccination efforts in BOP have achieved levels of coverage similar to the general population. To build on this initial success, BOP can consider strategies including re-offering vaccination to people who initially refused and tailoring communication strategies to groups with lower acceptance rates.

Factors associated with COVID-19 vaccine acceptance and hesitancy among residents of Northern California jails

“…Consistent with previous studies on incarcerated and non-incarcerated populations [11,12,20], we found higher COVID-19 vaccine uptake among older jail residents. However, while a recent report in US prisons showed lower COVID-19 vaccine uptake among incarcerated women than men [12], we found the opposite, perhaps due to differences in setting, population, period of observation, and/or distinct policies affecting COVID-19 risk and housing unit culture for women in these jails. Existing research also shows gender disparities in healthcare utilization, with women utilizing services and preventative health measures more frequently than men [21].…”

“…Despite the importance of achieving high vaccination rates in this population, there is a paucity of data on COVID-19 vaccine acceptance and reasons for hesitancy among incarcerated individuals to guide evidence-based vaccination efforts. Recent studies in US prisons have identified differences in COVID-19 vaccine acceptance by age, gender/sex, and race/ethnicity [11,12]. However, less is known about COVID-19 vaccination among people living in jails, where there is more frequent turnover than in prisons and where many people have not been convicted of a crime [13].…”

COVID-19 Vaccination Uptake and Related Determinants in Detained Subjects in Italy

“…In the same study, a lack of self-confidence in the ability to protect themselves from SARS-CoV-2 infection in the prison setting was declared by a large majority of the participants and this perception may have prompted the decision to undergo COVID-19 vaccination [ 21 ]. Contribution to this high vaccination coverage may have also been related, as reported by Hagan et al [ 31 ], to the relative absence of barriers for the accomplishment of vaccinations, which were offered by healthcare providers, and were performed on-site, without all the potential obstacles encountered by the general population for scheduling appointments, queueing in vaccination hubs, etc., which may have caused delays or refusal of vaccination.…”

“…Data reported in the literature account for very variable frequencies of uptake in the different countries; specifically, the WHO for the European Region has recently published a report of data obtained from voluntary submissions of Member States to the WHO Minimum Dataset Reporting System for places of detention, containing also cumulative vaccination coverage, with lowest adherence reported in Moldova (36.7%), as of August 2021, and Greece (57.6%), and highest in Spain (85.7%) and Poland (90%), as of October 2021 [ 1 ]. Outside Europe, Hagan et al have reported 64.2% uptake in a study of the US Bureau of Prison up to April 2021 [ 31 ], Chin et al 64.2% in California [ 25 ], and Berk et al 77.7% in Rhode Island, up to February 2021 [ 32 ]. It is noteworthy, however, that these studies refer to different phases of the vaccination campaigns, and that different strategies have been adopted for the detained subjects in the involved countries; therefore, comparisons should take into consideration that different coverage achievements might have derived from all these differences.…”

Testing Frequency Matters | An Evaluation of the Diagnostic Performance of a SARS-CoV-2 Rapid Antigen Test in United States Correctional Facilities

“…[2] Despite the development of COVID-19 vaccines and vaccination programs for incarcerated populations, vaccine coverage remains below that needed for population level protection. [3][4][5][6][7][8][9][10] Rapid and accurate SAR-CoV-2 testing will therefore remain a key component of infection prevention within correctional facilities.…”