Interventions to increase vaccine uptake among people who live and work in prisons: A global multistage scoping review

Vaccines and vaccination in prison settings: availability and model of service delivery in 20 European countries

Prisons, due to various risk factors, are environments that are conducive to infectious disease transmission, with significantly higher prevalence of infectious diseases within prisons compared to the general population. This underscores the importance of preventive measures, particularly vaccination. As part of the international project "Reaching the hard-to-reach: Increasing access and vaccine uptake among the prison population in Europe" (RISE-Vac), this study aimed to map the availability and delivery framework of vaccination services in prisons across Europe and beyond. A questionnaire designed to collect data on the availability and delivery model of vaccination services in prisons was validated and uploaded in SurveyMonkey in July 2023. Then, it was submitted to potential participants, with at least one representative from each European country. Potential participants emailed an invitation letter by the RISE-Vac partners and by the European Organization of Prison and Correctional Services (EUROPRIS). Twenty European countries responded. Vaccines are available in European countries, although their availability differs by country and type of vaccine. The first dose is offered to people living in prisons (PLP), mostly within one month, COVID-19 is the most widely offered vaccine. In all countries, vaccines are actively offered by healthcare workers; in most countries, there is no evaluation of vaccination status among people who work in prison. The survey shows variance in vaccine availability for PLP and staff across countries and vaccine types. Quality healthcare in prisons is not only a matter of the right to health but also a critical public health investment: enhancing vaccine uptake consistently among PLP and staff should be prioritized.

Cancer-preventing vaccination programs in prison: promoting health equity in Europe

The most important human oncogenic viruses are hepatitis B virus (HBV) and human papillomavirus (HPV). The roll-out of vaccinations against HPV and HBV is a significant public health initiative with robust evidence of impact on the prevention of infection and neoplastic disease sequelae. Incarcerated individuals frequently have suboptimal immunisation levels for a wide variety of vaccine-preventable diseases, including HBV and HPV, and a high burden of disease for HBV/HPV-related cancers. In this Personal View, we analyse evidence regarding HBV and HPV vaccination in prison settings in 20 European countries and integrate it with existing scientific literature to discuss the rationale and possible strategies to expand cancer-preventing vaccination in prison populations. Enhancing HBV/HPV vaccination offer and uptake of HBV/HPV vaccination for this population would not only contribute to reducing the derived burden among the European population, but would also foster health equity and boost efforts towards the attainment of global and regional public health targets.

Vaccination against emerging and reemerging infectious diseases in places of detention: a global multistage scoping review

Background

Despite the elevated risks of infection transmission, people in prisons frequently encounter significant barriers in accessing essential healthcare services in many countries. The present scoping review aimed to evaluate the state of availability and model of delivery of vaccination services within correctional facilities across the globe.

Methods

Following the methodological framework for scoping reviews and adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews criteria, we conducted a systematic search across four peer-reviewed literature databases (Medline via PubMed, Web of Science, the Cochrane Library, Science Direct, and EBSCO), as well as 14 sources of grey literature. Two researchers meticulously examined the identified papers independently to extract pertinent data published between 2012 and 2022. The quality of the selected publications was assessed using established quality assessment tools.

Results

Of the 11,281 identified papers 52 met the inclusion criteria. With the exception of one, all the included publications presented data from high-income countries, predominantly originating from the United States. Across the world, the most prevalent vaccines available in prison settings were COVID-19 and HBV vaccines, typically distributed in response to health crises such as pandemics, epidemics, and local outbreaks. Vaccine coverage and uptake rates within correctional facilities displayed noteworthy disparities among various countries and regions. Besides, individual and organizational barriers and facilitating factors of vaccination in prison settings emerged and discussed in the text.

Discussion

The lack of vaccination services combined with low rates of vaccination coverage and uptake among people living and working in correctional facilities represents a cause for concern. Prisons are not isolated from the broader community, therefore, efforts to increase vaccine uptake among people who live and work in prisons will yield broader public health benefits.