Vaccine hesitancy in prison populations

• Research type

  Research Study

• Full title

  Understanding COVID-19 vaccine hesitancy amongst prison populations

• IRAS ID

  315643

• Contact name

  Stephanie Perrett

• Contact email

  stephanie.perrett@wales.nhs.uk

• Sponsor organisation

  Public Health Wales

• Clinicaltrials.gov Identifier

  n/a, n/a

• Duration of Study in the UK

  0 years, 1 months, 1 days

• Research summary

  Research Summary

  Prisons are high risk settings for COVID-19 due to the close proximity in which people are held, and the poor health status of those resident in prisons. Prisons in England and Wales have reported the deaths of 159 prison residents confirmed to be caused by COVID-19 (MOJ, 2022). Since the start of the COVID-19 pandemic over 32,000 prison residents have tested positive for COVID-19 with nearly all prisons affected by outbreaks, many of which have been complex to control (MOJ, 2022).
  COVID-19 vaccines have been available for residents in England and Wales since the beginning of the national vaccine campaign and have been delivered to prison residents at the same pace and eligibility as the general community with those older and most vulnerable eligible first. Vaccine coverage amongst prison residents in Wales remains much lower than community coverage, and lower than community coverage within the most deprived areas of Wales.
  The reasons for low vaccine coverage amongst UK prisons are poorly understood. Reasons are likely to differ from the general community due to the uniqueness of the prison environment and overrepresentation of hard-to-reach populations that are less engaged with health services and have distrust in authority. Low coverage, and suggestions of high levels of hesitancy indicate a tailored approach will be needed to improve vaccine coverage amongst prison residents.
  To better understanding vaccine uptake and hesitancy amongst prison populations we propose to undertake a survey of prison residents in Wales. An anonymous, voluntary questionnaire will allow us to explore the beliefs, concerns, behavioural factors and information sources that underlie the decision to be vaccinated whilst in prison. Findings will be used to inform future service delivery to improve vaccine uptake amongst prison populations.

  Summary of Results

  • Survey responses were received from 727 individuals from across six prisons in Wales
  • Participants varied in age, with the youngest being 18-20 and the oldest being over 80. The majority of respondents were of white ethnicity (79%).

  Demographic predictors of vaccination
  • Older prisoners were more likely to report being vaccinated than younger inmates
  • Prisoners identifying as Asian or ‘other’ ethnicity demonstrated statistically significantly lower rates of vaccine uptake, compared to White inmates. There was a non-significant trend in the same direction in Black and Mixed inmates.
  • Longer prison stays were associated with higher levels of vaccination

  Access to vaccinations in prison
  • All respondents reported knowing how to access vaccines in prison
  • Very few respondents indicated they would choose to wait to be vaccinated in community healthcare settings
  • Very few respondents said they needed more information about vaccines.
  • Respondents’ main source of information was from the prison or prison healthcare with little evidence of persuasion from external sources or friends or family.

  Attitudes to vaccinations
  • Most respondents report believing that Covid-19 is a serious threat (49% agree or strongly agree, as opposed to 17% who disagree or strongly disagree and 22% who are unsure)
  • Similar numbers (44%) agree that Covid-19 vaccinations protect you from getting very ill (18% disagree and 25% report being unsure)

  Self-perception of health
  • Vaccination rates were highest in those reporting own health as ‘good’ with rates falling off above and below that
  • Previous history of Flu or Hep B vaccines were strong indicators for uptake of the COVID-19 vaccine
  • Respondents who said they had not had Covid-19 themselves were less likely to be vaccinated than those who had, especially those who had confirmed infection with a test.
  • Reporting knowing someone personally who died or became very ill from Covid-19 was a positive predictor of vaccine uptake.

  Trust
  • High levels of trust in ‘people in general’, prison staff and in pharmaceutical companies were strong predictors of vaccination
  • Trust in respondents’ doctor/nurse both in and outside of prison was also a strong predictor, as was trust in institutions, like the Welsh and UK Governments, and the media.

  Social capital
  • Respondents were asked about who they might go to for support while in prison, given options such as other prisoners, prison officers, chaplaincy, psychology etc. Those respondents who selected a greater number of people who they might go to for support were strikingly more likely to be vaccinated.
  • Being in a prison where other respondents tended to identify more sources of support was also associated with being vaccinated

• REC name

  Wales REC 3

• REC reference

  22/WA/0187

• Date of REC Opinion

  17 Aug 2022

• REC opinion

  Further Information Favourable Opinion