Theme: Social Science and Policy Research Year: 2021
Background: Canadian prisons experienced multiple COVID-19 outbreaks. Consequently, the National Advisory Committee on Immunization prioritized correctional facilities for COVID-19 vaccination. Given historically low vaccine uptake in these settings, we explored factors influencing COVID-19 vaccination acceptability among people incarcerated in federal prisons. Methods: Using a qualitative descriptive design, we remotely conducted in-depth semi-structured interviews with a diverse sample (gender, age, and ethnicity) of incarcerated persons from three sites in Quebec, Ontario, and British Columbia, chosen based on outbreak status and historical influenza vaccine uptake. We inductively and thematically analyzed audio-recorded transcripts. Results: From March 22-29, 2021, 15 participants (n=5 per site; n=5 women; median age=43 years) were interviewed, including five Indigenous people and five from other minority groups. We defined four themes regarding vaccine acceptability: 1) Trusting relationships with health care providers: participants identified knowledgeable, non-judgmental, supportive, and pro-active providers as facilitators to vaccine acceptability; 2) Perceived greater COVID-19 vulnerability in prisons: participants identified perceived COVID-19 severity and heightened prison-specific risk of transmission, challenges in implementing infection prevention and control measures, and accessing psychosocial support (e.g., family visits), as facilitators to vaccine acceptability; 3) Poor COVID-19 vaccine literacy: participants identified existing vaccine information as minimal, incomplete or inadequate, fueling beliefs in conspiracies to harm incarcerated people, as barriers to vaccine acceptability; and 4) Perceived individual and collective benefits of COVID-19 vaccination outweigh perceived risks: participants identified vaccine-related benefits, including preventing severe COVID19, ending lockdown measures, and re-accessing privileges, exceeded risks such as side effects, need for second doses, and inequities in vaccine distribution, as facilitators to vaccine acceptability. Conclusion: Our results highlight the importance of providing accurate information and establishing trust when offering health services, such as COVID-19 vaccination, to people in correctional settings. Tailored information sessions, provided by knowledgeable health care providers, may increase vaccine uptake and improve provider-inmate relationships. Disclosure of Interest Statement: Dr. Nadine Kronfli has received funding from the McGill Interdisciplinary Initiative in Infection and Immunity (Mi4) for this study. No pharmaceutical grants were received in the development of this study.
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