Knowledge, attitudes, and behavior of incarcerated people regarding COVID-19 and related vaccination: a survey in Italy

The cross-sectional study assessed knowledge, attitudes, and preventive practices toward COVID-19 disease of incarcerated people. A total of 685 subjects were surveyed. 94% were aware that respiratory droplets are involved in the transmission of COVID-19, and 77.2% that patients with chronic conditions are at risk of a more severe disease. Overall, 92.7% of respondents considered COVID-19 a more severe disease compared to influenza, and 85.4% believed that COVID-19 could cause serious consequences in their institution. Only 22.6% were self-confident about their ability to protect themselves from SARS-CoV-2 infection. This attitude was significantly higher in those who were involved in working activities in the institution, who did not report at least one common symptom compatible with COVID-19 in the previous 3 months, who did not show generalized anxiety symptoms, and did not need additional information. 63.9% of incarcerated people expressed willingness to receive COVID-19 vaccination. Older subjects, who knew that a COVID-19 vaccination is available, believed that COVID-19 is more serious than influenza, and were self-confident about their ability to protect themselves from SARS-CoV-2 infection, were significantly more willing to undergo COVID-19 vaccination. Public health response to COVID-19 in prisons should address vaccine hesitancy to increase vaccine confidence among incarcerated people.

Automated summary

This cross-sectional study assessed the knowledge, attitudes, and preventive practices of incarcerated people towards COVID-19. The findings showed that the majority of respondents were aware of the transmission of COVID-19 through respiratory droplets and the increased risk for severe disease in patients with chronic conditions. Most participants believed that COVID-19 is more severe than influenza and could have serious consequences in their institution. However, only a small percentage felt confident in their ability to protect themselves from SARS-CoV-2 infection. A significant number of incarcerated individuals expressed willingness to receive the COVID-19 vaccine, particularly those who were older, aware of the availability of the vaccine, believed in the severity of COVID-19 compared to influenza, and had confidence in their ability to protect themselves from infection. The study highlights the importance of addressing vaccine hesitancy in prisons to increase vaccine confidence among incarcerated populations.