COVID-19 vaccine deliberation in individuals directly impacted by incarceration

Delays in vaccinating communities of color to COVID-19 have signaled a need to investigate structural barriers to vaccine uptake, with mass incarceration demanding greater characterization as a potential factor. In a nationally representative survey from February-March 2021 (N = 1,157), exposure to the criminal legal system, defined as having been incarcerated in prison or jail or having had a family member or close friend incarcerated, was associated with higher odds for COVID-19 vaccine deliberation. Individuals with criminal legal system exposure reported lower confidence in physician recommendation as a reason to get vaccinated. They were also more likely to decline vaccination out of fear it would cause COVID-19 infection, and that the vaccine might be promoted as a political tool. Our analysis suggests that populations impacted by the criminal legal system would benefit from targeted vaccine outreach by trusted community members who can address distrust during current and future pandemics.(c) 2023 Elsevier Ltd. All rights reserved.

Automated summary

Delays in vaccinating communities of color signal the need to investigate structural barriers to vaccine uptake, with mass incarceration needing further characterization as a potential factor. A survey conducted from February to March 2021 showed that exposure to the criminal legal system was associated with higher odds for COVID-19 vaccine deliberation, lower confidence in physician recommendation as a reason to get vaccinated, and higher likelihood of declining vaccination out of fear of infection and political manipulation. Targeted vaccine outreach by trusted community members is needed to address distrust among populations impacted by the criminal legal system during current and future pandemics.