COVID-19 Vaccination Status as Well as Factors Associated with COVID-19 Vaccine Acceptance and Hesitancy among Prisoners and the Implications

Prisoners form a population who are highly vulnerable to COVID-19 due to overcrowding, limited movement, and a poor living environment. Consequently, there is a need to ascertain the status of COVID-19 vaccination and factors associated with hesitancy among prisoners. A cross-sectional questionnaire-based study was undertaken among prisoners at three district jails in Punjab Province, Pakistan. A total of 381 prisoners participated and none of the study participants had received an influenza vaccine this year. In total, 53% received at least one dose of a COVID-19 vaccine, with the majority having two doses. The top three reasons of vaccine acceptance were fear of contracting SARS-CoV-2 infection (56.9%), desire to return to a pre-pandemic routine as soon as possible (56.4%), and having no doubts on the safety of COVID-19 vaccines (39.6%). There was no statistically significant difference (p > 0.05) in any demographic variables between vaccinated and unvaccinated prisoners except for age, which was strongly association with COVID-19 vaccine uptake (& chi;(2)(3) = 76.645, p < 0.001, Cramer's V = 0.457). Among the unvaccinated prisoners (N = 179), only 16 subsequently showed willingness to receive a COVID-19 vaccine. The top three reasons for hesitancy were: COVID-19 is not a real problem/disease (60.1%), safety concerns (51.1%), and COVID-19 vaccine is a conspiracy (50.3%). Efforts are needed to address their concerns given this population's risks and high hesitancy rates, especially among younger prisoners.

Automated summary

Prisoners are particularly vulnerable to COVID-19 due to their living conditions and limited movement. A study found that 53% of prisoners surveyed had received at least one dose of a COVID-19 vaccine, with the main reasons being fear of infection, desire to return to normalcy, and trust in the vaccine's safety. Among the unvaccinated prisoners, hesitancy was primarily driven by disbelief in the seriousness of COVID-19, safety concerns, and conspiracy theories surrounding the vaccine.