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Determinants of COVID-19 vaccine willingness among people incarcerated in Canadian federal prisons: a cross-sectional study

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Speak with Kathryn Romanchuk about her practicum on January 31st from 3:45-4:15pm via this .

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View Kathryn Romanchuk's poster presentation in this video recording: 

Abstract

Prison represents a setting with many non-modifiable risk factors for outbreaks, such as close proximity, limited autonomy, an aging and increasingly comorbid population, and healthcare access barriers. Improved vaccination uptake is a well-established method of both future outbreak prevention and mitigation. Therefore, maximizing COVID-19 vaccination uptake within the Canadian Federal Prison System is a pragmatic method of maintaining and prioritizing the health and wellbeing of federally incarcerated people. Vaccine acceptance in the general population is a poorly understood and complex intersection of personal, familial, behavioral, and societal factors; in a prison setting vaccine acceptance is even less understood.  

During COVID-19 vaccine roll-out, we aimed to determine factors associated with willingness to receive a COVID-19 vaccine in Canadian federal prisons. Based on previously low influenza vaccine uptake, three Canadian federal prisons were selected for study recruitment. Participants self-administered a questionnaire assessing both COVID-19 specific and general vaccine knowledge, attitude, and beliefs. Our outcome of interest was COVID-19 vaccine willingness (measured using a five-point Likert response to the question “If a safe and effective COVID-19 vaccine becomes available in prison, how likely are you to get vaccinated?”). A priori identified independent variables’ relationship with COVID-19 vaccine willingness were examined using multivariate logistic regression to obtain adjusted odds ratio (aOR) and 95% confidence intervals (CI).  

Between the three prisons, 229 participants were included (median age: 46; female: 20%, Indigenous: 25%). Of these 189 (83%) were willing to receive a COVID-19 vaccine. Odds of COVID-19 vaccine acceptance was higher among participants who received the 2019-2020 influenza vaccine and those who perceived vaccines as important; respectively they had an estimated aOR of 4.24 (95% CI 1.61-12.40) and 10.20 (95% CI 4.33-26.00). Conversely, participants in medium security (aOR 0.27, 95% CI 0.07-0.88; vs. minimum security) had lower odds of COVID-19 vaccine willingness.  

The majority (83%) of participants were willing to receive a COVID-19 vaccine prior to vaccine roll-out even among prisons that had traditionally low flu vaccine uptake. Efforts focused on those who do not perceive vaccines as important and those in high-security prisons may help improve vaccine willingness among Canadian incarcerated individuals.  

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