COVID-19 Outbreak and BNT162b2 mRNA Vaccination Coverage in a Correctional Facility during Circulation of the SARS-CoV-2 Omicron BA.1 Variant in Italy

Abstract

Background. The recent spread of the highly mutated SARS-CoV-2 Omicron variant (B.1.1.529) has raised concerns about protection against COVID-19 in congregate settings such as prisons, characterized by a high risk of transmission and possible difficulties in obtaining adequate vaccination coverage. The present study aims to investigate the spread of an outbreak of COVID-19 in an Italian correctional facility during the dominant circulation of the Omicron BA.1 variant, and also considers BNT162b2 mRNA vaccination coverage among inmates. A COVID-19 screening campaign by RT-PCR was performed on 515 detainees from 4–30 January 2022, in response to an outbreak that began in the correctional facility. Furthermore, 101 serum samples collected from healthy inmates 21 days after having received the second dose of the BNT162b2 vaccine were tested for neutralizing antibodies against both the wild-type SARS-CoV-2 strain and the Omicron BA.1 variant. The global attack rate during the study period was 43.6% (RR 0.8), progressively reducing from unvaccinated inmates (62.7%, RR 1.8) to those who had one dose (52.3%, RR 1.5), two doses (full cycle) (45.0%, RR 1.3), and the third dose (booster) vaccinated group (31.4%, RR 0.7). The percentage of SARS-CoV-2 positive subjects among unvaccinated inmates was significantly higher than in the other groups (p < 0.001), while no significant difference was observed between inmates with one or two vaccine doses. Only two of the positive inmates were hospitalized for COVID-19. The geometric mean titer of neutralizing antibodies in the tested sub-group after two doses of vaccine was lower than in previous studies against the wild-type virus, and showed a complete lack of neutralization against the Omicron variant in 92.1% of individuals. The findings support the need to prioritize vaccination in correctional facilities, as a public health measure to increase the protection of inmates and consequently of prison workers and the community against COVID-19, in coordination with the other prevention strategies.

Evaluation of antibody response to SARS-CoV-2 variants after 2 doses of mRNA COVID-19 vaccine in a correctional facility

“…As reported in other studies, 16–36 the most striking reduction in comparison with the ancestral virus was found in the antibody response toward the Beta and Omicron variants, in both CO and inmates. Indeed, 91.2% and 93.9% of CO and 85.1% and 92.8% of inmates showed a ≥ 2-fold reduction in the median VN titer against the Beta and Omicron variants, respectively.…”

“…In the correctional facility under study, the prevalence of inmates that have received two vaccine doses was similar to that observed in the Italian general population, whereas the percentage of those receiving the third dose was lower. 16 …”

Controlling COVID-19 outbreaks in the correctional setting: A mathematical modelling study

“…Importantly however, the modelling indicates that high coverage immunisation alone is insufficient in preventing COVID-19 outbreaks. This concern may become increasingly evident if additional new variants emerge and vaccine-conferred cross-protection wanes [29].…”

Mental Health of Nurses Working in a Judicial Psychiatry Hospital during the COVID-19 Pandemic in Italy: An Online Survey

“…On the other hand, healthcare professionals had higher workloads and professional responsibilities. The onset of this pandemic has highlighted the numerous criticalities at the organizational level involving both the national healthcare and the judicial systems [ 2 , 3 ]. Inside the prisons, inmates and staff share a confined environment that could act as a reservoir for epidemics.…”

“…Healthcare personnel faced an unknown situation, aggravated by the presence of psychosocial risk factors, such as long work shifts, emergency/urgency management without knowledge of the case, and high emotional load deriving from constant contact with high-profile situations [ 8 , 9 ]. This set of factors has caused general uncertainty, making prisons a potentially work-related stress risk context and burnout [ 3 , 10 ]. Burnout is a syndrome that causes suffering and physical, mental, psychological, and/or social dysfunctions, which occur when the demands coming from the job are not adequate to the skills, resources, or needs of the worker [ 11 ].…”