Uptake of COVID-19 Vaccination Among Frontline Workers in California State Prisons

Abstract

IMPORTANCEPrisons and jails are high-risk environments for COVID-19. Vaccination levels among workers in many such settings remain markedly lower than those of residents and members of surrounding communities. The situation is troubling because prison staff are a key vector for COVID-19 transmission. OBJECTIVE To assess patterns and timing of staff vaccination in California state prisons and identify individual-level and community-level factors associated with remaining unvaccinated. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from December 22, 2020, through June 30, 2021, to quantify the fractions of staff and incarcerated residents who remained unvaccinated among 23 472 custody and 7617 health care staff who worked in roles requiring direct contact with residents at 33 of the 35 prisons operated by the California Department of Corrections and Rehabilitation. Multivariable probit regressions assessed demographic, community, and peer factors associated with staff vaccination uptake. MAIN OUTCOMES AND MEASURES Remaining unvaccinated throughout the study period. RESULTS Of 23 472 custody staff, 3751 (16%) were women, and 1454 (6%) were Asian/Pacific Islander individuals, 1571 (7%) Black individuals, 9008 (38%) Hispanic individuals, and 6666 (28%) White individuals. Of 7617 health care staff, 5434 (71%) were women, and 2148 (28%) were Asian/ Pacific Islander individuals, 1201 (16%) Black individuals, 1409 (18%) Hispanic individuals, and 1771 (23%) White individuals. A total of 6103 custody staff (26%) and 3961 health care staff (52%) received 1 or more doses of a COVID-19 vaccine during the first 2 months vaccines were offered, but vaccination rates stagnated thereafter. By June 30, 2021, 14 317 custody staff (61%) and 2819 health care staff (37%) remained unvaccinated. In adjusted analyses, remaining unvaccinated was positively associated with younger age (custody staff: age, 18-29 years vs Ն60 years

Importance of occupation for SARS-CoV-2 seroprevalence and COVID-19 vaccination among correctional workers in Quebec, Canada: A cross-sectional study

“…Prison occupation was also predictive of lower vaccine uptake, as has been found in another study ( 21 ), with COs being 1.2 times less likely to be vaccinated compared to other employees. In fact, COs comprised 70% of all workers who were not fully vaccinated.…”

“…Independent variables were selected based on a literature review of factors associated with SARS-CoV-2 seroprevalence and vaccine uptake among employees of congregate settings, including correctional facilities ( 6 , 14 , 16 , 21 , 30 ). Variables were grouped into the following categories: sociodemographic (age, sex, ethnicity, education level, and yearly income), clinical (self-reported history of prior SARS-CoV-2 PCR testing, COVID-19 symptoms, medical comorbidities, and COVID-19 vaccination), and carceral characteristics (provincial prison, prison occupation, number of workdays, meal consumption with others at work, direct daily contact with people in prison, ability to physically distance, and perceived concern of SARS-CoV-2 acquisition in prison).…”

“…Cognizant of the heightened risk of SARS-CoV-2 transmission in correctional settings, “resident and staff of congregate settings” were prioritized for early COVID-19 vaccination in December 2020 by the Canadian National Advisory Committee on Immunization ( 20 ). COVID-19 vaccine coverage among correctional workers remains lower than surrounding communities in many countries ( 21 – 23 ); however, very few studies have sought to understand individual- and occupation-related characteristics associated with vaccine uptake in these settings ( 21 ). To address these important knowledge gaps, we sought to examine the SARS-CoV-2 seroprevalence among correctional workers in Quebec provincial prisons, determine the effects of carceral and occupational exposures on SARS-CoV-2 seropositivity, and explore predictors of COVID-19 vaccine uptake.…”

Meeting the Moment by Vaccinating Prison Staff Against COVID-19

“…Correctional leadership often rely on top-down management systems that fail to incorporate user perspectives, but vaccination campaigns for carceral settings represent opportunities to include staff and incarcerated people in decision-making. Peer effects should be considered when delivering staff vaccination, but rather than encouraging staff to be vaccinated in private, as Prince et al suggest, 3 elevating the perspectives of vaccinated trusted messengers within staff ranks would leverage positive peer pressure and social desirability to increase vaccination.…”

VII. Die quantitative Studie – Covid-19 aus Sicht der Mitarbeitenden

“…Wallace et al (2021) zeigen dementsprechend auf, dass das Personal einen Einfluss auf die Übertragung der Krankheit im Vollzug hat und somit bei der Infektions kontrolle von entscheidender Bedeutung ist. Diese Thematik wird auch in der Studie von Prince et al (2021) fokussiert, die eine unterdurchschnitt liche Impfbereitschaft beim Personal in US-amerikanischen Gefängnissen anhand einer Stichprobe von rund 30.000 Mitarbeitenden feststellten und diese somit als besondere Gruppe für die Verbreitung der Krankheit in Ge fängnissen (sog. Hoch-Risiko-Settings) identifizierten.…”