Vaccination for Justice-Involved Youth

Abstract

Justice-involved youth are at increased risk for coronavirus disease 2019 (COVID-19) infection, and structural barriers may limit their access to vaccination. We implemented a COVID-19 vaccination initiative for justice-involved youth residing at the county juvenile detention center and enrolled in local community-based monitoring programs. Our overarching goal was to increase COVID-19 vaccine access and uptake for justice-involved youth in Allegheny County, Pennsylvania. Our efforts incorporated: a virtual forum with youth, guardians, and community partners; one-on-one outreach to guardians; motivational interviewing with youth; and coordination with organizational leaders. We collaborated with a multidisciplinary medical team to offer individualized education and counseling to parents and youth expressing vaccine hesitancy. We developed a logistical framework to ensure complete COVID-19 vaccination series for all youth, including centralized tracking and implementation of multiple community-based vaccine clinics. Through our initiative, 31 justice-involved youth have received at least 1 dose of the Pfizer-BioNTech COVID-19 vaccine. A total of 50 doses have been administered as a result of this initiative. This work has reaffirmed hypothesized barriers to vaccine access among justice-involved youth, including limited parental involvement, inadequate transportation, vaccine misinformation, and distrust rooted in histories of medical mistreatment of communities of color. Best practices for promoting equitable vaccination efforts among vulnerable subgroups include partnering closely with diverse community members; offering individualized, strengths-based counseling on vaccine safety, efficacy, and importance; and demonstrating provider trustworthiness by recognizing histories of oppression.

COVID-19 and Influenza Infection Prevention and Control Measures in U.S. Jails, Prisons, and Detention Centers: A Scoping Review

“…Nearly all results for both infection types were observational, with most analyzing cross-sectional data. No results discussed mitigation strategies in ICE detention centers, and only two results discussed them in youth detention centers (Goldman et al, 2022; Unruh et al, 2021). We will discuss the results in 6 subsections: vaccines, testing, de-densification, limited movement, masks, and contact tracing.…”

“…Compared with jails without a pandemic plan, jails that reported having a pandemic plan were 69% more likely to obtain the influenza vaccine to distribute to residents (95% CI; 1.19, 1.45) (Lee et al, 2014). Ten studies were on COVID-19 vaccination in detention facilities (Brinkley-Rubinstein, Peterson, et al, 2021; Chin, Leidner, et al, 2021; Chin, Leidner, Lamson, et al, 2022; Chin, Leidner, Zhang, et al, 2022; Garcia-Grossman et al, 2022; Goldhaber-Fiebert et al, 2022; Goldman et al, 2022; Hagan et al, 2021; Silverman et al, 2022; Tan et al, 2023). Silverman et al (Silverman et al, 2022), Chin et al (Chin, Leidner, et al, 2021), Chin et al (Chin, Leidner, Zhang, et al, 2022), Brinkley-Rubinstein et al (Brinkley-Rubinstein, Peterson, et al, 2021), and Tan et al (Tan et al, 2023) used cohort study designs to demonstrate that vaccination is an effective strategy for COVID-19 prevention in prisons.…”

“…Two studies, Chin et al (Chin, Leidner, Lamson, et al, 2022) and Goldhaber-Fiebert et al (Goldhaber-Fiebert et al, 2022), highlighted the need for booster doses of mRNA vaccines in California state prisons using case-control study designs. Goldman et al (Goldman et al, 2022) studied a multi-faceted outreach initiative at a juvenile detention center with a virtual forum, one-on-one outreach to guardians, motivational interviewing, and coordination with community leaders. While this program focused on youths residing at the detention center, individuals in the county’s Community Intensive Supervision Program were also eligible.…”

“…Goldman et al (Goldman et al, 2022) studied a multi-faceted outreach initiative at a juvenile detention center with a virtual forum, one-on-one outreach to guardians, motivational interviewing, and coordination with community leaders. While this program focused on youths residing at the detention center, individuals in the county's Community Intensive Supervision Program were also eligible.…”

“…While this program focused on youths residing at the detention center, individuals in the county's Community Intensive Supervision Program were also eligible. Out of 56 people receiving counseling through this program, 31 were vaccinated because of the initiative (Goldman et al, 2022). Garcia-Grossman et al (Garcia-Grossman et al, 2022) evaluated the impact of vaccination education events with informal question and answer sessions, trivia, and incentives for participation.…”