World Immunization Week aims to highlight the collective action needed to protect people from vaccine-preventable diseases. This year it runs from 24th-30th April, and at WEPHREN we will use this time to highlight immunisation issues for imprisoned people. People living in prisons are among a number of underserved groups with low vaccination coverage. They are also at increased vulnerability to vaccine-preventable diseases (VPD) because of a number of factors; these include the physical environment in which they live, as this is often overcrowded and poorly ventilated, and also individual level factors, for example, whether or not the person injects drugs.
To mark World Immunization Week, WEPHREN will be focusing on the work of RISE-Vac. The project's mission statement is 'Reaching the hard-to-reach: Increasing access and vaccine uptake among the prison population in Europe'. This is an EU funded project which will develop individual-centred and evidence-based models to increase vaccine literacy, access and vaccine uptake among prison populations, and will support decision-makers, experts and citizens to value and foster quality prison health care in order to tackle health inequalities and health gaps in the European population at large.
The six countries in the consortium, Cyprus, Italy, France, Germany, Moldova and the United Kingdom, all face issues around vaccination in prisons. Below, members from different countries within the consortium, highlight different issues in prisons in their countries and/or work ongoing as part of RISE-Vac.
Click here to access the video by Dr. Fadi Meroueh and Dr. Penelope Robin where they describe vaccination in prisons in France and their work in the RISE-Vac project.
Here we hear from Marianna Polidoro, who works in the San Vittore prison in Milan, Italy, on her experience working in the RISE-Vac project.
I started working in San Vittore in May 2020 with the aim of dealing with the consequences that the pandemic has brought over the last few years. There were many difficulties in prison, as one can imagine thinking of a place where personal freedom is already limited.
At that time, vaccination sessions for the administration of the COVID-19 vaccine were the priority and they were organized weekly; the greatest difficulties were due to the fact that often the prisoners did not have a vaccination certificate on previous administrations. The lack of a national health information network for COVID-19 meant having to contact many health facilities in Italy to retrieve the vaccination data and thus be able to administer the next dose.
Many people in that period felt obliged to get vaccinated in order to be able to carry out normal daily activities (talks with family members/judges/lawyers, work, school, free time); this feeling of uncertainty and distrust of vaccination was palpable in the corridors of the institute. On TV, the information was often conflicting and many inmates declared they were worried about their health since not much was known yet about the COVID-19 vaccine. However, ther were also many who expressed their confidence in research, public health and the government which had to adopt strict safety measures in a short time.
One of the people living in prison told me recently that he received five doses of the COVID-19 vaccine, in different geographical locations, because he did not have a vaccination certificate and he decided not to declare his vaccination history in order to obtain permission to enter more quickly.
Since the end of 2022, once the most difficult period linked to the pandemic was over, we have been able to move away from emergency response to COVID-19 and towards building the RISE-Vac project - specifically dealing with the organization of health counseling meetings, the administration of tests on infectious diseases, the administration of questionnaires in an important work involving the prison population (a survey that aims to understand what is the attitude towards vaccinations and what are the factors that influence it). Finally, through RISE-Vac I also help organize the vaccination sessions for the prevention of infectious disease. To date, we have administered the Monkeypox and penumococcal vaccines; soon, we hope to also administer HPV and diphtheria, tetanus and pertussis vaccines,in anticipation of the administration of the HBV vaccine.
Here we hear from Lucia Tataru, who works in the Moldovan National Administration of Penitentiaries on vaccination in Moldovan prisons and their involvement in the RISE-Vac project. We can also see a short video of a patient in prison in Moldova receiving their hepatitis B vaccine.
Immunization in prisons from the Republic of Moldova contributed both to reducing the risk of illness and to reducing the risk of developing a severe form of the disease. This was demonstrated by the disease rate of only 7.8% among people living in prison with the infection of COVID-19.
It is very unlikely that a vaccinated person will transmit an infectious disease to others. Thus immunization in prisons contributed to the protection of those who could not be vaccinated.
In prisons, the immunization of elderly people against influenza infection, led to the avoidance of complications of severe forms of the disease.
Hepatitis B vaccination was also implemented in 2022, among risk groups of people living in prison and collaborators, which was and is an enormous benefit for Penitentiary Institutions.
By helping to keep more inmates healthy, vaccination has helped reduce the social and psychological effects of disease on inmates and co-workers and decreases the burden of hospitalization.
From the United Kingdom, we hear from Paula Harriott from the Prison Reform Trust. She tells us about her experience from working in prisons and how to approach talking about vaccines with people living in prison. Access the full video here and our twitter post here.
In Germany, the Ministries of Justice in 16 states (Bundesländer) are responsible for providing healthcare services including vaccination in prisons. In light of limited data, evidence shows that vaccines are available and distributed among people living in prisons (PLP) in Germany, although the availability and model of delivery vary by region. In Frankfurt, for example, multiple vaccines including hepatitis A and B, influenza and COVID-19, human papillomavirus (HPV), diphtheria, pertussis, tetanus (DPT), measles, mumps and rubella (MMR), and pneumococcal disease are available to PLP on request. Data on various aspects of vaccination including the coverage and uptake in German prisons are scarce.
- Creating Supportive Conditions to Reduce Infectious Diseases in Prison Populations
- WHO/Europe training course for prison health-care workers: Prevention and Management of Infectious Diseases in Places of Detention
- Prisons and other places of detention in pandemic preparedness plans across the WHO European Region in the context of the COVID-19 pandemic