Department of Medical, Surgical and Experimental Sciences, Unit of Infectious Diseases, University of Sassari, Sassari, Italy.
Pallas Health Research and Consultancy B.V., Rotterdam, the Netherlands.
Vaccine. 2019 Aug 14;37(35):4906-4919. doi: 10.1016/j.vaccine.2019.07.014. Epub 2019 Jul 18.
In 2016, more than 600,000 persons were being held in EU/EEA correctional facilities on a given day. People in prison may be at risk of vaccine-preventable diseases. While vaccination recommendations for people in prison exist, little is known on coverage and implementation options.
We performed a systematic review on existing evidence on vaccination in prison settings in the EU/EEA. We searched peer-reviewed and grey literature following international methodology and reporting standards, to gather records published between 1980 and 2016 in all languages. We analysed quantitative (acceptance, uptake, cost-effectiveness) and qualitative (barriers) outcomes.
Out of 7041 identified records, 19 full-text articles were included from peer-reviewed literature and two from grey literature. Of these, 18 reported on hepatitis A and/or B virus (HAV/HBV), two on influenza and one on MMR vaccination. Two studies on HAV vaccine reported varying acceptance (5-91%) and uptake rates (62.9-70.5%). Seven studies reported on HBV vaccination. A comparative study showed a significantly higher uptake of the third HBV vaccine dose with the very rapid (63%) compared to the standard schedule (20%). HBV vaccination was generally well accepted (54-100%), whereas uptake was variable (dose 1:23-100%, dose 2:48-92%, dose 3:19-80%). One study on the combined HAV/HBV vaccine reported an acceptance rate of 34%, and declining uptake following dose 1. One study on influenza vaccine showed an uptake of 42-46%, while another reported a MMR vaccine acceptance of 80% and an uptake of 74%. Overall, main reasons for non-vaccination included release from/or transfer between prisons, and refusal.
This systematic review highlighted important knowledge gaps and operational challenges for vaccination in prison settings. Vaccination is an effective measure that warrants comprehensive and tailored implementation to reduce the preventable disease burden, avoid risks of large outbreaks of vaccine-preventable diseases, and contribute to health equity for people in prison.
2016 年，欧盟/欧洲经济区（EU/EEA）每天有超过 60 万人被关押在教养机构中。监狱中的人可能有感染疫苗可预防疾病的风险。尽管存在针对监狱囚犯的疫苗接种建议，但对于接种覆盖率和实施选项知之甚少。
我们对欧盟/欧洲经济区监狱环境中现有疫苗接种证据进行了系统评价。我们按照国际方法和报告标准，对同行评议文献和灰色文献进行了检索，以收集 1980 年至 2016 年间以各种语言发表的记录。我们分析了定量（接受率、接种率、成本效益）和定性（障碍）结果。
在 7041 条记录中，有 19 篇全文文章来自同行评议文献，2 篇来自灰色文献。其中，18 篇报告了甲型肝炎和/或乙型肝炎病毒（HAV/HBV），2 篇报告了流感，1 篇报告了麻疹、腮腺炎、风疹疫苗。两项关于甲型肝炎疫苗的研究报告了不同的接受率（5-91%）和接种率（62.9-70.5%）。有 7 项研究报告了乙型肝炎疫苗接种。一项比较研究表明，与标准方案（20%）相比，非常快速（63%）方案接种第三剂乙型肝炎疫苗的比例显著更高。乙型肝炎疫苗接种通常被广泛接受（54-100%），而接种率则有所不同（第 1 剂：23-100%，第 2 剂：48-92%，第 3 剂：19-80%）。一项关于甲型肝炎/乙型肝炎联合疫苗的研究报告称，接受率为 34%，第 1 剂接种后接种率下降。一项关于流感疫苗的研究报告接种率为 42-46%，另一项研究报告麻疹、腮腺炎、风疹疫苗的接受率为 80%，接种率为 74%。总体而言，不接种疫苗的主要原因包括从监狱获释/或在监狱之间转移，以及拒绝接种。
本系统评价突出了监狱环境中疫苗接种的重要知识差距和操作挑战。疫苗接种是一项有效的措施，需要全面和有针对性的实施，以减少可预防疾病负担，避免疫苗可预防疾病的大规模爆发，并促进监狱中人群的健康公平。
