Vaccination for Justice-Involved Youth.

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.