Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK.
Her Majesty's Prison and Probation Service, London, UK & the University of Nottingham, Nottingham, UK.
BMC Public Health. 2022 May 18;22(1):1003. doi: 10.1186/s12889-022-13219-4.
High incidence of cases and deaths due to coronavirus disease 2019 (COVID-19) have been reported in prisons worldwide. This study aimed to evaluate the impact of different COVID-19 vaccination strategies in epidemiologically semi-enclosed settings such as prisons, where staff interact regularly with those incarcerated and the wider community.
We used a metapopulation transmission-dynamic model of a local prison in England and Wales. Two-dose vaccination strategies included no vaccination, vaccination of all individuals who are incarcerated and/or staff, and an age-based approach. Outcomes were quantified in terms of COVID-19-related symptomatic cases, losses in quality-adjusted life-years (QALYs), and deaths.
Compared to no vaccination, vaccinating all people living and working in prison reduced cases, QALY loss and deaths over a one-year period by 41%, 32% and 36% respectively. However, if vaccine introduction was delayed until the start of an outbreak, the impact was negligible. Vaccinating individuals who are incarcerated and staff over 50 years old averted one death for every 104 vaccination courses administered. All-staff-only strategies reduced cases by up to 5%. Increasing coverage from 30 to 90% among those who are incarcerated reduced cases by around 30 percentage points.
The impact of vaccination in prison settings was highly dependent on early and rapid vaccine delivery. If administered to both those living and working in prison prior to an outbreak occurring, vaccines could substantially reduce COVID-19-related morbidity and mortality in prison settings.
全球范围内的监狱报告了大量的 2019 年冠状病毒病（COVID-19）病例和死亡。本研究旨在评估在监狱等半封闭环境中，对工作人员与被监禁者和更广泛的社区定期互动的人群采取不同的 COVID-19 疫苗接种策略的影响。
我们使用了英格兰和威尔士一个当地监狱的局域人群传播动力学模型。两剂疫苗接种策略包括不接种疫苗、对所有被监禁者和/或工作人员进行接种，以及基于年龄的方法。结果根据 COVID-19 相关症状病例、质量调整生命年（QALY）损失和死亡来量化。
与不接种疫苗相比，在监狱内居住和工作的所有人接种疫苗可将一年内的病例、QALY 损失和死亡分别减少 41%、32%和 36%。然而，如果疫苗接种延迟到疫情爆发开始时，其影响则可以忽略不计。为 50 岁以上的被监禁者和工作人员接种疫苗，每接种 104 剂疫苗可避免 1 人死亡。仅对工作人员进行接种的策略可减少多达 5%的病例。将被监禁者的接种覆盖率从 30%提高到 90%，可使病例减少约 30 个百分点。
疫苗接种在监狱环境中的影响高度依赖于早期和快速的疫苗接种。如果在疫情爆发前对所有在监狱内居住和工作的人进行接种，疫苗可以大大降低监狱环境中 COVID-19 相关的发病率和死亡率。
