Lodolo Laura, Smyth Emma, Ngassa Yvane, Pickard Bridget, LeClair Amy M, Beckwith Curt G, Wurcel Alysse
Tufts University School of Medicine, Boston, Massachusetts, USA.
Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts Medical Center, Boston, Massachusetts, USA.
Open Forum Infect Dis. 2023 Apr 19;10(5):ofad212. doi: 10.1093/ofid/ofad212. eCollection 2023 May.
Despite national guidelines on infectious disease testing and vaccination in prisons, there is heterogeneity on the implementation of these practices in jails. We sought to better understand perspectives on the implementation of opt-out vaccination for infectious diseases in jails by interviewing a broad group of stakeholders involved in infectious diseases vaccination, testing, and treatment in Massachusetts jails.
The research team conducted semistructured interviews with people incarcerated in Hampden County Jail (Ludlow, Massachusetts), clinicians working in jail and community settings, corrections administrators, and representatives from public health, government, and industry between July 2021 and March 2022.
Forty-eight people were interviewed, including 13 people incarcerated at the time of interview. Themes that emerged included the following: misunderstandings of what opt-out means, indifference to the way vaccines are offered, belief that using the opt-out approach will increase the number of individuals who receive vaccination, and that opt-out provides an easy way for vaccine rejection and reluctance to accept vaccination.
There was a clear divide in stakeholders' support of the opt-out approach, which was more universally supported by those who work outside of jails compared to those who work within or are incarcerated in jails. Compiling the perspectives of stakeholders inside and outside of jail settings on the opt-out approach to vaccination is the first step to develop feasible and effective strategies for implementing new health policies in jail settings.
尽管有关于监狱传染病检测和疫苗接种的国家指南，但这些做法在监狱中的实施情况存在异质性。我们试图通过采访马萨诸塞州监狱中参与传染病疫苗接种、检测和治疗的广泛利益相关者，更好地了解监狱中传染病选择退出式疫苗接种实施的相关观点。
2021年7月至2022年3月期间，研究团队对汉普登县监狱（马萨诸塞州卢德洛）的在押人员、在监狱和社区环境中工作的临床医生、惩教管理人员以及公共卫生、政府和行业代表进行了半结构化访谈。
共采访了48人，其中包括13名访谈时正在服刑的人员。出现的主题包括：对选择退出的含义存在误解、对疫苗提供方式漠不关心、认为采用选择退出方式会增加接种疫苗的人数，以及选择退出为疫苗拒绝和不愿接受接种提供了一种简便方式。
利益相关者对选择退出方式的支持存在明显分歧，与在监狱内工作或服刑的人员相比，监狱外的工作人员更普遍地支持这种方式。汇总监狱内外利益相关者对疫苗接种选择退出方式的观点，是制定在监狱环境中实施新卫生政策的可行有效策略的第一步。
