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Archer H, McCoy SI, Sears D, Kwan A, Kuersten M, Lewnard JA, Bertozzi SM. Indirect vaccine effectiveness in an outbreak of Alpha B.1.1.7 variant in a California state Prison, May 2021. Vaccine 2024; 42:3057-3065. [PMID: 38584059 DOI: 10.1016/j.vaccine.2024.03.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/09/2024]
Abstract
Incarcerated populations experienced high rates of SARS-CoV-2 infection and death during early phases of the COVID-19 pandemic. To evaluate vaccine effectiveness in the carceral context, we investigated the first outbreak of COVID-19 in a California state prison following widespread rollout of vaccines to residents in early 2021. We identified a cohort of 733 state prison residents presumed to be exposed between May 14 and June 22, 2021. 46.9 % (n = 344) were vaccinated, primarily with two doses of mRNA-1273 (n = 332, 93.6 %). In total, 92 PCR-positive cases were identified, of which 14 (14.5 %) occurred among mRNA-1273 vaccinated residents. No cases required hospitalization. All nine isolates collected belonged to the Alpha (B.1.1.7) variant. We used Cox proportional hazard regression to estimate vaccine effectiveness for at least one dose of any vaccine at the start of the outbreak. Vaccine effectiveness was 86 % (95 % CI: 75 %-97 %) against PCR-confirmed infection, with similar results for symptomatic infection. Higher rates of building-level vaccine uptake were associated with a lower overall rate of PCR-confirmed infection and symptomatic infection among unvaccinated residents. Among unvaccinated residents who lived in shared cells at the time of presumed exposure, exposure to a vaccinated cellmate was associated with a 38% (95% CI: 0.37, 1.04) lower hazard rate of PCR-confirmed infection over the study period. In this outbreak involving the Alpha SARS-CoV-2 variant, vaccination conferred direct and possibly indirect protection against SARS-CoV-2 infection and symptomatic COVID-19. Our results support the importance of vaccine uptake in mitigating outbreaks and severe disease in the prison setting and the consideration of community vaccination levels in policy and infection response.
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Affiliation(s)
- Helena Archer
- Division of Epidemiology, School of Public Health, University of California, Berkeley.
| | - Sandra I McCoy
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - David Sears
- Division of Infectious Diseases, Department of Medicine, University of California, San Francisco
| | - Ada Kwan
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco
| | | | - Joe A Lewnard
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - Stefano M Bertozzi
- Division of Health Policy and Management, School of Public Health, University of California, Berkeley; School of Public Health, University of Washington, Seattle; Instituto Nacional de Salud Pública, Cuernavaca.
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Hassan R, Meehan AA, Hughes S, Beeson A, Spencer H, Howard J, Tietje L, Richardson M, Schultz A, Zawitz C, Ghinai I, Hagan LM. Health Belief Model to Assess Mpox Knowledge, Attitudes, and Practices among Residents and Staff, Cook County Jail, Illinois, USA, July-August 2022. Emerg Infect Dis 2024; 30:S49-S55. [PMID: 38561645 PMCID: PMC10986831 DOI: 10.3201/eid3013.230643] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
In summer 2022, a case of mpox was confirmed in a resident at the Cook County Jail (CCJ) in Chicago, Illinois, USA. We conducted in-depth interviews with CCJ residents and staff to assess mpox knowledge, attitudes, and practices; hygiene and cleaning practices; and risk behaviors. We characterized findings by using health belief model constructs. CCJ residents and staff perceived increased mpox susceptibility but were unsure about infection severity; they were motivated to protect themselves but reported limited mpox knowledge as a barrier and desired clear communication to inform preventive actions. Residents expressed low self-efficacy to protect themselves because of contextual factors, including perceived limited access to cleaning, disinfecting, and hygiene items. Our findings suggest correctional facilities can support disease prevention by providing actionable and tailored messages; educating residents and staff about risk and vaccination options; and ensuring access to and training for hygiene, cleaning, and disinfecting supplies.
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Porter LJ, Rapheal E, Huebsch R, Bastian T, Robinson TJ, Chakoian H, Martin KG, Zipprich J. Development and Evaluation of Surveillance System for Identifying Jail-Associated COVID-19 Cases in Minnesota, USA, 2022. Emerg Infect Dis 2024; 30:S28-S35. [PMID: 38561640 PMCID: PMC10986828 DOI: 10.3201/eid3013.230719] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Confinement facilities are high-risk settings for the spread of infectious disease, necessitating timely surveillance to inform public health action. To identify jail-associated COVID-19 cases from electronic laboratory reports maintained in the Minnesota Electronic Disease Surveillance System (MEDSS), Minnesota, USA, the Minnesota Department of Health developed a surveillance system that used keyword and address matching (KAM). The KAM system used a SAS program (SAS Institute Inc., https://www.sas.com) and an automated program within MEDSS to identify confinement keywords and addresses. To evaluate KAM, we matched jail booking data from the Minnesota Statewide Supervision System by full name and birthdate to the MEDSS records of adults with COVID-19 for 2022. The KAM system identified 2,212 cases in persons detained in jail; sensitivity was 92.40% and specificity was 99.95%. The success of KAM demonstrates its potential to be applied to other diseases and congregate-living settings for real-time surveillance without added reporting burden.
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Qureshi NS, Miller LG, Judge SP, Tran NDT, Henderson SO. Characterizing predictors of COVID-19 vaccine refusal in an urban southern California jail population. Vaccine 2024; 42:777-781. [PMID: 38195263 DOI: 10.1016/j.vaccine.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND Correctional populations have been disproportionately affected by COVID-19, and many large outbreaks have occurred in jails and prisons. Vaccination is a key strategy to reduce the SARS-CoV-2 transmission in carceral settings. Although implementation can be challenging due to vaccine hesitancy and medical mistrust, correctional settings provide largely equitable healthcare access and present a unique opportunity to identify potential predictors of vaccine hesitancy independent of access issues. METHODS We retrospectively analyzed electronic health record data for individuals offered COVID-19 vaccination at the Los Angeles County Jail between January 19, 2021, and January 31, 2023, and used multivariable logistic regression to determine predictors of COVID-19 vaccine refusal. RESULTS Of the 21,424 individuals offered COVID-19 vaccination, 2,060 (9.6 %) refused. Refusal was associated with male sex ([aOR] = 2.3, 95 % CI (1.9, 2.8)), age 18-34 ([aOR] = 1.2, 95 % CI (1.1, 1.4), referent group: age 45-54), Black race ([aOR] = 1.2, 95 % CI (1.1, 1.4)), reporting ever being houseless ([aOR] = 1.2, 95 % CI (1.1, 1.3)), and having a history of not receiving influenza vaccination while incarcerated ([aOR] = 2.4, 95 % CI (2.0, 2.8)). When analyzing male and female populations separately, male-specific trends reflected those seen in the overall population, whereas the only significant predictor of vaccine refusal in the female population was not receiving influenza vaccination while in custody ([aOR] = 6.5, 95 % CI (2.4, 17.6)). CONCLUSION Identifying predictors of vaccine refusal in correctional populations is an essential first step in the development and implementation of targeted interventions to mitigate vaccine hesitancy.
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Affiliation(s)
- Nazia S Qureshi
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA.
| | - Loren G Miller
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA; David Geffen School of Medicine at UCLA, Los Angeles CA, USA; Harbor-UCLA Medical Center, 1000 West Carson Street, Box 466, Torrance, CA 90509, USA; Division of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Stephen P Judge
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA; Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA; David Geffen School of Medicine at UCLA, Los Angeles CA, USA; Harbor-UCLA Medical Center, 1000 West Carson Street, Box 466, Torrance, CA 90509, USA; Division of Infectious Diseases, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Ngoc Dung T Tran
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA
| | - Sean O Henderson
- Integrated Correctional Health Services-Los Angeles County Department of Health Services, 450 Bauchet St., Los Angeles, CA, USA
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Ackerman M, Holmes CS, Antigua JR, Riback LR, Zhang C, Walker JG, Vickerman P, Travers A, Linder M, Day R, Fox AD, Cunningham CO, Akiyama MJ. Mitigation through on-site testing & education among formerly incarcerated individuals against Covid-19 - The MOSAIC study: Design and rationale. Contemp Clin Trials 2024; 136:107406. [PMID: 38097063 PMCID: PMC11055630 DOI: 10.1016/j.cct.2023.107406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/29/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Many of the largest COVID-19 outbreaks in the United States have occurred at carceral facilities. Criminal legal system (CLS)-involved individuals typically face structural barriers accessing medical care post-release. Improving COVID-19 testing and education for CLS-involved individuals could improve health outcomes for this vulnerable population and the communities to which they return. Community-based organizations (CBO) and community health workers (CHWs) fill care gaps by connecting CLS-involved individuals with essential re-entry services. The MOSAIC study will: 1) test an onsite CHW-led SARS-CoV-2 testing and education intervention in a reentry CBO and 2) model the cost-effectiveness of this intervention compared to standard care. METHODS We will recruit 250 CLS-involved individuals who have left incarceration in the prior 90 days. Participants will be randomized to receive onsite Point-of-Care testing and education (O-PoC) or Standard of Care (SoC). Over one year, participants will complete quarterly questionnaires and biweekly short surveys through a mobile application, and be tested for SARS-CoV-2 quarterly, either at the CBO (O-PoC) or an offsite community testing site (SoC). O-PoC will also receive COVID-19 mitigation counseling and education from the CHW. Our primary outcome is the proportion of SARS-CoV-2 tests performed with results received by participants. Secondary outcomes include adherence to mitigation behaviors and cost-effectiveness of the intervention. DISCUSSION The MOSAIC study will offer insight into cost effective strategies for SARS-CoV-2 testing and education for CLS-involved individuals. The study will also contribute to the growing literature on CHW's role in health education, supportive counseling, and building trust between patients and healthcare organizations.
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Affiliation(s)
- Maxwell Ackerman
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America
| | - Connor S Holmes
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America
| | - Jordy Rojas Antigua
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America
| | - Lindsey R Riback
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America
| | - Chenshu Zhang
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America
| | - Josephine G Walker
- Bristol Medical School, Population Health Sciences, University of Bristol, Queens Road, Bristol BS8 1QU, UK
| | - Peter Vickerman
- Bristol Medical School, Population Health Sciences, University of Bristol, Queens Road, Bristol BS8 1QU, UK
| | - Ann Travers
- The Fortune Society, 2976 Northern Blvd, Long Island City, NY 11101, United States of America
| | - Micaela Linder
- The Fortune Society, 2976 Northern Blvd, Long Island City, NY 11101, United States of America
| | - Ronald Day
- The Fortune Society, 2976 Northern Blvd, Long Island City, NY 11101, United States of America
| | - Aaron D Fox
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America
| | - Chinazo O Cunningham
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America
| | - Matthew J Akiyama
- Albert Einstein College of Medicine, Montefiore Medical Center, Morris Park Ave, Bronx, NY 10467, United States of America.
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Farabee D, Hawken A. Perceptions of COVID-19 vaccine side effects by political affiliation. J Public Health (Oxf) 2023; 45:930-934. [PMID: 37414730 PMCID: PMC10687863 DOI: 10.1093/pubmed/fdad105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/26/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND We sought to assess the extent to which subjective experiences of COVID-19 vaccine side effects among US adults are associated with political party identification. METHODS An online survey was conducted of a national sample of US adults (N = 1259) identifying as either Republican or Democrat. RESULTS There was no significant difference by party identification in the perceived severity of vaccination side effects; however, Republicans were significantly less likely to recommend the vaccine to others in light of their experience (OR = 0.40; 95% CI, 0.31-0.51; P < 0.001). Republicans also reported having a larger share of COVID-19-vaccinated friends and family who experienced notable side effects (OR = 1.31; 95% CI, 1.02-1.68; P < 0.05). There was a positive association between respondents' perceived side-effect severity and the proportion of peers who also reported notable side effects (r = 0.43; P < 0.001). CONCLUSION Subjective appraisals of the vaccinated may affect broader vaccine acceptability.
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Affiliation(s)
- David Farabee
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Angela Hawken
- New York University Marron Institute, New York, NY, USA
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Arscott J, Doan B, Dayton L, Eber GB, Sufrin CB, Beyrer C, Rubenstein L. Pandemic detention: life with COVID-19 behind bars in Maryland. Front Public Health 2023; 11:1217857. [PMID: 37546323 PMCID: PMC10398335 DOI: 10.3389/fpubh.2023.1217857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 06/26/2023] [Indexed: 08/08/2023] Open
Abstract
Background People incarcerated during the COVID-19 pandemic face higher vulnerability to infection due to structural and social factors in carceral settings. Additionally, due to the higher prevalence of chronic health conditions among carceral populations, they are also at risk for more severe COVID-19 disease. This study was designed to explore the experiences of people incarcerated in prisons and jails in Maryland during the height of the pandemic. Methods We conducted semi-structured phone interviews between January 2021 and April 2022 with ten individuals incarcerated in Maryland carceral facilities during the height of the U.S. COVID-19 pandemic and were subsequently released from prison or jail. We transcribed the interviews, coded them, and engaged in content analysis, an inductive analytical approach to developing themes and meaning from qualitative data. Results Four themes emerged from participants' descriptions of their experiences: (1) distress from fear, vulnerability, and lack of knowledge about COVID-19 and how to protect themselves, (2) shortcomings of prison and jail administrators and other personnel through lack of transparency and arbitrary and punitive enforcement of COVID-19 protocols, (3) lack of access to programming and communication with others, and (4) absence of preparation for release and access to usual re-entry services. Conclusion Participants responded that the prison and jails' response during the COVID-19 pandemic was ill-prepared, inconsistent, and without appropriate measures to mitigate restrictions on liberty and prepare them for release. The lack of information sharing amplified their sense of fear and vulnerability unique to their incarceration status. Study findings have several institutional implications, such as requiring carceral facilities to establish public health preparedness procedures and making plans publicly available.
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Affiliation(s)
- Joyell Arscott
- Department of Epidemiology and Prevention Science, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Brandon Doan
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Lauren Dayton
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Gabriel B. Eber
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Carolyn B. Sufrin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Chris Beyrer
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Leonard Rubenstein
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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