Racial And Ethnic Inequalities In COVID-19 Mortality Within Carceral Settings: An Analysis Of Texas Prisons.

The COVID-19 pandemic has taken a heightened toll on people incarcerated in prisons in the United States, with those incarcerated experiencing a higher rate of infection and mortality than the US population more generally. What is less well known is the degree to which COVID-19 outcomes differ among incarcerated populations, especially by race and ethnicity, where significant differences have been found among the US population as a whole. This knowledge gap is, in part, due to a lack of reporting of COVID-19 outcomes by race and ethnicity by most state prison systems. To shed light on this topic, we analyzed mortality patterns of the population incarcerated in Texas state prison facilities during both the year before (beginning April 1, 2019) and the first year of (beginning April 1, 2020) the COVID-19 pandemic. We used a unique data set of roster information from the Texas Department of Criminal Justice and medical examiner records. COVID-19 mortality was 1.61 and 2.12 times higher for Black and Hispanic populations, respectively, when compared with the White population in Texas prisons. Strategies for COVID-19 mitigation in carceral settings, such as vaccination and decarceration, should include an equity component to minimize disparities.

Willingness to Receive a COVID-19 Vaccination Among Incarcerated or Detained Persons in Correctional and Detention Facilities - Four States, September-December 2020.

Incarcerated and detained persons are at increased risk for acquiring COVID-19. However, little is known about their willingness to receive a COVID-19 vaccination. During September-December 2020, residents in three prisons and 13 jails in four states were surveyed regarding their willingness to receive a COVID-19 vaccination and their reasons for COVID-19 vaccination hesitancy or refusal. Among 5,110 participants, 2,294 (44.9%) said they would receive a COVID-19 vaccination, 498 (9.8%) said they would hesitate to receive it, and 2,318 (45.4%) said they would refuse to receive it. Willingness to receive a COVID-19 vaccination was lowest among Black/African American (Black) (36.7%; 510 of 1,390) persons, participants aged 18-29 years (38.5%; 583 of 1,516), and those who lived in jails versus prisons (43.7%; 1,850 of 4,232). Common reasons reported for COVID-19 vaccine hesitancy were waiting for more information (54.8%) and efficacy or safety concerns (31.0%). The most common reason for COVID-19 vaccination refusal was distrust of health care, correctional, or government personnel or institutions (20.1%). Public health interventions to improve vaccine confidence and trust are needed to increase vaccination acceptance by incarcerated or detained persons.