COVID-19 and influenza vaccine uptake in adults under prison care
Winter 2024/25

About this release

This report describes the uptake of COVID-19 and influenza vaccines in adults under prison care in Scotland during the winter of 2024/25. Vaccine uptake by prison establishment, age, sex and deprivation are reported.
We are continuing to develop this report, and we will continue to engage with stakeholders, including the Scottish Prison Service and NHS Boards to inform further developments.

Main points

• The majority of adults eligible for COVID-19 (due to age) and influenza vaccination (all) under prison care were not vaccinated by early January in winter 2024/25. Prison establishments will have been at increased risk of outbreaks and vulnerable individuals at increased risk of severe clinical outcomes from infections.
• All adults under prison care were eligible for influenza vaccine. Influenza vaccine uptake was low in winter 2024/25. By early January, 9.3% (n=760) of all adults under prison care had received an influenza vaccination.
• COVID-19 vaccine uptake was also low in adults under prison care in winter 2024/25. In respect of those eligible to receive a COVID-19 vaccine due to their age (65 years and over), by early January an estimated 30.6% (n=93) of adults under prison care received a COVID-19 vaccine. In total 266 adults under prison care received a COVID-19 vaccine. PHS does not have access to the prison health care data required to report uptake data by eligibility group, other than age.
• Uptake of influenza and COVID-19 vaccines in adults under prison care was lower in winter 2024/25 than in winter 2023/24 (though there were some differences in the methodology used for the analysis between the years so direct comparisons should be interpreted with caution). Uptake was also lower in the general population in winter 2024/25 than in winter 2023/24.
• Influenza and COVID-19 vaccine uptake was lower in adults under prison care than in the general population in winter 2024/25. Demographic differences will contribute to these differences in uptake but for context uptake was lower in the prison population than in the most deprived quintile in the general population. Though there were also differences in eligibility for influenza vaccine between the prison and general population which limits the ability to apply standardisation methods and make direct comparisons.
• There was variation in influenza vaccine uptake rates (range: 3.7% to 37.1%) and COVID-19 vaccine uptake rates (range: 0.0% to 75.0% of those eligible due to age) in the prison population across 13 prison establishments.
• Influenza vaccine uptake was higher in females (20.9%) than males (8.8%).
• Influenza vaccine uptake was highest in those aged 65 years and over (36.8%) and lowest in those aged 18-29 years (5.4%).
• Influenza vaccine uptake was highest in those who were previously resident in the least deprived quintile, SIMD quintile 5 (13.3%) and lowest in those previously resident in SIMD quintile 3 (8.2%) and SIMD quintile 1 (the most deprived quintile; 8.9%).

Background

Adults under prison care are at increased risk from outbreaks of respiratory infections due to the closed setting environment of the prison. Adults under prison care are also at risk of more severe outcomes from infection due to pre-existing health inequalities in this population. Winter vaccination programmes offer protection against COVID-19 and influenza through vaccination of eligible individuals.

In winter 2024/25, adults under prison care aged 65 years and above, 18–64-year-olds at higher risk due to a clinical condition and individuals with a weakened immune system were eligible for the COVID-19 vaccination. However, PHS can only report COVID-19 percentage vaccine uptake in those eligible due to age (65 years and over). This is because PHS does not currently have access to all the information required to assess eligibility based on clinical risk for adults under prison care as for the majority of those in prison, information about clinical conditions is held within the prison primary care IT system. Planning is ongoing to upgrade prison GP IT infrastructure and to ensure appropriate data flows and interoperability. However, until these improvements are in place, PHS's ability to provide prison healthcare teams with eligibility information and undertake analysis of vaccine uptake in the at-risk prison population is limited.

Further information

The next release of this publication will be quarter 2 (April to June) 2026.