Prisoners are among the high-risk population highly vulnerable to COVID-19 due to over-crowding, limited movement and poor living environment. Consequently, there is a need to ascertain the status of COVID-19 vaccination and factors associated with their hesitancy among prisoners. A cross-sectional, questionnaire-based study was undertaken among prisoners at three district jails of province Punjab, Pakistan. A total of 381 prisoners participated and none of the study participants had received influenza vaccine this year. 53% received at-least one dose of COVID-19 vaccine, with the majority having two doses. The top three reasons of vaccine acceptance were “fear of contracting SARS-CoV-2 infection” (56.9%), “desire to return to pre-pandemic routine as soon as possible” (56.4%) and “having no doubts on the safety of COVID-19 vaccines” (39.6%). There was no statistically significant difference (p > 0.05) of any demographic variables between vaccinated and unvaccinated prisoners except for age, which had strong association with COVID-19 vaccine uptake (χ2(3) = 76.645, p < 0.001, Cramer’s V = 0.457). Among the unvaccinated prisoners (N = 179), only 16 subsequently showed willingness to take COVID-19 vaccine. Top five reasons for hesitancy were COVID-19 is not a real problem/disease (60.1%), safety concerns (51.1%), and COVID-19 vac-cine is a conspiracy (50.3%). Efforts are needed to address their concerns given this population and high hesitancy rates especially among younger prisoners.


© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

Cite as

Shabir, A., AlKubaisi, N., Shafiq, A., Salman, M., Baraka, M., Mustafa, Z., Khan, Y., Mallhi, T., Meyer, J. & Godman, B. 2023, 'COVID-19 vaccination status as well as factors associated with COVID-19 vaccine acceptance and hesitancy among prisoners and the implications', Vaccines, 11(6), article no: 1081. https://doi.org/10.3390/vaccines11061081

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Last updated: 03 May 2024
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