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.Correctional and detention facilities are at increased risk for COVID-19 outbreaks because of several factors, including difficulty maintaining physical distancing, limited space for isolation or quarantine, poor ventilation, and limited resources for testing and personal protective equipment (1).Members of racial and ethnic minority groups and persons with unstable housing, substance use disorders, and mental illness are disproportionately incarcerated and more likely to have chronic diseases resulting from disparities in social determinants of health (2).The higher prevalence of medical conditions associated with severe COVID-19 illness, delays in timely diagnosis, and inadequate treatment might all contribute to the increased risk for death from COVID-19 among incarcerated or detained persons (3).Recognizing this, some jurisdictions have prioritized incarcerated or detained persons for COVID-19 vaccination.*Data pertaining to willingness * Some jurisdictions have specifically prioritized staff members, residents of correctional or detention facilities, or both in their COVID-19 vaccination plans.