2370. Characterizing Predictors of COVID-19 Vaccine Refusal in an Urban Southern California Jail

Abstract

Abstract Background Correctional populations have been disproportionately affected by COVID-19, with majority of the largest single-site outbreaks being linked to jails and prisons. Vaccination is a key strategy to reduce the transmission of SARS-CoV-2 in carceral settings but can be challenging to implement due to vaccine hesitancy and medical mistrust. We sought to identify factors associated with COVID-19 vaccine refusal in the largest urban jail system in the Unites States. Methods We retrospectively analyzed electronic health record data for individuals who were 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, 2,060 (9.6%) refused vaccination. Refusal was associated with being male ([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/African American 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 the male and female populations separately, the 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. Disclosures Loren G. Miller, MD MPH, ContraFect: Grant/Research Support|GSK: Grant/Research Support|Medline: Grant/Research Support|Merck: Grant/Research Support|Paratek: Grant/Research Support