Hepatitis B Vaccination in Prison: The Perspectives of Formerly Incarcerated Men

Abstract

Nearly 30% of new hepatitis B virus (HBV) infections have been detected in people with a history of incarceration. Although a safe and effective HBV vaccine is available, it is not routinely provided to inmates. This is a significant missed public health opportunity. Barriers to routine vaccination include cost, difficulties completing vaccination series in a transient population, insufficient collaboration between public health organizations and correctional health systems, and inmate refusal. This study assessed inmates’ knowledge, attitudes, and perceptions of HBV and of HBV testing and vaccination. Hepatitis B virus testing and vaccination were offered. Interviews were conducted with 42 men, aged 18 to 29 years, recently released from prison. Of the 28 men who agreed to be tested, 71% were susceptible to HBV. Many had misconceptions about HBV or HBV vaccination, but most were willing to be vaccinated once informed. Barriers to vaccination during incarceration were fear of needles and distrust of prison staff; after release, barriers were time and cost. These findings support the need for education and routine HBV vaccination programs for inmates during incarceration.