The Association of Average Daily Population of Jails on 2009 H1N1 Influenza Vaccine Receipt Open Access

Abstract

The Association of Average Daily Population of Jails on 2009 H1N1 Influenza Vaccine Receipt

By Alice Lee

Background: Emergency preparedness efforts often overlook U.S. correctional facilities, as demonstrated in the 2009 H1N1 influenza pandemic. There are about 12 million admissions to U.S. jails and prisons each year, and rapid detainee turnover and facility overcrowding may exacerbate transmission of respiratory droplet-spread infectious diseases. The number of detained individuals varies tremendously across correctional facilities, especially among smaller jails. By collaborating with the correctional sector, public health professionals have an opportunity to reach individuals who may otherwise lack access to care.

Objective: To address the facilitating factors, as well as barriers, to vaccine receipt among correctional facilities during the 2009-2010 H1N1 influenza pandemic.

Methods: A nationwide facility-level survey of a randomly selected, representative sample of U.S. correctional facilities was conducted through fax, email, and phone. This survey examined the timing of vaccine receipt, H1N1 influenza cases among facilities, barriers to dispensing vaccine, and pandemic preparedness planning. The effect of correctional facility type on H1N1 influenza vaccine receipt was analyzed using logistic regression modeling techniques.

Results: Overall, the sample respondents incorporated in the analysis totaled 448 facilities, including 28 federal prisons, 135 non-federal prisons, and 285 jails. Fifty-five percent of jails never received vaccine during the pandemic period, whereas only 15% of federal prisons and 11% of non-federal prisons were without vaccine. The size of the facility given by average daily population (ADP) was the most significant predictor of the likelihood of vaccine receipt. Logistic modeling indicates that each 100 inmate increase in ADP resulted in a 32% increased likelihood of receiving 2009 H1N1 influenza vaccine among smaller jails. Influenza preparedness in correctional facilities varied by facility type.

Conclusions: Consideration of correctional facilities, especially jails, during vaccine distribution is essential to future pandemic response, given that 95% of persons who enter U.S. correctional facilities only stay in jails. Involving correctional facilities, especially smaller facilities, in pandemic preparedness planning may help protect correctional facility populations, and the community as a whole, in the event of future pandemics.

Table of Contents

TABLE OF CONTENTS

Literature Review...1

Abstract...11

Introduction...12

Methods...14

Results...20

Discussion...24

References...29

Figures & Tables...35

Public Health Implications...41

Appendices...43

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	H1N1 jail correctional facility vaccine influenza
Committee Chair / Thesis Advisor	Spaulding, Anne C, Emory University
Committee Members	Seib, Katy, Emory University Whitney, Ellen, Emory University
Partnering Agencies	US (Federal) agency other than CDC Industrial or Commercial (for-profit) organization National or regional non-profit organization (e.g., American Cancer Society)

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