Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccines Among Incarcerated People in California State Prisons: Retrospective Cohort Study

We conducted a retrospective cohort study to estimate effectiveness of messenger RNA (mRNA) vaccines, BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna), against confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among incarcerated people in California prisons from 22 December 2020 through 1 March 2021.

COVID-19
Vaccine
Vaccination
Effectiveness
Authors

Chin ET

Leidner D

Zhang Y

Long E

Prince L

Schrag SJ

Verani JR

Wiegand RE

Alarid-Escudero F

Goldhaber-Fiebert JD

Studdert DM

Andrews JR

Salomon JA

Published

January 27, 2022

Recommended citation

Chin ET, Leidner D, Zhang Y, Long E, Prince L, Schrag SJ, Verani JR, Wiegand RE, Alarid-Escudero F, Goldhaber-Fiebert JD, Studdert DM, Andrews JR, Salomon JA,. Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccines Among Incarcerated People in California State Prisons: Retrospective Cohort Study. Clinical Infectious Diseases, 2022;75(1):e838-e845.

   

Published in:

 

Abstract

 

Background

Prisons and jails are high-risk settings for coronavirus disease 2019 (COVID-19). Vaccines may substantially reduce these risks, but evidence is needed on COVID-19 vaccine effectiveness for incarcerated people, who are confined in large, risky congregate settings.

 

Methods

We conducted a retrospective cohort study to estimate effectiveness of messenger RNA (mRNA) vaccines, BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna), against confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among incarcerated people in California prisons from 22 December 2020 through 1 March 2021. The California Department of Corrections and Rehabilitation provided daily data for all prison residents including demographic, clinical, and carceral characteristics, as well as COVID-19 testing, vaccination, and outcomes. We estimated vaccine effectiveness using multivariable Cox models with time-varying covariates, adjusted for resident characteristics and infection rates across prisons.

 

Results

Among 60 707 cohort members, 49% received at least 1 BNT162b2 or mRNA-1273 dose during the study period. Estimated vaccine effectiveness was 74% (95% confidence interval [CI], 64%–82%) from day 14 after first dose until receipt of second dose and 97% (95% CI, 88%–99%) from day 14 after second dose. Effectiveness was similar among the subset of residents who were medically vulnerable: 74% (95% CI, 62%–82%) and 92% (95% CI, 74%–98%) from 14 days after first and second doses, respectively.  

Conclusions

Among 60 707 cohort members, 49% received at least 1 BNT162b2 or mRNA-1273 dose during the study period. Estimated vaccine effectiveness was 74% (95% confidence interval [CI], 64%–82%) from day 14 after first dose until receipt of second dose and 97% (95% CI, 88%–99%) from day 14 after second dose. Effectiveness was similar among the subset of residents who were medically vulnerable: 74% (95% CI, 62%–82%) and 92% (95% CI, 74%–98%) from 14 days after first and second doses, respectively.