There was an increased risk of Covid and flu outbreaks in Scottish prisons last winter due to falling vaccination rates among inmates, a new report has revealed.
It found that most adult prisoners eligible for both vaccines had not taken them up by January, despite having a higher risk of becoming seriously ill than the general population.
Prisons were “at increased risk of outbreaks and vulnerable individuals at increased risk of severe clinical outcomes” as a result, the Public Health Scotland (PHS) report said.
Experts told 1919 that the consequences for inmates, prison officers and the wider community could be “really severe” if a serious outbreak took place.
Of the 8,186 adults in prison in early January, only 9.3 per cent had received a flu vaccine. Of those eligible for a Covid vaccine based on their age, the figure was 30.6 per cent.
Uptake of both vaccines was lower last winter than in 2023/24, when 16.7 per cent of inmates had a flu jab and 44.5 per cent of eligible prisoners had a Covid jab.
The PHS report concluded that the low uptake “may be due to individuals’ attitudes to vaccination”, citing a prison focus group study published last year.
It said this found that among the reasons given by prisoners were “beliefs about vaccines and immunity, low awareness of impacts of Covid-19 on individuals (due to limited contact with people in the community), encountering vaccine hesitancy in others, and limited information sources”.
The low vaccination rate comes at a time when Scotland’s prison population is ageing. As 1919 has previously reported, the situation has prompted ministers to consider whether specialist units should be created to house rising numbers of elderly inmates.
The most recent annual figures show that around 500 prisoners were over the age of 60 in 2023/24, more than double the figure recorded in 2013/14. Of these, almost 150 were aged 70 or over, triple the number recorded 10 years earlier.
Dr Katrina Morrison, a lecturer in criminology at Edinburgh Napier University, said it was “positive” that PHS was producing research on prison vaccinations but that action was needed to increase uptake.
“It is really, really crucial that this focus is maintained, because the implications for both prisoners and everybody who works in the prison – and indeed for all of the communities connected with the prison – are really severe if outbreaks occur,” she told 1919.
“We need a much more concerted effort. It’s not enough just to go into prisons and say, ‘do you want a vaccine?’ You need more proactive engagement in order to ensure that vaccines are taken up when they’re offered.”
She added that an education campaign would be a “great place to start”, but that this would be less effective if it was delivered by authority figures such as prison guards or NHS officials.
“There’s a huge amount of mistrust, often between prisoners and the prison or the authorities,” she explained. “People in prison view somebody coming along and telling them that they need to do something with the same amount of mistrust.
“You could have, for example, ‘peer champions’ who would go into every prison – other prisoners who can spread the word about the benefits of vaccination, who will be listened to and taken seriously.”
Liam McArthur, justice spokesperson for the Scottish Liberal Democrats, said any outbreaks of Covid or flu in jails would “add even more pressure onto already overstretched prison staff”.
He added: “With better education and provision of jabs, it should be possible to get these numbers up. I hope that next winter the prison service can increase the uptake of these jabs dramatically.”
A Scottish Prison Service spokesperson said: “The health and wellbeing of those in our care is a key priority.
“We work closely with NHS partners, who are responsible for healthcare in prisons, to ensure people are supported and safeguarded, including through vaccination programmes.”
Public health minister Jenni Minto said: “Some prisoners can be more vulnerable to virus outbreaks, so we encourage everyone living in prison to take up the offer of vaccines when offered.
“The Scottish Government funds health boards with prisons to provide safe and effective healthcare to prisoners, at a minimum equivalent to that available in the community.
“We continue to fund the Scottish Ambulance Service mobile vaccination outreach service to support health boards in reaching communities with lower uptake, such as in prisons.”