Table 1.

Importance of vaccination in prisons

Access to vulnerable social groups
Groups with little normal access to the health system
Prisoners come from disadvantaged social strata (educational and socioeconomic level)
Greater history of illicit drug use before entering prison
Greater history of alcohol abuse
High prevalence of carriers of communicable diseases and other morbidities
Overrepresentation of especially-vulnerable groups: LGTB, sex workers, immigrants
Progressively greater proportion of elderly adults
High risk of acquiring infections in prison
Sexual activity, often unprotected, in prisons
High rate of starting or returning to illicit drug use (injectable and non-injectable)
Tattoos / piercings
Physical violence (injuries, rapes)
Permanent contact with the community
High rotation rates in prison (short sentences, transfers)
Visits/ staff/ temporary release
High risk of extreme behavior in the first weeks after release (drug abuse)
Prison population is known and concentrated in one place
Population identified and easily located

LGBT: gay, lesbian, transgender, bisexual.