Advancing Public Health Equity through Expanded Vaccination Services in prison: case studies from Italy and France

Abstract In Montpellier prison in France and San Vittore remand house in Italy, the provision of expanded, age-appropriate, coercion-free, and tailored vaccination services to PLP has emerged as a cornerstone in improving health outcomes within prison settings. The implementation of life course vaccination programs required the full integration of prison health into public health systems building on existing vaccination services covering HBV, flu and COVID-19. In San Vittore, a vaccination clinic aimed at people living in prison was set-up. Universal vaccination status assessment and vaccination catch-up was introduced targeting people admitted into prison. The vaccination clinic-related activities included information and awareness sessions on vaccination and health literacy offered regularly to PLP: increased vaccination knowledge is effective to enhance uptake. The vaccination clinic team consisted of infectious diseases physicians and a health assistant with an anthropological background, who ran the information and awareness sessions combining and adapting core content on vaccination with individual and community social and cultural contexts. Besides seasonal flu vaccination and anti-SARS-CoV-2 immunisation campaigns, vaccinations against pneumococcal pneumonia and herpes zoster were also offered to older and fragile individuals as per national immunization plan. One of the priority objectives of the vaccination clinic was the increase in vaccination coverage against HBV and HPV, not only as a tool for the prevention of infectious diseases, but as an innovative and effective tool of cancer prevention. As part of a more ambitious program to protect sexual health in prison and related to updated screening tools for the early diagnosis of lesions due to HPV infection, vaccination against HPV was also offered as part of a health empowerment project tailored to women in detention, with the aim of building self-awareness of their own health needs.