High willingness for new TB vaccine among people in Brazilian prisons

Tuberculosis remains a persistent public health problem and can hit some groups especially hard. A team led by José Victor Bortolotto Bampi set out to learn whether people deprived of liberty (PDL) in Brazil would be willing to receive a hypothetical new TB vaccine if one became available. The researchers carried out a cross-sectional study in eight prison units—six male and two female—across six Brazilian cities between April 2025 and October 2025. Eligible participants were adults over 18 who could give consent. Using prison census data, the team randomly selected 130 individuals for an initial structured evaluation that asked about sociodemographic information, beliefs about TB, willingness to take a new TB vaccine, trusted sources of information, and reasons that might make them decline vaccination. Respondents also rated statements about TB vaccines on a Likert scale. The final analytical set reported in the study included 941 people after 945 were evaluated and 4 were excluded for missing questionnaire data. The work focused on differences by prison gender and by groups defined by vaccine acceptance.

The study used structured questionnaires to capture knowledge, attitudes and intent to vaccinate, and it compared answers across gendered prison units and between those who said they would accept or refuse a vaccine. Key results were striking: overall acceptability was 95.2%. Acceptance in male prisons was 94.1% and in female prisons was 98.7%. Men, compared with women, reported higher levels of distrust in vaccine safety (28.9% versus 14.5%, p <0.001), more reports of community coercion to take vaccines (15.4% versus 5.6%, p <0.001) and poorer TB knowledge (44.6% versus 31.2%, p <0.001). Among the small group who said they would not accept a vaccine, 77.8% did not trust vaccine safety, 55.6% did not trust vaccine efficacy, 60.0% did not trust healthcare workers, and 20.0% reported community coercion as a factor. The investigators used these comparisons to sketch patterns of hesitancy within the incarcerated population.

These findings suggest that a newly available TB vaccine would likely be embraced by most people in the prison settings studied, but they also point to areas that need attention. High overall acceptance is encouraging for public health efforts that aim to reduce TB among vulnerable groups, yet the data reveal gendered differences in trust and knowledge that could influence how vaccination campaigns work in practice. The prominence of distrust in vaccine safety and efficacy, concerns about healthcare worker trust, and reports of community coercion among those who refused vaccination highlight the importance of clear, credible information and respectful consent processes. Addressing misinformation, strengthening relationships between health staff and incarcerated people, and ensuring voluntary and informed uptake could make vaccination efforts more equitable and effective. Overall, the study concludes that a new TB vaccine would be well accepted among people deprived of liberty in Brazil, while underscoring trust and coercion as issues to resolve before rollout.