{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T12:20:56Z","timestamp":1783340456218,"version":"3.54.6"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014895","name":"Open Philanthropy Project","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014895","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Several tuberculosis (TB) vaccine candidates are currently advancing to late-stage clinical trials. Prisons in low-and middle-income countries harbor some of the highest rates of TB in the world, making persons deprived of liberty (PDL) an important population to prioritize for the introduction of effective vaccines. However, the inclusion in clinical trials raises significant ethical concerns due to a history of exploitation and mistreatment within medical research. To date, PDL own perspectives on participating in vaccine research have been largely overlooked. This multicenter qualitative study employed focus group (FG) discussions in seven state prisons across four of the five regions of Brazil, involving 91 incarcerated individuals (64 men and 27 female) between February and August 2024. The discussions explored participants\u2019 perceptions regarding health in prisons, TB, vaccines in general, new TB vaccines, and their potential participation in research. Participants reported encountering difficulties in accessing healthcare services within the prison system and shared personal or indirect experiences with TB, as well as concerns about their family members being at risk for TB exposure. While they generally held positive perceptions about vaccines and trials, they emphasized the need for clear and transparent information, respect for individual autonomy, and assurances of accountability from researchers as conditions of their willingness to participate in future trials. PDL perceptions regarding participation in clinical trials for new TB vaccines are significantly influenced by their prior experiences with the prison health system and their level of trust in research institutions. To ethically and effectively include PDL in future research, it is crucial to prioritize respect for autonomy and transparent communication about the risks and potential benefits involved.<\/jats:p>","DOI":"10.1371\/journal.pgph.0004941","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T18:23:02Z","timestamp":1765909382000},"page":"e0004941","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Perceptions of persons deprived of liberty regarding tuberculosis vaccine research"],"prefix":"10.1371","volume":"5","author":[{"given":"Mariana Cristina Campos Falleiros","family":"Pires","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiran E.","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Everton Ferreira","family":"Lemos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliane","family":"Ferreira da Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Garcia","family":"Croda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5527-8622","authenticated-orcid":true,"given":"Monica","family":"Magalh\u00e3es","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dh\u00e9lio Batista","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7211-6887","authenticated-orcid":true,"given":"Mariana Pinheiro Alves","family":"Vasconcelos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosilene","family":"Ruffato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9187-3566","authenticated-orcid":true,"given":"Solana Monteiro","family":"Batista","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8118-8054","authenticated-orcid":true,"given":"Giselle Lima","family":"de Freitas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"Cordeiro-Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giane Zupellari dos","family":"Santos-Melo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6371-5773","authenticated-orcid":true,"given":"Jair","family":"dos Santos Pinheiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9565-7088","authenticated-orcid":true,"given":"Lara B. O.","family":"Assis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6425-3678","authenticated-orcid":true,"given":"Lia Gon\u00e7alves","family":"Possuelo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7024-7891","authenticated-orcid":true,"given":"Tiago Antonio","family":"Heringer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiane Kist","family":"Back","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"Schwarzbold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason R.","family":"Andrews","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crhistinne Cavalheiro Maymone","family":"Gon\u00e7alves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6665-6825","authenticated-orcid":true,"given":"Julio","family":"Croda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,12,16]]},"reference":[{"key":"pgph.0004941.ref001","author":"Who","year":"2024"},{"key":"pgph.0004941.ref002","author":"WPB WPB","year":"2024"},{"issue":"5","key":"pgph.0004941.ref003","doi-asserted-by":"crossref","DOI":"10.1016\/S2468-2667(21)00025-6","article-title":"Incidence and prevalence of tuberculosis in incarcerated populations: a systematic review and meta-analysis","volume":"6","author":"O Cords","year":"2021","journal-title":"Lancet Public Health"},{"issue":"1","key":"pgph.0004941.ref004","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002737","article-title":"Evaluating strategies for control of tuberculosis in prisons and prevention of spillover into communities: An observational and modeling study from Brazil","volume":"16","author":"TS Mabud","year":"2019","journal-title":"PLoS Med"},{"issue":"2","key":"pgph.0004941.ref005","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2023-014722","article-title":"Incarceration and TB: the epidemic beyond prison walls","volume":"9","author":"G Sequera","year":"2024","journal-title":"BMJ Glob Health"},{"issue":"11","key":"pgph.0004941.ref006","article-title":"Mass incarceration as a driver of the tuberculosis epidemic in Latin America and projected effects of policy alternatives: a mathematical modelling study","volume":"9","author":"YE Liu","year":"2024","journal-title":"Lancet Public Health"},{"key":"pgph.0004941.ref007","first-page":"100186","article-title":"The role of prisons in disseminating tuberculosis in Brazil: A genomic epidemiology study","volume":"9","author":"KS Walter","year":"2022","journal-title":"Lancet Reg Health Am"},{"key":"pgph.0004941.ref008","author":"Who","year":"2021"},{"issue":"6","key":"pgph.0004941.ref009","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1093\/cid\/ciae055","article-title":"Serial Mass Screening for Tuberculosis Among Incarcerated Persons in Brazil","volume":"78","author":"RC Pivetta de Araujo","year":"2024","journal-title":"Clin Infect Dis"},{"issue":"4","key":"pgph.0004941.ref010","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.4269\/ajtmh.20-0110","article-title":"Primary Prophylaxis to Prevent Tuberculosis Infection in Prison Inmates: A Randomized, Double-Blind, Placebo-Controlled Trial","volume":"103","author":"R Dias de Oliveira","year":"2020","journal-title":"Am J Trop Med Hyg"},{"issue":"4","key":"pgph.0004941.ref011","doi-asserted-by":"crossref","DOI":"10.1016\/S2468-2667(23)00002-6","article-title":"Scaling up evidence-based approaches to tuberculosis screening in prisons","volume":"8","author":"S Charalambous","year":"2023","journal-title":"Lancet Public Health"},{"issue":"9","key":"pgph.0004941.ref012","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(22)00283-2","article-title":"Infant BCG vaccination and risk of pulmonary and extrapulmonary tuberculosis throughout the life course: a systematic review and individual participant data meta-analysis","volume":"10","author":"L Martinez","year":"2022","journal-title":"Lancet Glob Health"},{"issue":"17","key":"pgph.0004941.ref013","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1056\/NEJMoa1803484","article-title":"Phase 2b Controlled Trial of M72\/AS01E Vaccine to Prevent Tuberculosis","volume":"379","author":"O Van Der Meeren","year":"2018","journal-title":"N Engl J Med"},{"issue":"6","key":"pgph.0004941.ref014","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1111\/joim.13197","article-title":"New tuberculosis vaccines: advances in clinical development and modelling","volume":"288","author":"CK Weerasuriya","year":"2020","journal-title":"J Intern Med"},{"key":"pgph.0004941.ref015","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.3389\/fimmu.2017.01147","article-title":"The Recombinant Bacille Calmette-Gu\u00e9rin Vaccine VPM1002: Ready for Clinical Efficacy Testing","volume":"8","author":"NE Nieuwenhuizen","year":"2017","journal-title":"Front Immunol"},{"key":"pgph.0004941.ref016","author":"Who WHO","year":"2024"},{"issue":"1","key":"pgph.0004941.ref017","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s40352-023-00240-x","article-title":"Facilitators and barriers to COVID-19 vaccination among incarcerated people and staff in three large, state prisons: a cross-sectional study","volume":"11","author":"I Osman","year":"2023","journal-title":"Health Justice"},{"key":"pgph.0004941.ref018","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.puhe.2020.07.008","article-title":"Ethical guidance for health research in prisons in low- and middle-income countries: a scoping review","volume":"186","author":"T Ako","year":"2020","journal-title":"Public Health"},{"issue":"4","key":"pgph.0004941.ref019","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1136\/medethics-2012-101059","article-title":"Prisoners as research participants: current practice and attitudes in the UK","volume":"42","author":"A Charles","year":"2016","journal-title":"J Med Ethics"},{"issue":"11","key":"pgph.0004941.ref020","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1001\/jama.2020.15589","article-title":"Ethical Considerations for COVID-19 Vaccine Trials in Correctional Facilities","volume":"324","author":"EA Wang","year":"2020","journal-title":"JAMA"},{"issue":"20","key":"pgph.0004941.ref021","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1056\/NEJMp2025955","article-title":"Covid-19 Vaccine Trials and Incarcerated People - The Ethics of Inclusion","volume":"383","author":"C Strassle","year":"2020","journal-title":"N Engl J Med"},{"key":"pgph.0004941.ref022","doi-asserted-by":"crossref","first-page":"100659","DOI":"10.1016\/j.eclinm.2020.100659","article-title":"Prioritizing incarcerated populations for COVID-19 vaccination and vaccine trials","volume":"31","author":"N Kronfli","year":"2020","journal-title":"EClinicalMedicine"},{"issue":"9","key":"pgph.0004941.ref023","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMp2021971","article-title":"Racial Disproportionality in Covid Clinical Trials","volume":"383","author":"DB Chastain","year":"2020","journal-title":"N Engl J Med"},{"issue":"10181","key":"pgph.0004941.ref024","doi-asserted-by":"crossref","DOI":"10.1016\/S0140-6736(19)30308-3","article-title":"Tuberculosis","volume":"393","author":"J Furin","year":"2019","journal-title":"Lancet"},{"issue":"10483","key":"pgph.0004941.ref025","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1016\/S0140-6736(25)00516-1","article-title":"The injustice of tuberculosis","volume":"405","author":"M Pai","year":"2025","journal-title":"The Lancet"},{"issue":"7","key":"pgph.0004941.ref026","doi-asserted-by":"crossref","DOI":"10.1016\/S1473-3099(25)00083-0","article-title":"Tuberculosis preventive therapy: scientific and ethical considerations for trials of ultra-short regimens","volume":"25","author":"TM Walker","year":"2025","journal-title":"Lancet Infect Dis"},{"key":"pgph.0004941.ref027","author":"Who","year":"2014"},{"key":"pgph.0004941.ref028","doi-asserted-by":"crossref","DOI":"10.7476\/9788575415474","volume-title":"Avalia\u00e7\u00e3o por triangula\u00e7\u00e3o de m\u00e9todos: abordagem de programas sociais","author":"MCdeS Minayo","year":"2005"},{"key":"pgph.0004941.ref029","author":"MAXQDA"},{"issue":"4","key":"pgph.0004941.ref030","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0231350","article-title":"Teach-back: A systematic review of implementation and impacts","volume":"15","author":"J Talevski","year":"2020","journal-title":"PLoS One"},{"key":"pgph.0004941.ref031","doi-asserted-by":"crossref","first-page":"1323195","DOI":"10.3389\/fpubh.2024.1323195","article-title":"Vaccination against emerging and reemerging infectious diseases in places of detention: a global multistage scoping review","volume":"12","author":"B Moazen","year":"2024","journal-title":"Front Public Health"},{"issue":"8","key":"pgph.0004941.ref032","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.3201\/eid3108.240571","article-title":"Surveillance of Viral Respiratory Infections within Maximum-Security Prison, Australia","volume":"31","author":"NM Legrand","year":"2025","journal-title":"Emerg Infect Dis"},{"issue":"24","key":"pgph.0004941.ref033","doi-asserted-by":"crossref","first-page":"2300","DOI":"10.1056\/NEJMc2114089","article-title":"Effectiveness of the mRNA-1273 Vaccine during a SARS-CoV-2 Delta Outbreak in a Prison","volume":"385","author":"ET Chin","year":"2021","journal-title":"N Engl J Med"},{"key":"pgph.0004941.ref034","doi-asserted-by":"crossref","DOI":"10.1017\/9781108768238","volume-title":"Prisons and Crime in Latin America [Internet]. 1o ed","author":"M Bergman","year":"2021"},{"key":"pgph.0004941.ref035","doi-asserted-by":"crossref","first-page":"100150","DOI":"10.1016\/j.jvacx.2022.100150","article-title":"Barriers and facilitators to COVID-19 vaccine acceptability among people incarcerated in Canadian federal prisons: A qualitative study","volume":"10","author":"D Lessard","year":"2022","journal-title":"Vaccine X"},{"issue":"3","key":"pgph.0004941.ref036","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0264145","article-title":"Reasons for COVID-19 vaccine refusal among people incarcerated in Canadian federal prisons","volume":"17","author":"D Ortiz-Paredes","year":"2022","journal-title":"PLoS One"},{"issue":"7","key":"pgph.0004941.ref037","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1016\/j.vaccine.2023.01.039","article-title":"COVID-19 vaccination hesitancy and uptake: Perspectives from people released from the Federal Bureau of Prisons","volume":"41","author":"C Kramer","year":"2023","journal-title":"Vaccine"},{"key":"pgph.0004941.ref038"},{"key":"pgph.0004941.ref039","author":"A Xanthaki"},{"issue":"12","key":"pgph.0004941.ref040","doi-asserted-by":"crossref","DOI":"10.1016\/S1473-3099(25)00305-6","article-title":"The participation of people deprived of liberty in tuberculosis vaccine trials: should they be protected from research, or through research?","volume":"25","author":"JR Andrews","year":"2025","journal-title":"Lancet Infect Dis"}],"updated-by":[{"DOI":"10.1371\/journal.pgph.0005922","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000}}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0004941","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T18:23:07Z","timestamp":1765909387000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0004941"}},"subtitle":[],"editor":[{"given":"Zulma Vanessa","family":"Rueda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,12,16]]},"references-count":40,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0004941","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,16]]}}}