Covid Outbreaks Devastated Prisons, but State Inmates’ Access to the Vaccine Varies Widely


This is an important analysis of the distribution of vaccine in prisons and jails. Vaccination varies by state. While Florida is not vaccinating inmates, New Hampshire vaccinates in the order they would become eligible if in the general public.

A state-by-state patchwork of vaccine rules has left prison inmates with different outlooks even as the C.D.C. has recommended prioritizing them.By Ann Hinga Klein and Derek M. Norman   March 17, 2021 New York Times

Nearly half of the roughly 8,700 state prison inmates in Kansas have received a coronavirus vaccine, and state officials say that all prisoners who want shots will have gotten at least a first dose by the middle of April.

But in Florida, no inmates in state-run correctional institutions have gotten shots, corrections officials said, not even those who would qualify under the state’s age and health guidelines if they were not behind bars.  “There’s no way you’re going to get some prisoner a vaccine over a senior citizen,” Gov. Ron DeSantis has said.

The Centers for Disease Control and Prevention has recommended prioritizing prisoners for vaccines along with some other vulnerable groups, but states have set their own eligibility lists for vaccines and have varied widely when it comes to when inmates can receive them. The likelihood that an inmate has been offered a Covid vaccination at this point depends largely on which state their prison is in.

About half of states, including California, Connecticut and Kansas, have included all inmates in early phases of their vaccination plans. Florida has yet to make state inmates eligible at all, while Texas and Arkansas this week announced that they would begin allowing some inmates to get shots. And many of the remaining states have chosen to vaccinate inmates based largely on their eligibility if they were not in prison; older inmates, for instance, are getting shots in many states, while young, healthier ones are not.

But many health experts, including the American Medical Association, say inmates should be given preference for vaccines because of their living situations: Social distancing is nearly impossible behind bars, overcrowding is common, and ventilation often is poor. Case rates among inmates are more than four times as high as those of the general public, and the death rate is more than twice as high. The virus has killed more than 2,600 prison and jail inmates and infected more than 515,000 others, according to a New York Times database, and health officials are particularly concerned about the risks of more readily transmitted variants of the virus in settings like prisons.

“People are unwilling to say we should vaccinate people who are incarcerated — who may have done something bad — before us,” Dr. Jaimie Meyer, an associate professor at the Yale School of Medicine, said. “It’s like, ‘How dare they?’ But that’s not the question here. It’s not what we value or who we value. This is about who is at risk of disease. That’s it.”

The C.D.C. has encouraged states to vaccinate incarcerated people at the same time as prison workers, who were recommended for an early phase of vaccines. Not all workers or inmates who have been offered shots have accepted them, but experts say making them eligible is essential given the challenges of slowing outbreaks in such settings.

“Based on the best data that we have, it is inadequate to only prioritize certain segments of the prison or jail population,” said Lauren Brinkley-Rubinstein, an assistant professor at the University of North Carolina School of Medicine. “The most effective strategy would be to prioritize all people, because of the risk of exposure in the setting.”

Beyond state prisons, officials have taken a range of approaches when it comes to vaccines for incarcerated people. This month, the federal prison system said it had fully inoculated more than 13,000 federal inmates among its approximately 151,000 prisoners. Local jails in Illinois and Massachusetts, among other states, are giving inmates shots, while many have yet to start vaccines for inmates. Corrections workers have been eligible in many states, along with police officers and firefighters.

In some places, the prospect that state prison inmates would get preference for vaccines has been met with political fury.

In Colorado, state prisoners were initially granted priority before some other vulnerable groups. The plan, devised by a panel of health experts, was discarded by Gov. Jared Polis, a Democrat, amid complaints from critics.

“There’s no way it’s going to go to prisoners before it goes to people who haven’t committed any crime,” Mr. Polis said late last year.

Colorado’s current vaccination plan no longer specifically mentions incarcerated people, but as of last week, about 1,400 inmates had received at least the first dose of the vaccine. The state began vaccinating state prison inmates based on their eligibility in the state if they were not incarcerated, a spokeswoman for the state’s corrections department said. And after health officials discovered that two staff members and an inmate at the Buena Vista Correctional Complex were infected with a worrisome variant — the first known detection in a U.S. correctional facility — the state authorized all inmates at that facility to be permitted to get shots.

In Oregon, after officials vaccinated more than 1,000 of the state’s 12,100 prison inmates in January, inoculations abruptly stopped after what the state’s corrections department said was a misunderstanding about which inmates were eligible. Public criticism had been mounting about prisoners being given precedence over older people, though the state was ultimately ordered by a federal judge to inoculate every prisoner.

In Kansas, Gov. Laura Kelly, a Democrat, pressed for vaccines for prisoners after getting guidance from an advisory committee that included educators, pharmacists and older residents. As of last week, Kansas has vaccinated about 4,200 inmates, nearly 50 percent of people in state prisons.

Governor Kelly’s decision to prioritize prisoners drew sharp criticism. In February, the Kansas Senate, where 29 of 40 members are Republicans, passed a nonbinding resolution demanding that the governor revise her vaccination plan.

Richard Hilderbrand, a chairman of the state’s Senate Public Health and Welfare Committee, said it had been unconscionable for Ms. Kelly to “put incarcerated individuals ahead of law-abiding citizens.”

“How do we explain to a law-abiding cancer survivor that they must continue to avoid family and stay locked in their homes while violent sex offenders and murderers receive the limited number of vaccines available?” Mr. Hilderbrand said.

Ms. Kelly has defended her decision, and members of the advisory committee said that they decided that the risks to incarcerated people left little question.

“All of us kind of came around to this notion that the most vulnerable is the most vulnerable,” said John Carney, president of the Center for Practical Bioethics, a Kansas City-based nonprofit group that offers guidance on medical ethics issues, and a member of the Kansas Coronavirus Vaccine Advisory Council.

In Florida, Governor DeSantis has taken a different stance. He has repeatedly said that he is prioritizing older residents for vaccines. They have suffered a disproportionate share of coronavirus-related deaths: About 35 percent of that state’s nearly 30,000 coronavirus deaths have occurred at nursing homes.

Florida’s prisoners have also been battered by the coronavirus. Nearly one-quarter of the state’s 80,000 inmates have been infected.

Mitch Stone, president of the Florida Association of Criminal Defense Lawyers, said he feared that unvaccinated inmates exposed to the virus in crowded jails might infect jurors and court workers when criminal trials resume this spring.

“From a safety standpoint, you always want to identify the people who have it and have more potential to spread it,” Mr. Stone said.

This week, it remained uncertain when inmates there will start getting shots. Florida prison officials say they are prepared to inoculate every prisoner who wants the shots, but that they still lack approval from the state.

“The Florida Department of Corrections is ready to vaccinate as soon as supplies become available to our agency,” Mark Inch, who oversees state prisons, said in a statement. “We will ensure community level care is given to anyone under our care and custody who chooses to be vaccinated.”

Kayle Smith, an inmate at Wakulla Correctional Institution in Crawfordville, Fla., said there were signs that shots might be coming.

“They came around to the dorm and went room to room with a clipboard for people to sign up to take it,” Mr. Smith said in a letter to his sister. But he added that he wasn’t sure what might happen next: “I’m sure that we are way down the list to get it.”

Reporting was contributed by Izzy Colón, Brendon Derr, Rebecca Griesbach, Danya Issawi, Chloe Reynolds, Libby Seline, Rachel Sherman and Maura Turcotte. Research was contributed by Jordan Allen, Alyssa Burr, Brandon Dupré, Benjamin Guggenheim, Alex Lemonides, Laney Pope, Kristine White and John Yoon.

Picture: Edward Anderson, an inmate at a Minnesota prison in Faribault, received the Covid-19 vaccination for a medically vulnerable prisoner in January. Credit...Aaron Lavinsky/Star Tribune, via Associated Press