Prioritizing the Incarcerated: A Logistical Struggle
With all kinds of medicine, vaccines have to undergo an extensive testing process before they are introduced to the public. The COVID-19 vaccine, having undergone a three phase human clinical trial, is now integrated into countries’ vaccination programs.
Given the fact that the initial vaccine supplies are limited, medical experts and policy-makers had to respond to challenging questions: How are vaccines going to be allocated and which criteria are going to be taken into consideration?
The Centers for Disease Control and Prevention (CDC), in collaboration with the Advisory Committee on Immunization Practices (ACIP), has provided local, state and federal authorities with recommendations regarding the COVID-19 vaccine rollout. The rationale behind the CDC’s proposals was the balancing of two main goals: 1) The decrease of mortality rates 2) The facilitation of societal functions. As a result, the rollout was divided into three phases. The first dose of the vaccine will be allocated to health-care workers and residents of long-term care facilities (Phase 1A), frontline essential workers and people aged 75 years and older (Phase 1B), and other essential workers as well as people aged 16 years and older who are at high risk of hospitalization and life-threatening complications due to the virus (phase 1C). All people aged 16 years and older, who are not recommended for phase 1, will be vaccinated during Phase 2.
Although the CDC refers only to correction officers and not prisoners, according to The New York Times, the Center’s proposal is for everyone in prisons to be vaccinated simultaneously (Phase 1B or 1C). However, not every state has adhered to the aforementioned recommendations, thus causing heated discussions regarding the prioritization of inmates in the rollout. For instance, New York’s vaccination plans, despite the increasing number of COVID-19 cases in prison, do not address the 50,000 people incarcerated in correctional facilities. Moreover, Colorado’s plan to distribute the vaccine inside prisons has received intense criticism, with an attorney accusing the local government for “putting the health of incarcerated murders ahead of law-abiding Coloradans.” Last but not least, Texan authorities have refused to publicly address the vaccination of inmates, despite the rising mortality rates in their correctional facilities (2 of every 1000 prisoners).
According to the Prison Policy Initiative, more than half a million people who live and work in US prisons have tested positive for the virus. On the other hand, at least 27 states have included inmates in the rollout, with 10,000 prisoners to be vaccinated in Massachusetts by the end of February. Most of the countries in the European Union have adopted similar guidelines. All 30 EU countries have prioritized health-care personnel as well as vulnerable health-wise groups, such as the elderly. However, given the limited vaccine supply, countries make adjustments when it comes to priority groups. It is essential to mention that only 6 EU Member States, Austria, Belgium, Estonia, Latvia, Malta, and Romania, have planned for vaccination sites to be made available in prisons. Lastly, in the UK, discrimination towards inmates will not be tolerated since “prisoners will be vaccinated as they would be if they were living in the community,” according to the Minister of Justice, Lucy Frazer.
It is evident that the fight against the pandemic has raised important ethical questions. The question of which groups should be prioritized in national vaccination strategies has received a great variety of answers, thus making it even harder to determine which strategy is the most effective. To truly achieve herd immunity, vaccinations are the only answer to the Coronavirus outbreaks.
Given the fact that the initial vaccine supplies are limited, medical experts and policy-makers had to respond to challenging questions: How are vaccines going to be allocated and which criteria are going to be taken into consideration?
The Centers for Disease Control and Prevention (CDC), in collaboration with the Advisory Committee on Immunization Practices (ACIP), has provided local, state and federal authorities with recommendations regarding the COVID-19 vaccine rollout. The rationale behind the CDC’s proposals was the balancing of two main goals: 1) The decrease of mortality rates 2) The facilitation of societal functions. As a result, the rollout was divided into three phases. The first dose of the vaccine will be allocated to health-care workers and residents of long-term care facilities (Phase 1A), frontline essential workers and people aged 75 years and older (Phase 1B), and other essential workers as well as people aged 16 years and older who are at high risk of hospitalization and life-threatening complications due to the virus (phase 1C). All people aged 16 years and older, who are not recommended for phase 1, will be vaccinated during Phase 2.
Although the CDC refers only to correction officers and not prisoners, according to The New York Times, the Center’s proposal is for everyone in prisons to be vaccinated simultaneously (Phase 1B or 1C). However, not every state has adhered to the aforementioned recommendations, thus causing heated discussions regarding the prioritization of inmates in the rollout. For instance, New York’s vaccination plans, despite the increasing number of COVID-19 cases in prison, do not address the 50,000 people incarcerated in correctional facilities. Moreover, Colorado’s plan to distribute the vaccine inside prisons has received intense criticism, with an attorney accusing the local government for “putting the health of incarcerated murders ahead of law-abiding Coloradans.” Last but not least, Texan authorities have refused to publicly address the vaccination of inmates, despite the rising mortality rates in their correctional facilities (2 of every 1000 prisoners).
According to the Prison Policy Initiative, more than half a million people who live and work in US prisons have tested positive for the virus. On the other hand, at least 27 states have included inmates in the rollout, with 10,000 prisoners to be vaccinated in Massachusetts by the end of February. Most of the countries in the European Union have adopted similar guidelines. All 30 EU countries have prioritized health-care personnel as well as vulnerable health-wise groups, such as the elderly. However, given the limited vaccine supply, countries make adjustments when it comes to priority groups. It is essential to mention that only 6 EU Member States, Austria, Belgium, Estonia, Latvia, Malta, and Romania, have planned for vaccination sites to be made available in prisons. Lastly, in the UK, discrimination towards inmates will not be tolerated since “prisoners will be vaccinated as they would be if they were living in the community,” according to the Minister of Justice, Lucy Frazer.
It is evident that the fight against the pandemic has raised important ethical questions. The question of which groups should be prioritized in national vaccination strategies has received a great variety of answers, thus making it even harder to determine which strategy is the most effective. To truly achieve herd immunity, vaccinations are the only answer to the Coronavirus outbreaks.
A Numbers Game with the Highest Stakes
The World Health Organization has no specific guidelines for when imprisoned populations should be vaccinated. However, according to the Marshal Project, one in five American prisoners has already tested positive for COVID-19. In New York, one tenth of the state’s 50,000 prisoner population have the virus, and 12 individuals have died. This situation leads to a new discussion: is keeping prisoners away from vaccines crossing the borders of punitivism through putting lives in danger, especially in states and countries with no death penalty?
It is undeniable that the pandemic has reached unimaginable levels. As of February 6th, 2021, almost 27 million cases have been registered in the United States alone. There is a high demand for the vaccine and a limited supply. Risk groups such as the elderly or those with pre-existing conditions are the priority. However, when examining the qualifications for risk groups, the discussion arose about whether or not prisoners should be categorized as a vulnerable population. Seena Fazel, a University of Oxford psychiatrist reasons, “Our research suggests that people in prison should be among the first groups to receive any COVID-19 vaccine to protect against infection and to prevent further spread of the disease.” She states that most prisoners disproportionately come from marginalized areas or groups. Because of this marginalization, they are already at a higher risk for diseases such as hypertension or diabetes, which are considered health risks that increase one’s susceptibility of COVID-19 and their severity of illness.
Grady is a 66-year-old woman married to a man who is serving a 40-year sentence for attempted murder and robbery at Green Haven Correctional Facility. Her husband has diabetes and high blood pressure and has reported the lack of use of masks by officers. He wants more information on the vaccine before taking it. However, he notes the lack of outreach to the prisoners about health matters as such. “I’m afraid that by the time they offer this vaccine and get the education around it, it’ll be too late for him,” Ms. Grady says.
However, there still is a strong resistance to the vaccination of inmates: the head of the Canadian conservative party, Erin O’Toole, writes on Twitter that “not one criminal should be vaccinated ahead of any vulnerable Canadian or frontline health worker.” A parliament member of the Liberal Party, Mark Gerretsen, replies, “How about we let health professionals decide who gets a vaccine and when?” The resistance to vaccinating prisoners expands to other nations such as China, Russia, France and Germany, all of which have little to no plans of supplying vaccines to inmates. South Korea has implemented stricter distancing measures for prisoners. Canada and about a dozen American states have set the vaccination of older and medically vulnerable federal prisoners to the earlier stages.
Government and health officials find it difficult to define where prisoners fall. Policies in multiple areas disagree with health professionals’ opinions, which is concerning. According to Ashish Prashar, an advocate for prison reform in the US and the UK, “If you don’t vaccinate inside prisons, you’re never going to stop outbreaks outside of prisons.” In a politically charged issue that strongly correlates to American policies - being the United States, the country with the highest incarceration rate in the world - public health should not be seen as something with which to be toyed.
It is undeniable that the pandemic has reached unimaginable levels. As of February 6th, 2021, almost 27 million cases have been registered in the United States alone. There is a high demand for the vaccine and a limited supply. Risk groups such as the elderly or those with pre-existing conditions are the priority. However, when examining the qualifications for risk groups, the discussion arose about whether or not prisoners should be categorized as a vulnerable population. Seena Fazel, a University of Oxford psychiatrist reasons, “Our research suggests that people in prison should be among the first groups to receive any COVID-19 vaccine to protect against infection and to prevent further spread of the disease.” She states that most prisoners disproportionately come from marginalized areas or groups. Because of this marginalization, they are already at a higher risk for diseases such as hypertension or diabetes, which are considered health risks that increase one’s susceptibility of COVID-19 and their severity of illness.
Grady is a 66-year-old woman married to a man who is serving a 40-year sentence for attempted murder and robbery at Green Haven Correctional Facility. Her husband has diabetes and high blood pressure and has reported the lack of use of masks by officers. He wants more information on the vaccine before taking it. However, he notes the lack of outreach to the prisoners about health matters as such. “I’m afraid that by the time they offer this vaccine and get the education around it, it’ll be too late for him,” Ms. Grady says.
However, there still is a strong resistance to the vaccination of inmates: the head of the Canadian conservative party, Erin O’Toole, writes on Twitter that “not one criminal should be vaccinated ahead of any vulnerable Canadian or frontline health worker.” A parliament member of the Liberal Party, Mark Gerretsen, replies, “How about we let health professionals decide who gets a vaccine and when?” The resistance to vaccinating prisoners expands to other nations such as China, Russia, France and Germany, all of which have little to no plans of supplying vaccines to inmates. South Korea has implemented stricter distancing measures for prisoners. Canada and about a dozen American states have set the vaccination of older and medically vulnerable federal prisoners to the earlier stages.
Government and health officials find it difficult to define where prisoners fall. Policies in multiple areas disagree with health professionals’ opinions, which is concerning. According to Ashish Prashar, an advocate for prison reform in the US and the UK, “If you don’t vaccinate inside prisons, you’re never going to stop outbreaks outside of prisons.” In a politically charged issue that strongly correlates to American policies - being the United States, the country with the highest incarceration rate in the world - public health should not be seen as something with which to be toyed.
