Who gets to be at the front of the long line for a coronavirus vaccination? It’s a question that each state must answer as it prepares to distribute precious doses of much-anticipated vaccines. As governors and other officials decide which groups to prioritize, a crucial test of their commitment to public health and ethics will be how they treat those behind bars.
People in jail or prison are four times as likely to be infected with the coronavirus as the general population and twice as likely to die from it, according to the National Commission on Covid-19 and Criminal Justice. A New York Times database shows 200,000 infections and 1,450 deaths among incarcerated people and corrections officers. Grim death tolls have mounted in prisons across the country, including at San Quentin in California, Pickaway in Ohio and Laurel Highlands in Pennsylvania.
Outbreaks in prisons and jails also pose a serious danger to the surrounding community. A study published in the journal Health Affairs in June traced 16 percent of Covid-19 cases in Chicago through mid-April to a node of infections at the Cook County Jail.
In October, the National Academies of Sciences, Engineering and Medicine released a framework for the equitable allocation of the vaccines. People 65 and older in prisons and jails, and those of like age in nursing homes and assisted-living facilities were ranked just behind health care workers and emergency medical workers on the suggested Phase 1 priority list.
The reason: “joint risk factors” of age and transmission in their congregate settings. Phase 2 priorities include incarcerated people under 65, along with others “in high-risk settings who cannot avoid a high risk of exposure to Covid-19,” like teachers and other school employees and bus drivers, and workers in child care, public transit and food supply.
The recommendations by the National Academies underscore two crucial points. People who are locked up have little or no control over whether they can socially distance or have access to masks and other protective gear. And jails and prisons are vectors for outbreaks that can be spread outside their walls by guards, visitors and those who are released. Preventing the virus from spreading on the inside has an outsize benefit on the outside.
But some state officials dismiss the pragmatic and ethical arguments for the early vaccination of inmates. “There’s no way it’s going to go to prisoners before it goes to people who haven’t committed any crime,” Gov. Jared Polis of Colorado, a Democrat, said this week.
On Tuesday, the committee advising the Centers for Disease Control and Prevention on the vaccine rollout included residents of nursing homes and long-term-care facilities (along with health workers) in its recommendation for the first people to receive the vaccine. But not older people in jail or prison.
The C.D.C.’s director, Dr. Robert Redfield, accepted the panel’s guidance on Wednesday. His decision isn’t binding on states, but it is expected to be influential. With about 21 million health care workers and emergency medical workers across the country, and about three million nursing-home and assisted-living residents, there’s competition for the 22.5 million complete vaccines that Pfizer and Moderna, the first companies going through the federal approval process, estimate will be ready in December. (A complete vaccine requires two doses, given a few weeks apart.)
By the end of January, the companies hope to provide enough vaccine to raise the number of people covered to 55 million at most, with additional production continuing from there. People in detention account for only a small fraction of that number — 2.3 million in total, including about 500,000 who are presumed innocent as they await trial in jail, 44,000 in juvenile facilities and 42,000 in immigration detention centers.
The nation’s 400,000 corrections officers also should be counted as critical, high-risk workers. The current plan of the federal Bureau of Prisons to give its first vaccine allotment to staff members over detainees 65 and older seems dubious, epidemiologically and ethically, without evidence that staff vaccinations would be enough to stop the spread of infection.
Some states, including North Carolina and Washington, have drafted guidelines in which incarcerated people are given priority along with others in congregated living settings, like long-term care, farmworker housing and homeless shelters. But as the states finalize their plans, politics could force people in jail or prison to the back of the line, as Governor Polis’s dismissal of them suggests.
“It’s especially disappointing to hear this from a governor who has done more than most to release people from prison due to Covid,” said Nick Turner, the vice president of the Vera Institute of Justice. “Immunizing incarcerated people is not only a moral imperative; it’s a practical necessity to stop the spread of Covid-19.” (Governor Polis and his husband tested positive for the coronavirus last week.)
As the promise of vaccination becomes real, stopping the spread of infection and recognizing our shared humanity should be uppermost. Vaccinating people behind bars serves both goals.
Emily Bazelon is a staff writer at The New York Times Magazine and is the Truman Capote Fellow for Creative Writing and Law at Yale Law School. She is the author, most recently, of “Charged: The New Movement to Transform American Prosecution and End Mass Incarceration.”
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