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Experts say inmates who contract COVID-19 can transmit the disease to prison employees as well as healthcare workers. SANDY HUFFAKER/Getty Images
  • States are debating whether prisoners should be among the first groups to receive COVID-19 vaccines.
  • Experts say inmates can transmit the disease to prison employees as well as healthcare workers who treat them.
  • A tracking project reports that 250,000 inmates nationwide have tested positive for COVID-19 and 1,700 have died. They add that 62,000 prison employees have tested positive and 108 have died.

As the coveted vials of COVID-19 vaccine begin rolling out across the country, some states are still scrambling to figure out who should be first in line to get the limited shots.

The Centers for Disease Control and Prevention (CDC) says healthcare workers and people in long-term care facilities should be prioritized.

But a handful of states have added another group to that first tier: prisoners.

According to the nonprofit research and advocacy group, Prison Policy Initiative, six states — Massachusetts, Connecticut, Delaware, Maryland, Nebraska, and New Mexico — are moving inmates toward the front of the vaccination line.

In Colorado, it’s a different story.

Prisoners were recently moved out of a priority second tier. Officials in the Colorado health department had recommended inmates be in a category just below “critical workforce” and “high-risk individuals” but ahead of the general public, including people over age 65.

That sparked a political backlash.

“There’s no way [the vaccine] is going to go to prisoners… before it goes to the people who haven’t committed any crime,” said Governor Jared Polis.

Experts say this isn’t good health policy.

“This is misguided moral grandstanding that not only dehumanizes human beings who are not sentenced to die of a virus behind bars, but also fundamentally misunderstands how prisons work and how viruses work,” said Hadar Aviram, a law professor at the University of California Hastings Law in San Francisco who specializes in criminal justice and civil rights.

Last month, the American Medical Association recommended that inmates should be prioritized.

“Recognizing that detention center and correctional workers, incarcerated people, and detained immigrants are at high risk for COVID-19, the new policy also makes clear that these individuals should be prioritized in receiving access to safe, effective COVID-19 vaccines in the initial phases of distribution,” the association stated.

The National Academies of Science, Engineering, and Medicine released its “Framework for Equitable Allocation of a COVID-19 Vaccine for Adoption by HHS, State, Tribal, Local, and Territorial Authorities” in October.

It included some prisoners in category 1B of its 4-phase vaccine distribution plan.

That list includes people of all ages with underlying health conditions, as well as those over age 65 who live in congregate settings such as “nursing homes, long-term care facilities, homeless shelters, group homes, prisons, or jails.”

The National Commission on COVID-19 and Criminal Justice reports that as of mid-August, “correctional facilities represented 19 of the top 20 clusters of confirmed COVID-19 cases” in the United States.

The rate of positive tests? Four times that of the general population.

Dr. Charles D. Lee, the president-elect of the American College of Correctional Physicians, said conditions are ripe in prisons to quickly transmit the novel coronavirus.

“The prisons are overcrowded, the inmates live in close quarters and can’t socially distance,” he told Healthline. “Some of the buildings date back to the 1800s. There’s poor ventilation.”

“Jail ages inmates, their bodies deteriorate, they often have underlying illnesses like diabetes, asthma, seizures,” Lee added.

According to the Marshall Project, nearly 250,000 prisoners have tested positive for COVID-19. Nearly 1,700 have died.

San Quentin in Northern California may be the poster child for what can go wrong in a prison outbreak. More than 2,200 inmates have contracted COVID-19 and 28 of them have died.

During the summer, as the virus tore through the prison, San Quentin officials set up giant tents in the prison yard to try to isolate the inmates with the disease.

Eventually, a judge ordered the state to either release or transfer 1,500 inmates.

Lee said once inmates get sick, they have to be treated somewhere.

“That often means they’re treated on the outside, in neighboring hospitals and intensive care units,” he explained.

Lee said it’s not just the inmates who are affected but also healthcare and other workers. That includes doctors, social workers, kitchen staff, and maintenance workers, as well as the jail guards who come and go.

The latest data from the Marshall Project shows that more than 62,000 prison employees have tested positive for the virus and 108 have died.

“Those workers who are infected inside, take it outside. They stop at the gas station, the Walmart, then go home to their families,” Lee said. “The more people are infected on the inside, the more it hurts the outside.”

“One of the things we’re finding is that spikes in COVID-19 inside prisons correlate with spikes in the surrounding and neighboring counties,” Avarim told Healthline.

“People have the perception that prisons are this locked up place and that you’re safer when people are behind bars,” she added. “That’s simply not true. Vaccinating people behind bars protects not only them, but it also protects you and saves lives on the outside.”

The Associated Press obtained internal Bureau of Prison documents showing the federal prison system will be among the first agencies to get the COVID-19 vaccine.

But the early allotments will go to prison staff — not inmates — even though the more than 3,600 federal prisoners who are sick vastly outnumber the 1,200 employees who are ill.

Some states, such as Nevada, are also following that model, putting correction officers in that first tier but not inmates.

Lee said he hopes as states make their priority lists, they’ll include both prison workers and inmates.

“What often happens is to make inmates last in line. They are people, too. Just because they are incarcerated doesn’t take away their right to get good medical care and be treated like a human being,” he said.