The blog of the Urban Institute
January 6, 2021

Incarcerated People Need Priority Access to the COVID-19 Vaccine

Last spring, as COVID-19 began to spread across the US, health officials urged people to wash their hands, use hand sanitizer, wear masks, and practice social distancing to stop the spread of the virus. However, in overcrowded prisons and jails, where access to supplies is limited and the ability to distance is compromised, these precautions are difficult to follow—making correctional facilities some of the most dangerous places to be during the pandemic.

The devastating outbreaks and deaths in prisons and jails—with at least 1,738 incarcerated people and 113 correctional staff having died of COVID-19 as of December 15—in the nine months following these directives were both predictable and preventable. Though data on racial and ethnic disparities are largely unavailable, the elevated risks in prisons and jails compound with findings that Black Americans—a group disproportionately represented in correctional facilities as a result of structural racism and racial and ethnic disparities throughout the justice system—are more likely to become infected and die from COVID-19. While officials organized large-scale prison releases (though criticized as not nearly large enough) between March and June, the rate of releases has since declined, county jail populations have since increased, and releases may have increased racial disparities, with reports emerging that Black people were released at lower rates than white people.

Rapidly increasing COVID-19 cases in prisons and jails show that incarcerated people and correctional staff continue to be at a high risk of contracting the virus. As federal and state governments finalize their vaccine dissemination plans and begin to distribute the vaccine, public health officials have argued for priority consideration for vulnerable populations, which include both incarcerated people and correctional staff. Given incarcerated people’s vulnerability to COVID-19 and the significant racial and ethnic disparities in prison and jail populations, governments should comply with health experts’ recommendations and commit to quickly vaccinating people in prisons and jails.

COVID-19 cases among incarcerated people and correctional staff are increasing—and are likely undercounted

Prisons and jails are the sites of some of the worst COVID-19 outbreaks in the country, and data limitations suggest that reported cases, deaths, and racial and ethnic disparities in correctional facilities are undercounted. According to the Marshall Project, one in five people incarcerated in state or federal prisons has tested positive for COVID-19—a rate more than four times as high as the general population. In December, new cases among incarcerated people reached their highest levels since the beginning of the pandemic.

Though both correctional staff and incarcerated people are vulnerable to COVID-19, incarcerated people face even higher infection and death rates than staff. In California, the state with some of the worst COVID-19 outbreaks in its prisons, there are 1,947 known cases and 2.2 deaths per 10,000 staff—compared with 2,614 cases and 9 deaths per 10,000 incarcerated people. Further, data on COVID-19 in correctional facilities are extremely limited, and data on racial and ethnic disparities in COVID-19 cases and deaths are nearly nonexistent (PDF), though it is likely that disparities in rates outside of correctional facilities persist within them.

Federal and most state prison systems are failing to prioritize incarcerated people in vaccination plans

Though incarcerated people are particularly vulnerable to COVID-19, governments are prioritizing other groups in their vaccination plans. At the federal level, Federal Bureau of Prisons documents specify that initial allotments of the vaccine will be reserved for staff, not incarcerated people. Though some have argued that vaccinated staff, as the likely entry point of the virus, would be sufficient to stop the spread of COVID-19, these statements have yet to be supported by evidence.

At the state level, only 14 states include correctional staff in the first phase of vaccine distribution, and only 7 states include incarcerated people in the first phase. A few states, including New Jersey, Rhode Island, and Washington, have started distributing vaccinations to incarcerated people. However, in 11 states, incarcerated people are not included or even implied to be included in the first, second, or third phases. Though a few states, like Massachusetts, are recognizing the need to prioritize people in prisons given their high level of risk, most states are failing to protect incarcerated people, despite recommendations (PDF) from experts to vaccinate incarcerated people in the same phase as correctional officers.

People in prisons and jails need priority access to the COVID-19 vaccine

With COVID-19 vaccination distributions already underway across the country, prominent health officials (PDF) and organizations are urging governments to prioritize incarcerated people and correctional staff in their plans. Experts have found that incarcerated people, in particular, are at higher risk (PDF) of contracting and dying from the coronavirus than are correctional staff. In addition to prison conditions that place people at increased risk for transmission, today’s state prison populations include a larger share of older adults than young people and higher rates of preexisting conditions, making incarcerated people particularly vulnerable to COVID-19.

In addition to prioritizing people in prisons and jails for the COVID-19 vaccine, officials must ensure that incarcerated people are fully informed of the efficacy and risks of the vaccine to be able to provide informed consent. An open letter (PDF), released by the University of California, Los Angeles, School of Law’s COVID-19 Behind Bars Data Project, highlights the “historical legacy of medical experimentation, the inherent reality of coercive control in carceral environments, and the deep distrust many incarcerated people and their families feel towards correctional authorities” as key considerations when distributing the vaccine to incarcerated people.

Though correctional facilities have failed to protect incarcerated people from the COVID-19 pandemic thus far, providing early access to the vaccine could save their lives. The pandemic has further exposed the inequities inherent in the US justice system, and has led many to call for a reimagining of what the justice system looks like.

Governments owe it to all of the incarcerated people who they have failed to protect and the Black and Latinx communities they have overpoliced, disproportionately incarcerated, and discriminated against to provide this vaccine to people in prisons and jails as soon as possible.

Physician assistant Adriana Reyna prepares doses of the Moderna COVID-19 vaccine at Forand Manor in Central Falls, Rhode Island, on December 30, 2020. (Photo by Craig F. Walker/The Boston Globe via Getty Images)

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As an organization, the Urban Institute does not take positions on issues. Experts are independent and empowered to share their evidence-based views and recommendations shaped by research.