Oklahoma inmates, a group four times more likely to contract the coronavirus than the general population, won’t receive initial doses of the COVID-19 vaccine.
Residents and workers in congregate living facilities are assigned to phase 2E of the state’s vaccine distribution plan, immediately behind older adults and teachers. Phase two is expected to begin next month and last several weeks. State health officials may modify the plan if certain populations see an uptick in cases.
More than 6,700 state inmates have tested positive for COVID-19 and 40 have died since April. The state medical examiner’s office has determined COVID-19 as the primary cause of death in 20 of these 40 deaths. The remaining deaths are under investigation.
Oklahoma ranks ninth in inmate coronavirus cases and 16th in cases per 10,000 inmates, according to data compiled by The Marshall Project and The Associated Press. Nationwide, one in five inmates in state and federal facilities has contracted COVID-19.
Overcrowded conditions make social distancing difficult inside most prisons and jails, and a disproportionate number of inmates suffer from comorbidities like high blood pressure and heart disease. Public health experts say inmates and corrections staff should be prioritized in state plans to distribute the vaccine.
The National Commission on COVID-19 and Criminal Justice, a group of justice system leaders and health experts that includes former U.S. Attys. Gen. Loretta Lynch and Albert Gonzales, recommends inmates and guards be vaccinated immediately after healthcare workers and elderly people living in nursing homes.
“Many of the largest reported clusters of COVID-19 infections are in correctional facilities, and the disparities between correctional and community COVID-19 rates are increasing,” the commission said in a Dec. 14 report. “To maintain public health as well as public safety, frontline staff and incarcerated individuals should be among those who are given priority access to vaccines.”
In one Oklahoma prison, 82% of inmates tested positive for COVID-19. One of them was Robert Lavern.
Seven states have included inmates in phase one of their vaccine plan, according to data from the Prison Policy Initiative, while 13 states plan to vaccinate corrections staff early. Oklahoma inmates and corrections staff will likely have to wait months to receive the vaccine.
Nicole McAfee, director of policy and advocacy for the American Civil Liberties Union of Oklahoma, said it will be difficult for state officials to get the pandemic under control without first stopping prison and jail outbreaks. McAfee sent a letter to Gov. Kevin Stitt earlier this month urging the state to include inmates and corrections staff in phase one.
“Folks who staff these facilities go into their communities at the end of the day,” she said. “They shop in grocery stores, they have kids who are in public schools, they have family members they live with who may have to go into essential jobs. That’s why we see bumps in the counties where these prisons are located.”
McAfee said prison outbreaks can also impact hospital capacity, especially in rural areas, as protocol requires more hospital workers to be in a room with an inmate than a non-incarcerated individual.
Minimizing the Most Harm
On Dec. 1, Colorado Gov. Jared Polis said there was “no way” prisoners would get the vaccine ahead of vulnerable populations who had not committed a crime. Eight days later, inmates were officially moved down Colorado’s vaccine priority list.
Polis’ remarks drew criticism from public health officials who say the vaccine should be distributed based solely on who is most likely to contract the disease and suffer.
“It shouldn’t be our job to say who is more valued by society or not,” said Saad Omer, director of the Yale Institute of Global Health, during a Dec. 2 webinar hosted by the SEICHE center. “Public health has a principle of equal respect because we are not a part of the criminal justice system, and shouldn’t be part of the punitive part of society.”
Holly Taylor, a research bioethicist at the National Institutes of Health, said it’s incredibly difficult to stop person-to-person transmission inside prisons and jails. Of the nation’s 60 largest coronavirus outbreaks, 30 have been in correctional facilities, she said.
“If you’re going to be driven by epidemiology in terms of where minimizing harm is most likely, I would argue that incarcerated populations ought to be high on the list,” she said during the webinar.
But what if everyone in a prison has already contracted COVID-19? At two state prisons, the Eddie Warrior Correctional Center in Taft and William S. Key Correctional Center in Fort Supply, more than 80% of the inmate population has tested positive for the coronavirus.
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The vast majority of people who contract COVID-19 develop antibodies, but some studies have suggested that these antibodies decrease within two or three months of recovery. Because the length of protection remains unknown, health experts say those who have contracted COVID-19 should still be vaccinated.
Douglas Drevets, an Oklahoma City infectious disease specialist, said during a Dec. 11 press conference that herd immunity generally occurs when 70 to 80% of a population has been infected. While herd immunity can be effective for a short period of time, Drevets said vaccination is the most effective tool to slow the spread of COVID-19.
“Herd immunity is a good thing, but it’s not great,” Drevets said. “For example, before we had vaccines all we had was herd immunity in populations, but that didn’t prevent smallpox from continuing to infect people.”
Mandating the Vaccine
As vaccine availability becomes more widespread in the late spring and summer, some businesses may require employees to submit proof of COVID-19 vaccination before they’re eligible to work.
While employees who don’t want to get vaccinated can find another job, inmates can’t decide to leave jail or prison.
During a Dec. 3 press conference, state health commissioner Lance Frye said the health department won’t mandate the vaccine for inmates or prison staff, but individual facilities or the corrections department can choose to take action.
Justin Wolf, spokesman for the corrections department, said the agency is working with the health department to finalize a distribution plan and no decision on a vaccine mandate for staff or inmates has been made.
Omer, the Yale health expert, said corrections officials should educate inmates about the vaccine and consider a mandate for staff.
“I don’t think this pandemic warrants the higher bar for an [inmate] mandate,” he said. “It may be met if there’s a raging outbreak where other prisoners are dying, and you need to control that. ”
Note: This story was updated to clarify the number of known inmate COVID-19 deaths.
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