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States should prioritize vaccinating prisoners

Prisoners in Massachusetts will be among the first to get vaccinated. Other states — and the federal government — should follow suit.

Only seven other states have been clear about including prisoners in phase one of their COVID-19 vaccine distribution plans. Given how high risk the prison population is, other states and the federal government should follow Massachusetts’s example.KATHRYN GAMBLE/NYT

Since the start of the pandemic, one in five people in prison has been infected with the coronavirus. According to The Marshall Project, US prisons have now recorded over 275,000 positive cases and at least 1,700 people have died of COVID-19 behind bars. The rate of infection in prisons was at one point more than five times higher than the country at large, with prisoners dying at three times the rate of the general public. Since November, the situation has only worsened: The number of new prison cases has been reaching new peaks almost every week.

These kinds of statistics are the reason Massachusetts is prioritizing prisoners and including them in the first phase of vaccine distribution, alongside health care workers and emergency responders, as well as those living or working in long-term care facilities and homeless shelters. But the Commonwealth doesn’t have much company: Only seven other states have been clear about including prisoners in phase one of their distribution plans, one of which only includes some prisoners depending on their underlying health conditions. Given how high-risk the prison population is, other states and the federal government should follow Massachusetts’s example.


From a public health standpoint, vaccinating people in prison early on in the distribution process makes sense. The reality is that prisoners are especially vulnerable to contracting and dying from the disease, in part because it’s difficult to follow public health guidelines or get access to good quality care in US prisons, and in part because the prison population is more likely than the general public to have chronic health conditions that make the virus all the more dangerous.

But in spite of the fact that states impose the harsh living conditions that make prisoners more prone to infection, some governors have neglected to make the incarcerated population a priority group. According to the Prison Policy Initiative, 11 states do not not include people behind bars in any part of their vaccine rollout plans. That includes states with alarmingly high rates of infection in prisons, such as Michigan, where one in every two prisoners has been infected, and South Dakota, where a staggering 62 percent of the prison population has gotten COVID-19. (Those cases don’t mean prisoners in those states necessarily have natural immunity now, since reinfections have been reported, even if rare. And because the prison population is fluid, with inmates coming in and out, every new entrant is susceptible to the same high-risk conditions that prisoners have already been exposed to up until this point.)


On the federal level, guidance on administering the vaccine in prisons has been elusive. While federal prisons have begun vaccinating some inmates, the Centers for Disease Control and Prevention has so far stayed silent on whether incarcerated people should take precedence over other groups in distribution plans. Instead, the CDC has deemed correctional staff to be frontline workers, suggesting that they should be prioritized and receive the vaccine before the prisoners themselves. Several states have followed the CDC and included prison staff in the early stages of vaccine distribution while leaving prisoners out of their plans entirely.

The lack of federal guidance has also allowed governors and local politicians to make decisions driven by optics, because putting prisoners above free citizens — no matter how low-risk some may be — is perceived to be deeply unpopular. When Colorado’s Democratic governor, Jared Polis, who has yet to include prisoners in his state’s vaccine rollout plan, was asked about the issue, he said, “There’s no way [the vaccine is] going to go to prisoners before it goes to people who haven’t committed any crime. That’s obvious.” But while comments like that may sound like good politics, they’re dehumanizing — and promote bad public health policy. Because prisons are such hotbeds of infection, the communities around them can also be subject to more contagion. According to a recent study, one in seven coronavirus infections in Chicago can be traced back to the Cook County Jail as a result of cycling people in and out of pretrial detention.


But regardless of public health outcomes outside the prison gates, states have a duty to protect the health of those who are in their care. In fact, international law requires that prisoners be given access to care without discrimination. If states are ignoring the incarcerated population while prioritizing other high-risk groups, they would be discriminating against prisoners and violating international human rights standards.

Because many US prisons provide substandard living conditions, the carceral system has only made the pandemic worse. People in prisons virtually have no way to protect themselves from the coronavirus unless states provide them with resources like the vaccine. Failing to do so quickly will only lead to more preventable deaths in and outside prison. In the end, choosing not to vaccinate people for the sole reason that they are in prison is not just misguided public health policy; it’s a punishment — one that is too cruel and unusual for any citizen to accept. This is an instance where Massachusetts can serve as an example for the nation.


Editorials represent the views of the Boston Globe Editorial Board. Follow us @GlobeOpinion.