As health care workers and nursing home residents are getting vaccinated against COVID-19, officials are still finalizing the distribution plan for the so-called Phase 1B group. This next phase of vaccine distribution includes first responders, critical workers and those with pre-existing conditions that put them more at risk of severe illness from the coronavirus.
The homeless, incarcerated and those who work in homeless shelters and corrections facilities are included in this group, but some advocates say they should be further prioritized for vaccine access.
More than 400 experts in bioethics, public health, criminal legal policy and epidemiology penned a letter to the Centers for Disease Control and Prevention urging its advisory committee on immunization practices to vaccinate incarcerated people alongside those in long-term care facilities.
The letter cites a study published in the Journal of the American Medical Association that found incarcerated populations were more than five times more likely to be infected with COVID-19 than members of the general population in the United States. The study also found that those incarcerated were three times more likely to die of the virus compared to their non-incarcerated peers.
Outbreaks in correctional facilities impact nearby communities. Prison staff could be exposed to the virus spreading among the incarcerated and then carry and potentially spread it when they leave work. The Philadelphia Inquirer reported that prison staff across Pennsylvania are not required to take COVID-19 tests.
“This is about keeping people safe,” Jaclyn Kurin, a staff attorney at the Abolitionist Law Center said of the importance of vaccinating the incarcerated people and prison staff. As of mid-December, 72 incarcerated individuals have tested positive for COVID-19 at the Allegheny County Jail; 44 of those people have since recovered or been released.
The Pennsylvania Department of Corrections oversees 24 state prisons. While facilities saw clusters of positive cases in the spring, the fall surge dramatically affected correctional facilities across the state. According to WHYY, SCI Laurel Highlands, located in western Pennsylvania, has racked up the highest total cases in the state prison system at 344.
Spokespeople for the state and Allegheny County both said plans for vaccinating incarcerated people in state and county jails are forthcoming. Allegheny County Health Department Director Dr. Debra Bogen is expected to announce a county-level vaccination plan after Jan. 1.
Another issue is making sure those incarcerated get both doses of the COVID-19 vaccine. Both available vaccines require two shots. Jails will have to determine what to do when someone is released before their second vaccine shot.
“There’s not much turnover in the state prisons so all the inmates will pretty much be there for the second shot,” John Hargreaves, PA Prison Society’s director of volunteers, said. “The county [facilities], it’s not necessarily the case.” The average stay at Allegheny County Jail is about 35 days.
Kurin said county jails already have experience keeping tabs on parolees that they can bring to bear on the issue of vaccination. “If there’s no problem with monitoring their compliance [with the terms of their parole] … then there is no problem in contacting these people for life-saving medical care. If they can do the first then they can do the second,” she said.
People experiencing homelessness are another transient group that presents logistical challenges to public health officials. The homeless and those who work at homeless shelters are also listed in the Phase 1B group.
Jay Poliziani, director of Northside Common Ministries and the Pleasant Valley Men’s Shelter, noted that many experiencing homelessness work in the service industry and other jobs where they face increased risk of exposure.
“A lot of our guys are working at places like Amazon, candy factories, places like that,” he said. “We’re hopeful that we can see these vaccines coming to us as soon as possible, because if they bring that back to the congregation of folks that are [in the shelter] it could be pretty disastrous.”
Some healthcare groups who work with homeless populations are expected to receive vaccines to administer. The CDC also recommends state distribution plans include strategies to bring vaccines to people in encampments or other known locations where people experiencing homelessness spend time.
