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Vaccine Rates Among the Incarcerated Remain Low Amid Mistrust and Misinformation

Many people behind bars are turning down or deferring vaccination, despite months of advocacy to get vaccines into jails and prisons.

The incarcerated in New York have been vaccinated at less than half the rate of the general population.
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“Nightmare” is an understatement for Kevin Hayes’s first months with the pandemic. The father of three was serving his 28-year sentence in the Fishkill Correctional Facility when the coronavirus crept in. Six of the facility’s incarcerated have died from the disease, and the 57 year old says he roomed with the virus’s first victim in the prison.

“I had been in the same room with Mr. Stan Li for a year and he fell sick right before my very eyes,” he shared over email.

As Hayes lay in their tiny cell, watching as the 66-year-old Li labored to breathe and eventually stopped eating, he couldn’t help but inform a corrections officer. Li died on a respirator in April of 2020. It would be another eight months before the first COVID-19 vaccine was authorized for emergency use in the United States—and longer still before the shots would make it into prisons and jails.

Indeed, incarcerated individuals have been an afterthought in states’ vaccine rollouts, despite cramped and unsanitary conditions and high comorbidity rates in carceral settings. It took a February lawsuit by an activist coalition for New York State officials to provide vaccines to incarcerated people 65 and older. A month later, a state Supreme Court Justice mandated universal access for jails and prisons, finding “no acceptable excuse” for the delay up to that point.

Advocates framed this previous lack of access as an injustice. But many people behind bars just aren’t up for the jab, often citing the most common fears and misconceptions about the vaccines and the virus. Many don’t receive adequate information needed to make informed decisions for themselves.

Hayes, who had an asymptomatic case shortly after Li’s death, signed up for either the Pfizer or Moderna doses. But state corrections officials later announced their switch to the one-shot Johnson & Johnson vaccine, effective April 6. Then the CDC’s pause on the vaccine also halted prison and jail systems’ use of J&J. Hayes says the vaccine’s rare instances of blood clotting, along with the perceived lower efficacy of the shot, leave him and others in the facility with little confidence. Some are even waiting to get vaccinated after their release. “We feel as though we’re being used as their guinea pigs,” he says. 

Many of the younger men in his unit, according to Hayes, don’t think they’re at risk of serious illness from the virus and brush off the need for vaccination. By contrast, he says most of the older men have already been vaccinated or are eagerly waiting their turn.

About 74 percent of those 65 and older in the state’s prisons have received both Moderna doses, according to state corrections spokesperson Thomas Mailey. But only 59.5 percent of those with at least one comorbidity opted for both doses. Hundreds refused the second dose, were released, or were unavailable due to outside medical trips.

Several Factors Hindering the Vaccination Effort

Overall, delays in the vaccine rollout—combined with mistrust, misinformation, and information gaps in prisons—have translated to only 17 percent of the total incarcerated population being fully vaccinated as of May 2. That’s compared to a little more than 35 percent of the statewide population, according to the state’s COVID-19 vaccine tracker.

The Correctional Association of New York, a nonprofit prison monitoring group, was told by Greene Correctional Facility staff that only 40 percent of the roughly 900-person prison expressed interest in vaccination. “It seemed that more than half of people we spoke to were hesitant, and it sounded like the Johnson & Johnson pause contributed to that, among other concerns,” says Jennifer Scaife, executive director of the organization.

Vaccination rates are even harder to track in county jails because their populations fluctuate daily as people are moved to state prisons, serve shorter sentences, or are released pretrial. The River contacted seven of the Hudson Valley’s county jails, with average monthly populations ranging from 400 to 33, and found that less than 35 percent of their incarcerated populations are partially or fully vaccinated at a time. Putnam County Jail, which had an average March population of 40, has only vaccinated one person since February.

Current case numbers provide more hopeful, if presumably short-term, optimism. Most jails contacted by The River have reported zero cases in recent weeks. Scaife says infection rates in prisons have also dropped since mass outbreaks in January. And while sanitation and mask wearing have improved in some facilities, the trend is anything but uniform. “The [correctional] system is managing the pandemic with much more consistency and public health awareness than at the beginning,” Scaife says.

But those measures aren’t enough on their own. There are still far too many people behind bars in New York to make social distancing possible in carceral settings. Bail reforms shrunk the state’s jail population by 31 percent last year, and efforts to reduce populations in county jails amid the pandemic yielded another 17 percent drop between March and April in 2020, with reductions continuing through July. Officials also released thousands of people with technical parole violations and low-level crime convictions last year from state prisons. But jail numbers have ticked back up since the summer, after reform opponents won rollbacks on the bail law.

Prisons have gone the opposite direction under the state corrections department’s early release program: Almost 4,000 convicted of nonviolent crimes, non-sex offenses, and low-level parole violations have been released as of May 2, according to a department spokesperson. That’s compared to roughly 3,000 releases by October of last year. Early releases and a decline trend predating the pandemic have shrunk the state’s prison population to 31,511 people.

Gregg Gonsalves, an epidemiologist at the Yale School of Public Health, says that decarceration and vaccinations are the key to curbing the virus in jails and prisons. Otherwise, continued spread and outbreaks aren’t just bad news for incarcerated populations: “We know that the rates of COVID inside of prisons often spread to the surrounding community because people go in and out.”

The phenomenon is more pronounced with county jails and their fluctuating populations. A 2020 study found that people cycling through Chicago’s Cook County Jail caused 15.7 percent and 15.9 percent of all documented COVID-19 cases in Illinois and Chicago, respectively, on April 19, 2020. Those numbers don’t account for jail administrators and staff who return to their communities after a day’s work. “The reason we’re getting everybody vaccinated is so we can protect not just ourselves but the people around us,” Gonsalves says. (Cook County officials, including officials from the jail and the Chicago Department of Public Health, have criticized the report, saying it relies on old data that does not account for changes the jail had made to its COVID safety protocols.)*

Yet some correctional administrators, including in jails, are taking a relatively lax approach to vaccine refusal and hesitancy. “Maybe it’s because they’re afraid of needles, or they don’t trust the vaccine, or we’re giving a particular vaccine as opposed to another one,” says William Hilscher, assistant administrator at Columbia County Jail. “It’s anyone’s prerogative to change their mind if they want, so we continuously survey our population.”

Others are having more personalized dialogues with incarcerated people. “I personally spoke to our population of the importance of getting vaccinated and our medical staff has educated the population on the different vaccinations available,” Ulster County Sheriff Juan Figueroa says. “I am fully vaccinated and described my experience to the inmate population.”

Gonsalves says that a more hands-off approach will ultimately cost lives: “Not stepping forward as a warden or corrections official to make sure that you’re doing your very best to convince people to get vaccinated in your facility is a dereliction of duty and care.”

An Informational Issue

Education on the virus and vaccines is often uneven, unreliable, and sparse in correctional facilities. Inmates watch cable news when they can. And family and friends share info—which may or may not be reliable—during phone calls or via email.

Each prison’s Inmate Liaison Committee (ILC), a group of incarcerated individuals elected by their peers to relay the general population’s concerns to administrators, are also supposed to provide info. Some, including Hayes, say they aren’t that informative or helpful, though reports have found communication disparities between corrections staff and the committees.

Corrections officials say staff provide pamphlets or post flyers from the CDC on bulletin boards, and regularly canvass prison populations to gauge interest in getting vaccinated. Scaife has also heard reports of staff playing videos from the state health department—and of Tyler Perry encouraging people to take the vaccines. “There’s no context that all the public health experts say that this is why we should take the vaccine, but if you don’t believe us, here’s a celebrity,” she says. “You really have to advocate for yourself and inform yourself.”

Scaife says that because prison populations are diverse, approaches to building trust and combatting vaccine hesitancy should also vary. New York’s jails and prisons are majority Black and Latinx, populations historically underserved and discriminated against in health care.

In one rare approach to information dissemination, Superintendent Michael Capra at Sing Sing Correctional Facility reportedly held “town halls” in the facility’s chapel, where ILC members and leaders from religious and cultural groups were present. Some say that being informed is often more about empowering incarcerated people to make informed decisions than it is convincing them to get vaccinated.

Ultimately, increasing vaccination rates in jails and prisons will be an ongoing struggle for a population routinely cast aside, and intentionally harmed, by society. “Nobody’s shown any regard for the health of people incarcerated for the past 16 months,” Gonsalves says. “It’s a stretch to say, ‘Well, now we care about you.’”