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In About-Face, Missouri Places Prison Inmates In Final COVID-19 Vaccination Group

Dr. Randall Williams, the state's public health director, said chances of catching the coronavirus are the highest they've ever been in Missouri.
In October, Dr. Randall Williams, the state's public health director, defended early vaccination for inmates.

Missouri officials initially slated inmates for earlier vaccination due to their higher risk for COVID-19 infection.

When Missouri officials initially introduced their COVID-19 vaccination plans last year, they announced that prison inmates would get priority because they are at higher risk for COVID-19 infection.

But in the latest version of the state's vaccination plan, the health department has placed prison inmates among the last to be vaccinated.

Health care advocates say that prison inmates, who have experienced high rates of COVID-19, will continue to suffer disproportionately unless they're given priority access to the vaccines.

“The built environment of prisons and jails lend themselves to rapid transmission of COVID-19,” said Lauren Brinkley-Rubinstein, an assistant professor of social medicine at the University of North Carolina and co-founder of the COVID Prison Project, which tracks coronavirus data and policies in prisons. “They are often congregant living spaces, people in dormitory-style housing, (with) little ability to engage in social distancing.”

Prison inmates also tend to have higher rates of chronic illness that place them at higher risk for severe disease.

On Oct. 21, shortly after Missouri officials introduced their initial plan for the vaccine rollout, Department of Health and Human Services Director Dr. Randall Williams defended the state’s decision to prioritize prison inmates for COVID-19 vaccinations as residents of congregant living facilities. He did not specify precisely where inmates would be placed within the higher priority group.

“Clearly, we know from our data that people in congregant living facilities are at higher risk,” Williams said.

COVID-19 outbreaks have been common in Missouri prisons. Nearly 8,000 cases have been identified and 54 COVID-19 deaths have occurred among prison inmates and staff. Meanwhile, six prison facilities currently have inmates with active COVID-19 cases, according to the Missouri Department of Corrections.

Prison inmates have not been specifically listed in the state’s current vaccination plan, but state officials told KCUR this week they would be vaccinated as part of the final Phase 3 group.

“Once we began seeing our weekly vaccine allotments, we determined we had to narrow our focus of eligible individuals for vaccination based on prioritizing those who were more likely to get sick if infected with COVID-19,” health department spokeswoman Lisa Cox said in a statement.

Prison inmates who are elderly or have underlying health conditions that put them at higher risk for severe disease were eligible to receive vaccines earlier as part of Phase 1B–Tier 2, which went into effect on Jan. 18. Corrections staff were eligible in January as part of Phase 1B–Tier 1.

State officials didn’t immediately respond to requests for data on how many vaccine doses administered among the roughly 24,000 inmates in Missouri.

Brinkley-Rubinstein said other states have also changed their prison prioritization plans after vaccine supplies turned out to be lower than anticipated. That, she said, threatens to prolong the pandemic, not just for inmates, but also for communities to which visitors, staff and newly released inmates return.

“We’re just going to continue to see large-scale outbreaks in these settings which impact people who are incarcerated, staff that work in those settings, but it also has an impact in the community,” Brinkley-Rubinstein said.

Several states, including California, Massachusetts, Rhode Island and Virginia, have continued to prioritize COVID-19 vaccinations among inmates despite low vaccine supplies, according to COVID Prison Project data.

As a health care reporter, I aim to empower my audience to take steps to improve health care and make informed decisions as consumers and voters. I tell human stories augmented with research and data to explain how our health care system works and sometimes fails us. Email me at alexs@kcur.org.
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