Irish Penal Reform Trust

HIQA: Evidence for vaccination of those living or working in crowded conditions

31st March 2021

The Health Information and Quality Authority (HIQA) has published a report to inform the national policy on the allocation of COVID-19 vaccines to those aged 18-64 years living or working in crowded accommodation, where self-isolation and social distancing are difficult to maintain.

The report explored the appropriateness of inclusion of certain populations within the group, based on their risk of infection and or risk of severe disease. These populations were: Travellers, Roma community, residents and staff of accommodation centres for international protection applicants and programme refugees, prisoners and prison staff, people who are homeless and staff in homeless facilities, addiction service users and staff in these services, people working in food processing plants, residents and staff of women's refuges, undocumented migrants, sex workers, seasonal harvest workers, and religious communities.

The report found that all of the populations identified “typically presented an elevated risk of infection and or risk of severe disease relative to the general population, or were noted to have a plausible elevated risk in the absence of supporting data”.

Below, we have compiled some of the findings as they relate specifically to prisoners.

Rates of infection were noted to be comparatively low for those living or working in prison settings. However, the authors note that this finding should not be conflated with these being low-risk populations, and that “these rates are likely reflective of the measures taken to protect these groups rather than the inherent risks for these populations”. (p.41)

The report notes that these efforts, although seemingly very effective “are unlikely to be sustainable in the longer term for the service providers or acceptable to the populations with whom they work”. (p.55) The report goes on to reference a study of Scottish prisoners which found that prisoners have felt an increased weight of time in custody during the pandemic with challenges such as poor communication about COVID-19 and restrictive measures, feelings of isolation, and detachment from family and friends.

The authors note that although generally representing a younger population, “prisoners may be more likely to have poorer health status and could be susceptible to poor outcomes if outbreaks are encountered”. (p.46) (A position widely supported in research, including by WHO.)

While the report does not account for time-related periods of infection, it notes that times of higher disease incidence in the community would likely be associated with higher risk in the groups examined in the report, which is “particularly relevant for settings in which there is a high turnover rate, such as prisons where approximately 75% of sentences are less than one year”. (p.54)

Read the report in full on the HIQA website here.

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