PRI and HRI: COVID-19 vaccinations for prison populations and staff

14th December 2021

Penal Reform International (PRI) and Harm Reduction International (HRI) have published a report outlining how prison populations and staff were included in national vaccination plans, and the current roll-out of vaccines in prison worldwide.

People in Prison and COVID-19

The report makes clear that people in prison are more likely to have chronic health problems, and experience accelerated ageing due to their health status and the conditions in prison. Since prison healthcare systems are often worse than those in the community, this means that the risk and impact of COVID-19 has been aggravated for people in prison.

People in prison are also more likely to be exposed to COVID-19 due to a lack of physical distancing, hygiene measures, and inability to properly quarantine due to overcrowding. The report found that at least 119 countries are operating above capacity, despite the increased risk. International standards indicate the need for equivalence of healthcare in prisons, which means that diagnosis and treatment of people in prison who test positive, along with special measures to protect at-risk groups, should be implemented. Therefore, people in prison should be given priority in national vaccination plans.

Scarce Data

A notable finding in the report was the lack of transparency in countries related to vaccinating prison populations and staff. This lack of clarity was highlighted in relation to Ireland, where the report found that although people “living or working in crowded accommodation” were initially included as a priority group in national vaccination plans, it was not clear if prisons were included. Overall, the report found that only six countries published official and updated statistics on the vaccine rollout in prisons. In Honduras, on the other hand, the information given in official plans on the vaccination of prison populations varied from reports by the Ministry of Health.

There was even less information on the vaccination of prison staff. Some plans viewed prison staff as high-risk frontline workers, while others did not classify them at all. Staff were also occasionally classified under different headings depending on the nature of their role.

Prioritisation

Of the 133 countries that had vaccination plans, only 56 mentioned prison populations, and of those only 51 envisaged a level of priority for people in prison. Prison staff are mentioned in 66 vaccination plans, but only 51 give them priority, and 15 in only certain cases such as age or those in security forces. 30% of vaccination plans gave prison staff the highest priority, but only 16% of plans did the same for people in prison.

In other countries, the prison population was not treated as a priority group of their own, with France vaccinating certain people in prison as their priority group in the community was also being vaccinated.

Vaccine Roll-out

As of 30 September 2021, vaccine roll-outs for people in prison had begun in 120 countries, and for prison staff in 94 countries. Only 20 countries have provided at least 80% of their prison population with at least one dose of the vaccine, but of the 86 countries for which data is available, 29 have vaccinated less than 10% of their prison population. Some vaccination plans that prioritised people in prison have not lived up to their goals – as of May 2021, only 1,000 vaccine doses were administered to the Brazilian population out of a population of nearly 754,000. The report does not mention the delay in vaccinating the Irish prison population. (See IPRT’s statement here.) Vaccination of prison staff has begun in at least 94 countries, and at least seven have vaccinated all consenting staff. In Italy and New Zealand, prison staff are now required to be vaccinated, as they are more likely to spread the virus to the vulnerable communities they work with.

Vaccine Hesitancy

The willingness of prison populations to receive the vaccine has varied across countries. In Greece, 6,105 out of the 11,000 people in prison indicated their willingness to get the vaccine. Ireland was lauded as a good example in this regard, as a video was produced on vaccines for the prison population, and 84% subsequently got the vaccine.

The report does not mention the harsh restrictions many people in Irish prisons have been subjected to over the course of the pandemic in order to stem the spread of the virus. Therefore, the vaccination rate is only one metric by which to measure Ireland’s response to COVID-19 in prisons.

Recommendations

Among the recommendations in the report were to include and prioritise prison populations and staff in COVID-19 response plans; to publish accurate and updated data on vaccinations in prisons; and to provide adequate healthcare that is equal to that in the community, including vaccinations.

Read COVID-19 vaccinations for prison populations and staff: Report on global scan in full here.

Read IPRT’s response to the report here.