The covid-19 vaccines and prisoners


As I expected, there has been some controversy about how to prioritize the order of who gets the vaccines. For example, health guidelines suggest that those who are for whatever reason forced to be in very confined spaces or have to deal with large numbers of people should get it even before older people like me who are low risk because we have little contact with people and have no complicating risk factors. That sounds reasonable enough but that list of people who should have higher priority includes prisoners because, for obvious reasons, prisons have been the source of some of the biggest outbreaks of covid-19 and those outbreaks have not stayed within their walls but have also spread to the nearby communities because prison employees and visitors go in and out of the place all the time, thus aiding the spread.

But of course, some have raised the cry that killers are getting the vaccine before grandma and this caused the governor of Colorado, for example, to intervene and change the guidelines put out by the CDC.

Speaking to reporters on Tuesday, Gov. Jared Polis forcefully denied criticism that Colorado’s plan for prioritizing allocation of coronavirus vaccines will place incarcerated individuals ahead of healthy older Coloradans.

“That won’t happen,” Polis said. “There’s no way that prisoners are going to get it before members of a vulnerable population . … There’s no way it’s going to go to prisoners before it goes to people who haven’t committed any crime. That’s obvious. So those are just false.”

But the draft plan for prioritizing vaccine allocation that the state sent to the federal Centers for Disease Control and Prevention in October specifically places people in prisons and jails in a higher priority tier than healthy adults who are age 65 or older.

The draft plan includes inmates with other people who live in congregate housing situations, such as college students living in dorm rooms or seasonal workers at ski areas. People living in those situations are considered to be vulnerable not because they may suffer severe complications from a coronavirus infection but because they are less able to socially distance. That puts them at greater risk of a disease outbreak that could spread into the broader community.

People seem to think that just because people are in prison, they cease to be human beings, even if they are there for non-violent victimless offenses such as personal drug possession. People don’t seem to understand that the more we stop infection transmissions, which means targeting those places where they are most likely to spread, the safer all of us become.

There are other issues on the horizon that have to be dealt with. While it is all well and good to define categories of people in the priority list, the success of the program will depend largely on the honor system. If it is said, for example, that people with complicating health factors should get the vaccine before those who do not have them, will there be people who falsely claim that they have (say) diabetes in order to cut in line? It would be onerous to force people to provide documentation when the goal is to vaccinate as many people as quickly as possible.

“I haven’t seen anything that’s going to say, ‘We’re going to stop people from gaming the system,’” said Jen Kates, a senior vice president at the Kaiser Family Foundation, who said the state vaccination plans she’s reviewed have had no language on requiring patients to provide proof of residency, which would prevent people from hopping to another state with more available vaccine to try and get a shot.

The loose controls threaten to continue the pattern of inequities seen throughout the pandemic. In the spring and summer, many waited in line for hours to have their noses swabbed while professional athletes were getting tested multiple times a week and concierge medical practices were supplying tests to celebrities.

“If a person presents at one of our health departments and says they have diabetes, we won’t ask for a note from their doctor or a list of their medications,” said Dr. Karen Landers, a medical officer at the Alabama Department of Public Health. “They have a reason for being there, and it’s a matter of trying to get a vaccine out in the most efficient way possible.”

It would be nice to think that people would respect the honor system but given what I see these days on the state of civic mindedness in this country, I am not hopeful. The best we may be able to hope for is if there are no brawls, like those seen on Black Friday shopping days, among people in line for the vaccines at pharmacies.

One group that we do not have to worry about cutting in line are the determined anti-vaxxers who are apparently flooding social media with misinformation and coaching people on how to refuse to take the vaccine, which seems a bit pointless since there are no plans to force people to do so.

They begin by warning people that they should not outright refuse the vaccine, “otherwise you will be considered belligerent. Instead, you can politely decline the service.”

To decline the vaccine, the posts recommend two methods. First, it says people should ask: “Does the vaccine have MRC-5 in it? (THEY ALL DO).”

MRC-5 is a cell-line originally taken from the lung tissue of an aborted human fetus in the 1960s, but it wasn’t used in the development or production of the COVID-19 vaccines. Instead, pharmaceutical companies uses a different cell-line — called HEK-293 and originally cultivated from an aborted fetus in the Netherlands in 1973 — during the vaccine’s development, but those cells are not contained in the final product.

If that doesn’t work, the anti-vaxxers suggest people should ask: “Is there a possibility of an “IATROGENIC REACTION?”

This refers to an adverse reaction caused by any number of drugs, including paracetamol. Health care professionals administering the vaccine typically assess the risk involved in each case based on medical history and any adverse reactions a patient might have to other medicine. 

Concerns about this highly tenuous connection to the HEK-293 cell line was what caused the Catholic Church to step in and tell people to not worry about the abortion connection and just take the damn vaccine.

Comments

  1. Who Cares says

    People don’t seem to understand that the more we stop infection transmissions, which means targeting those places where they are most likely to spread, the safer all of us become.

    This is not limited to people agitating against use in prisons.
    The administrators of the hospital of Standford University ran a basic algorithm to prioritize who needs the vaccine first, result the old people and not the ones at the bedside of patients got it first. They found out and said though luck, despite protests against it, until they got publicly shamed in major newspapers like the Washington Post.

  2. Just an Organic Regular Expression says

    You might want to make a post about this one:

    https://www.sfchronicle.com/health/article/Stanford-doctors-protest-vaccine-plan-saying-15814502.php

    At world-renowned Stanford Medical Center, the initial roll-out of vaccines skipped over front-line residents and nurses. That produced a vigorous protest. The protest and news coverage produced an almost immediate, and quite thorough, apology with a promise to do unspecified things to fix it.

  3. Pierce R. Butler says

    Interesting but not surprising how the anti-vaxxers don’t bother to distinguish between the Pfizer and Moderna vaccines, or any of the others likely to go into distribution soon.

    Health care professionals administering the vaccine typically assess the risk involved in each case based on medical history …

    Not when doing a mass “everybody get in line and roll up your sleeve, please!” group inoculation.

    If negative reactions show up, having health-care providers and nursing home residents as the initial test populations will at least facilitate rapid identification of symptoms and vulnerable groups.

  4. billseymour says

    Marcus Ranum @4:  I so want to agree with you, but I think that there’s a rational argument that the government needs to keep governing (maybe not a great argument, but at least a rational one).

  5. says

    “People seem to think that just because people are in prison, they cease to be human beings, even if they are there for non-violent victimless offenses such as personal drug possession.”

    They also assume that everyone in prison has actually committed crimes. If they had even a passing knowledge of the “justice” system they’d know this to not be true.

  6. Ridana says

    5) @billseymour: I think that there’s a rational argument that the government needs to keep governing

    Exactly. Which is why Republicans should be last in line, so the government can start functioning again.

    Unfortunately, even leaving them unvaccinated would not help, as it has been empirically shown that being pure evil at one’s core is the most effective protection against the virus.

  7. prl says

    Intransitive @11: That’s complicated by the fact that many richer countries, like here in Australia, have pre-orders for many more vaccines than they can reasonably use, and in the end, those orders won’t be taken up in their entirety, and so presumably will become available for others to use.

    Australia (pop ~25.7 million) will need about 53 million doses (for two-dose vaccines), but has supply agreements for many more:
    Oxford/AstraZeneca: 53.8 million doses (3.8 million purchased from overseas, 30 million manufactured here)
    Novax: 51 million doses
    Pfizer/BioNTech: 10 million doses

    I’d expect that more than half of the vaccine doses covered by those supply agreements will in fact be available for distribution elsewhere.

    As in Canada, provision of the Covid-19 vaccine will publicly funded and at no direct cost to recipients.

    More on topic, Australia groups “people in … correctional and detention facilities” are in the same larger priority group as others “at an increased risk of exposure, infection and transmission of COVID-19, or are in a setting with high transmission potential.” That larger group includes health and aged care workers.

    But vaccine distribution isn’t scheduled to start in Australia until March. There were 40 new cases nationally reported today, so the level of urgency isn’t as high as in many other places. When the rollout starts, there may be more controversy about the order of the rollout.

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