Inmates need priority access to coronavirus vaccine, AMA says

The American Medical Association (AMA) has called for stronger disease mitigation measures at the nation’s correctional and immigrant detention facilities, and has called for correctional workers, incarcerated people and detained immigrants to be included in the initial phases of coronavirus vaccine distribution.

“Throughout the COVID-19 pandemic, we’ve seen the virus spread quickly in high-density populations, particularly in correctional facilities,” Ilse R. Levin, D.O., M.P.H., T.M., and AMA board member said, in a news release on Tuesday. “Because of the high risk of SARS-CoV-2 infection among people who are incarcerated and correctional and detention center workers, the AMA is advocating for increased infection control measures, additional PPE, and priority access to vaccines to prevent the spread of COVID-19. Being incarcerated or detained should not be synonymous with being left totally vulnerable to COVID-19. These steps are vital to protect people and stop the spread of the virus.”

The new policy calls for all correctional and immigrant detention facilities to implement coronavirus infection prevention and control guidance, provide access to personal protective equipment, testing kits, sanitize and disinfect equipment, and “ensure human, safe quarantine protocols for anyone testing positive for or exposed to SARS-CoV-2.”

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No decision has been made as to who will be the first to get the coronavirus vaccine once a candidate is approved by the FDA. The Centers for Disease Control and Prevention (CDC) is currently working to make recommendations on distribution based on input from the Advisory Committee on Immunization Practices (ACIP), a federal advisory committee made up of medical and public health experts.

The committee has set forth four groups to be considered for early vaccination, including health care personnel, workers in essential and critical industries, people at high risk for severe COVID-19 illness due to underlying medical conditions, and those 65 years and older.

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Essential critical infrastructure workers include those who work with communication, chemicals, critical manufacturing, dams, defense industrial base, emergency services, commercial facilities, financial, energy, food and agricultural, government facilities, nuclear reactors, materials and waste, information technology, water, transportations systems, and health care and public health.

The AMA calls for prisoners to be among early recipients of the vaccine is not unlike other so-called “tiered approach” distribution plans. One set forth by the U.S. National Academies of Sciences, Engineering and Medicine called for prisoners and people in homeless shelters to be included in “phase 3” of a five-phase plan for distribution, ranking after health care workers and first responders, and those with underlying health conditions that put them at risk for severe illness or death and older adults living in densely populated settings.

The AMA also further calls for the expanded data reporting to include testing rates and demographic breakdown for cases, and support for policies that facilitate compassionate releases. The group said it will work with “appropriate stakeholders” to develop criteria for compassionate releases.

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“Given that physicians are required to determine medical eligibility for potential candidates for compassionate release, it is vital that the criteria for eligibility is clear to physicians so they feel comfortable determining if someone meets the criteria without fear of liability,” Levin said.

According to the Federal Bureau of Prisons (BOP), there are currently 3,048 federal inmates and over 1,113 staff with confirmed COVID-19. Over 18,000 inmates and 1,677 staff have recovered from the virus, and the deaths of 141 federal inmates and two staff members have been attributed to the disease.  

Since late March, 17,332 inmates who have COVID-19 risk factors and were found to be eligible were placed on home confinement. Four of the inmate deaths occurred in the home confinement group.