As new outbreaks of COVID-19 driven by the more contagious Delta variant ravage undervaccinated pockets of the country, low rates of immunization in Pennsylvania prisons leave them vulnerable to a resurgence. We recently completed another survey of county jails and found that the number of people in custody and staff who have been vaccinated remains troublingly low. That makes it even more important that counties renew their efforts to reduce their jail populations in order to give them greater protection against outbreaks.

Vaccination rates remain low in county jails

While we can now confirm that over two-thirds of Pennsylvania county jails have provided COVID-19 vaccinations to incarcerated people, there are still 18 counties where vaccine access is uncertain. At least one county, McKean, was still not offering vaccinations as of last week. The Prison Society’s interactive map shows which counties have made vaccines available to date.

In jails that have offered the shots, vaccination rates are typically low. The frequent turnover of the jail population makes it difficult to measure the exact rate at any given moment, but in the 15 jails that provided us with data in this round of surveys, the median vaccination rate for incarcerated people was 28%. Only five counties provided data on staff vaccinations, which showed a median rate of 43%.

Meanwhile, new coronavirus infections have tripled in the United States over the past month in what the CDC is calling a “pandemic of the unvaccinated.” In Pennsylvania, the daily number of new cases remains relatively low but has doubled in the past two weeks. The CDC also reported this week that the highly contagious Delta variant is now the dominant strain of the virus, exacerbating outbreaks that are rampant in areas of the country with poor vaccination coverage. ICE detention centers are one of the areas suffering from the surge, showing how easily the virus can still spread in prisons with low vaccination rates. Since just April, 7,500 ICE detainees have become infected with the coronavirus. During this surge, only about 20% of ICE detainees were vaccinated.

Vaccinations alone won’t be enough to stop prison outbreaks

The “triple threat” of low vaccination rates, the rise of the Delta variant, and people living in close proximity leaves prisons especially vulnerable to future outbreaks, according to Salmaan Keshavjee, a professor of global health and social medicine at Harvard Medical School. Vaccination rates in Pennsylvania’s jails would need to be far higher to prevent an infected person from spreading the coronavirus to others and stop an outbreak in its tracks, Keshavjee says. But because the virus spreads so rapidly in a prison environment, simply increasing vaccination rates won’t be enough.

In an article published in the New England Journal of Medicine, Keshavjee and his colleagues explain that prisons and jails also need to continue to focus on decarceration as a strategy to protect themselves from further outbreaks. The authors point to a study that found that the coronavirus spreads faster in an urban jail than any other environment that has been studied, which they attribute to factors like “rampant overcrowding, inadequate testing and health care,” and “high-volume daily inflow and outflow of staff and detainees.” Keshavjee says that the rapid transmission behind bars means that vaccines need to be both highly effective and widely utilized to stop outbreaks from taking hold. But the Delta variant has made vaccines somewhat less effective, and vaccination rates aren’t anywhere near what they would need to be.

"You then have to think of what else can we do to bring down transmission,” Keshavjee says. “You can move people further apart."

Reducing the incarcerated population creates space for more social distancing that helps to slow down the spread of the virus.

The Prison Society calls on all state and county officials to:

• Redouble efforts to offer COVID-19 vaccinations to all people in custody and staff in prisons and jails, and
• Expand efforts to safely reduce the number of people in custody.

In addition, we continue to call on all state and county officials to:

• Implement weekly, rapid testing of all staff that come into contact with people in custody until they are vaccinated;    
• Require that every county publicly report prison testing results and virus-related deaths in custody; and
• Test and quarantine every new person entering custody.

‍