Vaccinations in many American prisons, jails and detention centers are lagging far behind the United States as a whole, prompting public health officials to worry that these settings will remain fertile ground for frequent, fast-spreading coronavirus outbreaks for a long time to come.
Nationally, more than 61 percent of people ages 18 or older have received at least one dose of vaccine so far. But only about 40 percent of federal prison inmates, and half of those in the largest state prison systems, have done so. And in immigration detention centers, the figure is just 20 percent.
With the overall pace of vaccinations slowing in the United States — down to about 1.87 million doses a day on average, according to federal data — the Biden administration has been stepping up efforts to win over the hesitant and to reach people in underserved and vulnerable communities and those facing access issues.
Over the course of the pandemic, prison inmates have been more than three times as likely as other Americans to become infected with the virus, according to a New York Times database. The virus has killed prisoners at higher rates than the general population, the data shows, and at least 2,700 have died in custody.
No racial breakdown is available for coronavirus cases in prisons, but health officials say African-Americans are likely to be overrepresented, since they account for a much larger share of inmates (33 percent) than they do of the overall population (13 percent), and the pandemic has disproportionately hit Black Americans in general.
Black and Hispanic people across the United States have received a disproportionately smaller share of vaccinations to date, according to a New York Times analysis of state-reported race and ethnicity information, though some progress has been made.
High vaccination rates in another kind of high-risk setting, nursing homes, have greatly reduced the spread of the virus there. But unlike nursing home residents, prisoners were generally not a high priority for early vaccination. By April 19, the 50 states, the District of Columbia and Puerto Rico had expanded eligibility to all adults. Still, refusal rates in prisons have been high.
Many inmates say they mistrust both the vaccine and the prison authorities who try to persuade them to get inoculated. Beyond that, some prison vaccination efforts have been hampered by mistakes.
Prison officials in some states have tried offering inmates incentives to be vaccinated, including extra food — with varying degrees of success.
Jonathan Brooks, who is incarcerated at Wake Correctional Center in North Carolina, said incentives like free phone calls and approval priority for family visits were insulting.
“That’s something that we are required to have anyway — phone calls and receiving visits from our loved ones — so to actually recommend something like that to get us to take the vaccine, I feel like that’s really a slap in the face,” he said. Mr. Brooks said he did not intend to get the vaccine.
Prison guards have also tended to be skeptical about getting vaccinated. Colorado began offering correctional officers $500 bonuses to get inoculated.
A review of seven of the largest state prison systems found a wide range in vaccination rates. Pennsylvania has gotten at least one shot into 71 percent of inmates, while neighboring New York has managed just 35 percent. In California the figure is 68 percent; in Texas, 50 percent.
Michael Carvajal, director of the federal prison system, told the Senate Judiciary Committee in April that each of the system’s 126,000 inmates would have access to the vaccine by mid-May. But as of Thursday morning, only 40 percent of inmates and 50 percent of employees had been vaccinated.
Emily Wang, a professor at the Yale School of Medicine who studies prison health care, said it is often difficult to gauge prison vaccination rates with certainty because inmates are often transferred, and many state prison systems do not disclose vaccine rates at all.
“If the best estimates are 50 percent, I’ll bet it’s lower,” Dr. Wang said. “And we’re not close to the mark. There’s no question in my mind, this hasn’t gone well.”