LEXINGTON, Ky. — Phase 1 of COVID-19 vaccines are now being administered to people the most at-risk, such as front-line health care workers and residents of long-term care facilities. While others wait to receive the vaccine, experts are recommending to continue wearing a mask and social distancing. But what about people in close quarters who can’t social distance, such as inmates and staff at Kentucky’s jails and prisons? 

Inmates in Kentucky may not be included in Phase 2 of the vaccination rollout, either, but there is a push to have “essential workers,” which includes jail and prison employees, included in Phase 2. When inmates in Kentucky will be vaccinated remains unknown, and there seems to be some controversy surrounding that issue in many states as groups such as The Marshall Project and the Covid Prison Project push for prison and jail populations to be considered critical. Six states have included incarcerated people in the first phase of their vaccine rollout plans. 

The Advisory Committee on Immunization Practices (ACIP) guidelines were made available to states and territories Sunday, Dec. 20, and Susan Dunlap at the Kentucky Cabinet for Health and Family Services said information specific to inmates in congregate settings is not yet known. 

There has been a total of 3,430 positive inmate cases in Kentucky Department of Corrections prisons and there are 560 active cases as of Friday, Dec. 19. There has been a total of 502 employees test positive and there 61 active cases. Visitation and volunteer activities at all facilities are suspended until further notice. 

Lexington Community Corrections Public Information Officer Lt. Matthew LeMonds said neither the pre-trial detainees being housed at the Lexington-Fayette County Detention Center nor employees can be forced to receive the vaccine without judicial orders, a route he admitted is not likely to be taken, but everyone is being encouraged to participate when the time comes. 

“We’re kind of doing the, ‘Hey, let's get everybody on board’ method to get as many people to take the vaccine that wants to take it,” he said. “We had a similar thing a few years back with Hepatitis A; when that was going around our population was especially vulnerable. But we had a really good turnout as far as the number of inmates that wanted to get the vaccine were able to get the vaccine administered by the health department. A big thing for the inmate population is getting some education out there – especially targeting those that we might have that are more vulnerable – to make sure they have all the information they need to decide if they want to take it.”

LeMonds said COVID-19 outbreaks are prone to “sneak up” on a jail population. 

“A lot of the cases we have had are asymptomatic, so it's not like they see it coming,” he said. “If there was a disease that as soon as you got it your nose turned really red, well, then we could see who to isolate from, whereas most of our cases have been people that are asymptomatic. We have some people get it that are more susceptible and have a stronger reaction to it, just like anywhere else.”

There are currently 13 positive cases among the 955 pre-trial detainees at the Lexington-Fayette County Detention Center, down from a high of 400 cases in mid-November.

“We keep inmates in groups based on their booking date and we keep them isolated with that group for 14 days through that initial quarantine period,” LeMonds said. “If we notice anything we can kind of keep it consolidated. What happened in November is a few people got through that and weren't really showing symptoms until later and it mirrored the surge that there's been in the community. But we're very fortunate that right now to have only 13 actively positive cases.”

A push is on to urge states to move workers and prisoners in jails and prisons toward the front of the vaccine lines. More than 40 draft proposals analyzed by the Covid Prison Project and The Marshall Project show that in at least six states, incarcerated people will be among the “phase one” recipients of the vaccine, along with medical personnel and essential workers. In many more states, they are slated to receive the vaccine during phase two as members of “critical populations.” 

On the federal level, according to documents obtained by The Associated Press, officials at the Bureau of Prisons said doses that are sent to federal penitentiaries “will be reserved for staff.” AP says 10 times more prisoners have tested positive for COVID-19 than prison workers (18,467 inmates and 1,736 Bureau of Prisons staff members). At least 141 federal prisoners and two staff members have died from COVID-19. 

American Medical Association (AMA) President Dr. Susan Bailey said vaccinating inmates is a “very important question to consider,” adding the ACIP guidelines are guidelines, not binding rules.

“As the vaccine supply increases, that's going to be less of an issue,” she said. “But there has been a lot of discussion about the need for vaccination in the incarcerated population. “It is very, very important for prison populations to receive immunizations because their risk of contracting the disease is so high because of their living situation – we just don't know yet where that's going to fall on the priority list. There are lots of questions to be asked about prison populations, about teachers, about other types of people that aren't necessarily essential – spouses of people that are on the list – the questions go on and on. But most medical authorities agree that the prison population is a very important one that they consider.”

More than 60 prison staff are infected in Kentucky and at least three have died. Of the more than 400 inmates infected, 28 have died. Those numbers do not include the thousands who are in county jails.