Thursday, December 10, 2020
PMT: The case for vaccinating those in prison (almost) first
Vaccines are about to be approved and distributed, just as the pandemic hits a new peak, with over 3,000 Americans dead of the coronavirus yesterday, a new high. And the debate over who should get a vaccine is raging.
Let's clarify one thing: no reasonable person seems to disagree that medical workers should be vaccinated first. And of course they should-- they are in direct contact with infected people, and at the greatest risk, PPE or no.
Beyond that, though, opinions diverge. Some think we should inoculate the elderly next, particularly those in congregate living situations like nursing homes. I agree with that. But on an equal level should be those in prison.
Here's why: like those in nursing homes, those in prison do not have the ability to control their environment- in fact, their inability to create social distance is probably even greater. And I have previously discussed the recurring tragedy of COVID in prisons, where waves of infection sweep quickly through the population, then spread to nearby areas.
I realize that some people oppose giving precious vaccines to those in prison because they are (mostly) guilty of crimes. But the punishment they are supposed to face at the hands of the state is a loss of freedom, not biological assault-- that would be torture. Those incarcerated people may deserve punishment, merit confinement, etc., but they are people deserving of human dignity and an approach as fellow citizens who almost all will return to life among the rest of us. Torture-- confining them as a pandemic threatens their lives-- is not supposed to be part of the deal.
Few states are likely to follow this protocol, though-- our ingrained ideas of those in prison as less than human are too strong. And that is a tragedy that will outlast the pandemic.
Comments:
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Thank you, Mark. As per your usual, you offer a reasonable and well-considered plan--which I am happy to endorse.
In general, I would like to distribute the vaccines with priority based solely on vulnerability. Some of us have a 1/100 chance of suffering harsh effects from the virus, some of us 1/1,000, some of us 1/100,000, and some of us are 50-50. I hope we have a plan (and I think we probably do) to get the vaccines out to our citizens (and non-citizens) most at risk. I have no problem with prioritizing medical workers and first responders (even to the extent that protocol violates my first principle of vulnerability), but they have earned that privileged status.
But, with that caveat, it will be important (vital to our success) to get my 78-year-old mom vaccinated right off (and her cohort). And people of all ages with contributing risk factors. At fifty-six and reasonably healthy, I am happy to wait until the vaccine comes around flu-vaccine-style to my office and I stand in line with my colleagues in some designated lecture hall in the spring or summer or even next fall. My 18 and 21 year-olds? Whenever. Initially, our national vaccine supply will be in the tens of millions. We ought to be wise in how we triage and distribute. And, by all means, let's make sure we don't discriminate based on incarceration or immigration status or any other arbitrary classification. Let's be smart about how we achieve herd immunity.
In general, I would like to distribute the vaccines with priority based solely on vulnerability. Some of us have a 1/100 chance of suffering harsh effects from the virus, some of us 1/1,000, some of us 1/100,000, and some of us are 50-50. I hope we have a plan (and I think we probably do) to get the vaccines out to our citizens (and non-citizens) most at risk. I have no problem with prioritizing medical workers and first responders (even to the extent that protocol violates my first principle of vulnerability), but they have earned that privileged status.
But, with that caveat, it will be important (vital to our success) to get my 78-year-old mom vaccinated right off (and her cohort). And people of all ages with contributing risk factors. At fifty-six and reasonably healthy, I am happy to wait until the vaccine comes around flu-vaccine-style to my office and I stand in line with my colleagues in some designated lecture hall in the spring or summer or even next fall. My 18 and 21 year-olds? Whenever. Initially, our national vaccine supply will be in the tens of millions. We ought to be wise in how we triage and distribute. And, by all means, let's make sure we don't discriminate based on incarceration or immigration status or any other arbitrary classification. Let's be smart about how we achieve herd immunity.
WF-- I agree with you on the priority for the most vulnerable. And I would personally administer the vaccine to my parents if necessary!
Ugh - I had a response typed on my phone and then I clicked the wrong button so I will begin again.
I definitely have thoughts on the priority and even used a NY Times interactive article the other day; state and county specific, which showed my husband eligible at 23,000 and me at 250,000 out of 330,000 residents in our county (age and covid comorbidity were factors). Obviously there are many more factors but it gave one a general idea of where they fall in the line. The result was not surprising and my county is chock full of medical workers, for both the Duke and UNC hospital systems, so I will be at the back of the line.
My Priority list:
Front line healthcare workers, emts, fire rescue, and hospital janitorial staffs are at the top of my list along with LT Care staff and Residents.
I feel that seniors over 'x' age (maybe 75) should be high up the list so they can stop living in too much isolation.
Grocery store workers, Public transportation and school bus drivers, people with multiple comorbidities, teachers, police.
Then within prison system suggest the newly incarcerated and those incarcerated who HAVE NOT already contracted COVID.**
For selfish reasons I feel people who have contracted COVID/tested positive should be at the bottom of the list unless they are experiencing diagnosed long haul issues. Donating convalescent plasma should boost them up the list.
Now my husband will be eligible well in front of me due to his non-Hodgkin's Lymphoma that caused chronic (although controlled) kidney disease. If his doctors for some reason feel he should not be vaccinated then I should be pushed up the list and vaccinated in his place so that his risk is decreased.
My Mom has a doctors appointment next week and I told her to ask him at what point she will be eligible for the vaccine. I would give it to my Mom as well.
*The new wrinkle I heard about this morning had to do with people who have severe allergic reactions requiring the use of Epi-pens may not be good candidates for one of the vaccines (but I need to read more).
** I realize the argument might be they are a captive audience and making sure they get both vaccines is pretty much assured but I feel even within the prison environment there should be some prioritization.
I definitely have thoughts on the priority and even used a NY Times interactive article the other day; state and county specific, which showed my husband eligible at 23,000 and me at 250,000 out of 330,000 residents in our county (age and covid comorbidity were factors). Obviously there are many more factors but it gave one a general idea of where they fall in the line. The result was not surprising and my county is chock full of medical workers, for both the Duke and UNC hospital systems, so I will be at the back of the line.
My Priority list:
Front line healthcare workers, emts, fire rescue, and hospital janitorial staffs are at the top of my list along with LT Care staff and Residents.
I feel that seniors over 'x' age (maybe 75) should be high up the list so they can stop living in too much isolation.
Grocery store workers, Public transportation and school bus drivers, people with multiple comorbidities, teachers, police.
Then within prison system suggest the newly incarcerated and those incarcerated who HAVE NOT already contracted COVID.**
For selfish reasons I feel people who have contracted COVID/tested positive should be at the bottom of the list unless they are experiencing diagnosed long haul issues. Donating convalescent plasma should boost them up the list.
Now my husband will be eligible well in front of me due to his non-Hodgkin's Lymphoma that caused chronic (although controlled) kidney disease. If his doctors for some reason feel he should not be vaccinated then I should be pushed up the list and vaccinated in his place so that his risk is decreased.
My Mom has a doctors appointment next week and I told her to ask him at what point she will be eligible for the vaccine. I would give it to my Mom as well.
*The new wrinkle I heard about this morning had to do with people who have severe allergic reactions requiring the use of Epi-pens may not be good candidates for one of the vaccines (but I need to read more).
** I realize the argument might be they are a captive audience and making sure they get both vaccines is pretty much assured but I feel even within the prison environment there should be some prioritization.
Christine-- I like that you listed hospital janitors... good catch! As a former janitor, I know how vulnerable they must be.
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