An Analysis of Interim COVID-19 Vaccination Plans

*Note: This post is regularly updated with the most current information by Forrest Behne.

Each U.S. state is developing programs to plan and operationalize a vaccination response to COVID-19 within their jurisdiction based on the Centers for Disease Control and Prevention (CDC) COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations, released October 29, 2020. States were tasked with developing a vaccine plan that includes three phases, ordered from highest to lowest priority, and ensuring equitable access for CDC defined “critical populations,” including (1) critical infrastructure workforce, (2) people at increased risk for severe COVID-19 illness, (3) people at increased risk of acquiring or transmitting COVID-19, and (4) people with limited access to routine vaccination services. 

CPP analyzed each of these plans to identify in which phase incarcerated people are targeted for COVID-19 vaccination. Thirty-four (34) States/Territories have, so far, included incarcerated populations as part of their Phase 1 vaccine distribution; of these 34 States/Territories, three (3) have specifically prioritized incarcerated populations that are medically vulnerable to COVID-19. These states are Arizona, South Dakota, and Utah. Medically vulnerable populations include incarcerated people that are over the age of 65 or have two or more chronic conditions. Four (4) states include incarcerated populations as part of their Phase 2 vaccine distribution. Tennessee and Missouri designate incarcerated populations for vaccination in phase 3 while correctional staff are targeted for Phase 1. We have categorized Montana as Phase 1 but must note that they organized their prioritization categories as tiers, making their plan more difficult to discern. Thirteen (13) states did not explicitly identify how they would prioritize incarcerated populations in the distribution of vaccines.

The image below shows how states have categorized incarcerated people into various phases for vaccine distribution. This analysis and figure are being updated as revisions to the states’ final plans occur. Vaccination plans may not be reflective of actual distribution. See our COVID-19 Vaccine Doses page for further details.

Prioritizing the COVID vaccine: Correctional Staff vs. Incarcerated people

CDC guidance states that incarcerated people and staff should be vaccinated in the same phase since both groups are at increased risk of contracting COVID-19. Despite this, almost all states/territories prioritize correctional staff over incarcerated people for vaccination.

We analyzed the most recent edition of each state’s vaccine distribution plan to compare the prioritization of correctional staff and incarcerated people. As indicated in the graphic below, there are significant discrepancies between these two groups. Incarcerated people are categorized in Phase 1 in only 48% of states, whereas staff are categorized in Phase 1 in 72% of states. Similarly, incarcerated populations are not categorized into in any phase in vaccination plans in 23% of states, whereas correctional staff are only left out of 14% of state vaccination plans.

For more insight into COVID-19 vaccinations in correctional facilities, check out our blog post about vaccination plans in each state and our vaccine dose tracker!

Updates to CPP’s Dataset

Currently, CPP publishes five primary variables to the public: incarcerated positive, incarcerated tested, incarcerated deaths, staff positive, and staff deaths. However, we have been collecting all data reported by state Department of Corrections (DOC) since April of 2020. This includes additional variables such as the number of incarcerated people who have recovered from COVID-19 and the number of current active cases of COVID-19. We have been in the process of thoroughly cleaning this larger dataset, addressing discrepancies in the data, and contacting DOC’s for clarification on variables they are reporting.

In preparation for the release of this important dataset, we wanted to share several disclaimers and provide links to documents that keep track of the definitions we are using and inconsistencies in reporting:

  1. We sometimes have to perform our own calculations for cumulative variables. For example, for some systems, we calculate positive cases by combining the number of reported active and recovered cases. Our data dictionary keeps a record of how each DOC defines these variables and how CPP defines these variables. The data dictionary also keeps track of any changes in data reporting and any facilities excluded by CPP (for example, parole facilities that do not house incarcerated people overnight).
  2. We also have a daily running data log that keeps track of data discrepancies and data entry errors when they arise. Any errors are rectified immediately and any changes in data reporting are recorded in our data dictionary.
  3. There have been several cases where cumulative data will decrease on the DOC’s website. When this occurs, we reach out to DOC’s for explanation. Sometimes, we get a response indicating that this change was due to a data entry error on their part or a change in how they are reporting a certain variable. Most of the time, we do not get a response and must leave the data as reported by each DOC.

We are looking forward to reaching this milestone for the Covid Prison Project! If you have any questions or comments about how we are recording and reporting our data, feel free to contact us at

MO: Changes in data reporting

On November 9th, Missouri stopped reporting deaths of incarcerated people and staff and the number of incarcerated people tested for COVID-19. On November 24th, CPP began reporting these variables as not reported (“NR”). On November 25th, Missouri resumed reporting of deaths but did not resume reporting the number of people tested. CPP reached out to Missouri’s DOC to understand why there was a change in data reporting and have not yet received a response.

CO: Changes in data reporting; count decrease

Colorado began reporting cumulative inmate positives and inmates tested under different variable names. With these changes, there was a significant decrease in the reported number of incarcerated people tested for COVID-19. CPP was told by a DOC representative that this decrease was due to changes in data reporting and that these values will likely continue to fluctuate until data has been merged to their new system.

Language Matters: Reporting COVID-19 in Prison Systems

CPP collects and analyzes data on five primary variables reported by 53 sources: each state prison system, ICE, the Federal Bureau of Prisons, and Puerto Rico. In an analysis of definitions available on each system’s website, discrepancies in language used to report COVID-related data were identified. Specifically, definitions of the number of people who are incarcerated who are tested for COVID-19 (“Inmates Tested”)  and positive cases in staff (“Staff Positive”) vary. These differences in terminology are important: reporting the number of tests given does not capture how many of them are re-tests of the same individual, due to either re-exposure to the virus or sentinel surveillance testing. 

Historically, CPP has defined “Inmates Tested” as the total number of incarcerated individuals in prisons who have received a COVID test. This was mostly the case early in the course of the pandemic wherein testing was slow to ramp up. However, more recently, as reductions in population have occurred and more robust testing efforts have been deployed, systems have begun defining their testing data disparately. Our team recently did a content analysis of reporting across all of the systems we are tracking. What we found is detailed here in Table 1. 

Definition of “Inmates Tested”Percentage  
Number of COVID tests given 23%
Number of people tested26%
Undefined 30%
Variable not reported by DOC 26%
Table 1. System Definitions of “Inmates Tested.” Note: Colorado, Vermont, and Washington report both the number of people tested and the number of tests given. 

Very few of the systems reporting data are providing information relevant to staff testing. Out of 53 systems, only 7 are reporting the number of staff that have been tested (defined by CPP as “Staff Tested”). Of these 7 systems, only 1 defines the variable as the number of DOC-administered tests to staff. For the remaining systems, 3 leave “staff tested” as undefined, and 3 specify that testing is self-reported by staff members. 

Systems should aim to be clear in how they define variables related to COVID-19 testing and cases, particularly when it comes to re-exposures and retesting incarcerated people and staff members. In light of these findings, CPP will begin to report two categories of data for relevant systems: both the number of people tested and the number of tests given. For more insight into how systems and CPP define these COVID-related variables, check out our “Data Dictionary” here. We continue to re-evaluate how these definitions differ between systems and what it means for the standardization of data on CPP’s platform.