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.

Reported COVID Vaccinations by State: May 7, 2021

There have been many continued calls to prioritize COVID-19 vaccinations among incarcerated populations given their high and disproportionate risk of COVID-19 infection and death. Additionally, all adults 16+ are now eligible for COVID-19 vaccinations in the United States. Despite this, few systems are reporting vaccination data and the majority of systems reporting data have vaccinated their incarcerated population at a lower rate than the general population.

As of May 7, 2021, 23 states (AK, AL, AZ, CA, CO, CT, DE, GA, ID, MA, MD, ME, MN, MO, NC, NH, NJ, TN, UT, VA, WA, WI, WV) have reported vaccination numbers for their incarcerated population. In the past week, ME and NJ have begun reporting vaccination numbers for their incarcerated populations. Among states reporting data, 46% of the general population has received at least one dose of a COVID-19 vaccine (similar to the national average of 45%) and 50% of incarcerated populations have received at least one dose of a COVID-19 vaccine. However, these percentages vary drastically by state. The percent of the population that has received at least one vaccine in prisons ranges from 6% in MN to 94% in ID. In over half of the states reporting data (AL, CT, MD, ME, MN, MO, NC, NH, NJ, UT, WA, WI) the vaccination rate in the general population exceeds that of the prison population. Similar to last week, MN has still only vaccinated its incarcerated population at one-tenth the rate of its general population while AL and NC have vaccinated their incarcerated populations at less than half the rate of the general population. In GA, MA, and NH, the vaccination rates are similar between the general and prison populations. AK, AZ, CA, CO, DE, GA, ID, MA, TN, VA, and WV have vaccinated their incarcerated populations at a higher rate than the general population with ID having vaccinated their incarcerated population at over twice the rate of their general population. ID has vaccinated 94% of its incarcerated population and 35% of its general population.

We report the share of the total population that has received at least one vaccine dose. While an important public health metric, this does not equal the share that are fully vaccinated if the vaccine requires two doses. As states vary in the type of vaccines administered in prisons, the rate of the incarcerated population that is fully vaccinated varies across states. It is also possible that states’ rate of full vaccination varies between their general and incarcerated populations.

Another important aspect of vaccinations is the prioritization of vaccinations in prisons, which varies widely by state. However, as all adults are now eligible for COVID-19 vaccinations in the United States, vaccines should be available for all incarcerated persons despite their state’s prioritization of them.

Lastly, vaccine hesitancy and the speed of vaccination distribution within carceral settings deserve attention. Staff members in prisons have reported high vaccine hesitancy. Additionally, structural racism and the historically unethical treatment of incarcerated persons by our nation’s public health and medical systems contribute to incarcerated individuals being wary of the vaccine. This concern has increased as some incarcerated individuals have been given overdose amounts of the vaccine by staff, some were denied any COVID-19 vaccine during the Johnson & Johnson pause, others were given expired COVID-19 vaccines, and there are reports of incarcerated persons not receiving incentives they were promised for taking the vaccine (e.g., free phone calls).

As COVID-19 spreads particularly rapidly in congregate settings, it is crucial that all incarcerated persons are offered the COVID-19 vaccine. Critically, herd immunity is based on how contagious a disease is, making it likely that the relationship between COVID-19 vaccination rates and slowing case rates looks differently in carceral settings than in the general population with more incarcerated persons needing to be vaccinated to slow the spread. It is also important that these data are transparently reported on public systems. It is only through these data that we can comprehensively understand the progress of the COVID-19 pandemic and the role that vaccinations are playing within carceral settings.

All data reported here comes from official dashboards reported by Departments of Correction. All data was pulled from state dashboards on May 7th. We do not publish data from the Federal Bureau of Prisons here as it is unclear if they are reporting the population that is fully vaccinated as opposed to having received at least one dose. Additionally, there is no relevant general population to compare the Federal Bureau of Prisons to. The COVID Prison Project also analyzes media reports to track vaccination plans for states that are not reporting public vaccination counts.

Our team previously had an error in reporting vaccinations given to the incarcerated population in MA in previous posts. We have since correct the error. 60% of MA’s incarcerated population have received at least one dose of a COVID-19 vaccine as of May 7th.

Reported COVID Vaccinations by State: April 30, 2021

There have been many continued calls to prioritize COVID-19 vaccinations among incarcerated populations given their high and disproportionate risk of COVID-19 infection and death. Additionally, all adults 16+ are now eligible for COVID-19 vaccinations in the United States. Despite this, few systems are reporting vaccination data and the majority of systems reporting data have vaccinated their incarcerated population at a lower rate than the general population.

As of April 30, 2021, 21 states (AK, AL, AZ, CA, CO, CT, DE, GA, ID, MA, MD, MN, MO, NC, NH, TN, UT, VA, WA, WI, WV) have reported vaccination numbers for their incarcerated population. In the past week, GA and UT have begun reporting vaccination numbers for their incarcerated populations. The rate that has received at least one vaccine in prisons ranges from 6,281 per 100,000 (6%) in MN to 81,524 per 100,000 (82%) in ID. In 12 of the states reporting data (AL, CT, GA, MD, MN, MO, NC, NH, UT, WA, WI, WV) the vaccination rate in the general population exceeds that of the prison population. MN has vaccinated its incarcerated population at one-tenth the rate of its general population. AL and NC have vaccinated their incarcerated populations at less than half the rate of the general population. In WV, the vaccination rates are similar between the general and prison populations. However, AK, AZ, CA, CO, DE, ID, MA, TN, and VA have vaccinated their incarcerated populations at a higher rate than the general population with ID having vaccinated their incarcerated population at over twice the rate of their general population. ID has vaccinated 82% of its incarcerated population and 34% of its general population.

We report the share of the total population that has received at least one vaccine dose. While an important public health metric, this does not equal the share that are fully vaccinated if the vaccine requires two doses. As states vary in the type of vaccines administered in prisons, the rate of the incarcerated population that is fully vaccinated varies across states. It is also possible that states’ rate of full vaccination varies between their general and incarcerated populations.

Another important aspect of vaccinations is the prioritization of vaccinations in prisons, which varies widely by state. Twelve states reporting vaccination data (AK, AL, CA, CT, DE, MA, MD, MN, NC, VA, WA, WI) have prioritized incarcerated populations in Phase 1 and AZ and UT prioritized medically vulnerable incarcerated persons in Phase 1. However, as all adults are now eligible for COVID-19 vaccinations in the United States, vaccines should be available for all incarcerated persons despite their state’s prioritization of them.

Lastly, vaccine hesitancy and the speed of vaccination distribution within carceral settings deserve attention. Staff members in prisons have reported high vaccine hesitancy. Additionally, structural racism and the historically unethical treatment of incarcerated persons by our nation’s public health and medical systems contribute to incarcerated individuals being wary of the vaccine. This concern has increased as some incarcerated individuals have been given overdose amounts of the vaccine by staff and others were denied any COVID-19 vaccine during the Johnson & Johnson pause.

All data reported here comes from official dashboards reported by Departments of Correction. All data was pulled from state dashboards on April 30th. We do not publish data from the Federal Bureau of Prisons here as it is unclear if they are reporting the population that is fully vaccinated as opposed to having received at least one dose. Additionally, there is no relevant general population to compare the Federal Bureau of Prisons to. The COVID Prison Project also analyzes media reports to track vaccination plans for states that are not reporting public vaccination counts.

Reported COVID Vaccinations by State: April 23, 2021

There have been many continued calls to prioritize COVID-19 vaccinations among incarcerated populations given their high and disproportionate risk of COVID-19 infection and death. Despite this, few systems are reporting vaccination data and the majority of systems reporting data have vaccinated their incarcerated population at a far lower rate than the general population. Additionally, the recent halt of the Johnson & Johnson vaccine reportedly led to some prison systems stopping vaccinations entirely. Over the weekend, multiple prison systems announced that they will resume administrating the Johnson & Johnson vaccine now that the United States regulatory agencies have lifted its pause.

As of April 23, 2021, 19 states (AK, AL, AZ, CA, CO, CT, DE, ID, MA, MD, MN, MO, NC, NH, TN, VA, WA, WI, WV) have reported vaccination numbers for their incarcerated population. In the past week, AZ, WA, and WV have begun reporting vaccination numbers for their incarcerated populations. The rate that has received at least one vaccine in prisons ranges from 4,969 per 100,000 (5%) in MN to 73,712 per 100,000 (74%) in CO. In 11 of the states reporting data (AL, CT, ID, MD, MN, MO, NC, NH, WA, WI, WV) the vaccination rate in the general population exceeds that of the prison population. MN has vaccinated its incarcerated population at one-tenth the rate of its general population. AL, MO, NH, and WI have vaccinated their incarcerated populations at less than half the rate of the general population. In ID and CT, the vaccination rates are similar between the general and prison populations. However, AK, AZ, CA, CO, DE, TN, MA, and VA have vaccinated their incarcerated populations at a higher rate than the general population with CO having vaccinated their incarcerated population at 1.67 times the rate of their general population. CO has vaccinated 74% of its incarcerated population and 44% of its general population.

We report the share of the total population that has received at least one vaccine dose. While an important public health metric, this does not equal the share that are fully vaccinated if the vaccine requires two doses. As states vary in the type of vaccines administered in prisons, the rate of the incarcerated population that is fully vaccinated varies across states. It is also possible that states’ rate of full vaccination varies between their general and incarcerated populations.

Another important aspect of vaccinations is the prioritization of vaccinations in prisons, which varies widely by state. Twelve states reporting vaccination data (AK, AL, CA, CT, DE, MA, MD, MN, NC, VA, WA, WI) have prioritized incarcerated populations in Phase 1 and AZ prioritized medically vulnerable incarcerated persons in Phase 1.

Lastly, vaccine hesitancy and the speed of vaccination distribution within carceral settings deserve attention. Staff members in prisons have reported high vaccine hesitancy. Additionally, structural racism and the historically unethical treatment of incarcerated persons by our nation’s public health and medical systems contribute to incarcerated individuals being wary of the vaccine. This concern has increased as some incarcerated individuals have been given overdose amounts of the vaccine by staff and others have been denied any COVID-19 vaccine during the Johnson & Johnson pause.

All data reported here comes from official dashboards reported by Departments of Correction. All data was pulled from state dashboards on April 23rd. We do not publish data from the Federal Bureau of Prisons here as it is unclear if they are reporting the population that is fully vaccinated as opposed to having received at least one dose. Additionally, there is no relevant general population to compare the Federal Bureau of Prisons to. The COVID Prison Project also analyzes media reports to track vaccination plans for states that are not reporting public vaccination counts.

Communication of COVID-19 related policies in February 2021

The COVID Prison Project continues to track and grade how effectively different systems have utilized their Department of Corrections (DOC) website and social media to communicate their COVID-19 policies to the general populace. Due to the rapid developments concerning COVID-19, it is crucial that systems continue to evaluate and communicate their policies promptly. Clear and frequent communication allows us to better understand the conditions that people who are incarcerated, staff and others who are in frequent contact with these systems, are experiencing. 

In the month of February, all 53 systems continued to provide COVID-19 related information on their DOC website. In comparison to January, there was a decrease in the percentage of policy reporting on Facebook, but an increase in the usage of Instagram. The percentage of policy reporting through Twitter and Youtube remained the same. 

Other Key Findings:

  • Several systems posted about vaccinations. Most notably, Arkansas, Tennessee, and Ohio all shared multiple photos and videos of their staff receiving vaccines or why they received one. 
  • ICE, the Federal BOP, Nevada and Wyoming all received a score of 1 meaning they only provided information through their official website.
  • Both California and Tennessee earned a full score of 6.3, communicating policy related information about their system and P&P through their DOC website as well as all their social media platforms.

Reported COVID Vaccinations by State: April 15, 2021

There have been many continued calls to prioritize COVID-19 vaccinations among incarcerated populations given their high and disproportionate risk of COVID-19 infection and death. Despite this, few systems are reporting vaccination data and the majority of systems reporting data have vaccinated their incarcerated population at a far lower rate than the general population. Additionally, the recent pause of the Johnson & Johnson vaccine has led to some prison systems pausing vaccinations entirely.

As of April 15, 2021, 15 states (AK, AL, CA, CO, CT, DE, ID, MA, MD, NC, NH, TN, VA, WI) had reported vaccination numbers for their incarcerated population. Alabama began reporting vaccination numbers since our last post. The rate that has received at least one vaccine in prisons ranges from 6,666 per 100,000 (7%) in AL to 72,437 per 100,000 (72%) in CO. In five of the states reporting data (AL, ID, MD, NH, WI) the vaccination rate in the general population exceeds that of the prison population. AL and WI have vaccinated their incarcerated population at less than 0.20 times the rate of their general population. Similarly, ID and NH have vaccinated their incarcerated population at around 0.40 times the rate of the general population and MD at around half the rate of the general population. In NC and MN, the vaccination rates are the same between the general and prison populations with NC having vaccinated 35% and MN having vaccinated 41% of both populations. However, AK, CT, CA, CO, DE, TN, MA, and VA have vaccinated their incarcerated populations at a higher rate than the general population with CO having vaccinated their incarcerated population at 1.80 times the rate of their general population. CO has vaccinated 72% of its incarcerated population and 40% of its general population.

We report the share of the total population that has received at least one vaccine dose. While an important public health metric, this does not equal the share that are fully vaccinated if the vaccine requires two doses. As states vary in the type of vaccines administered in prisons, the rate of the incarcerated population that is fully vaccinated varies across states. It is also possible that states’ rate of full vaccination varies between their general and incarcerated populations.

Another important aspect of vaccinations is the prioritization of vaccinations in prisons, which varies widely by state. Eleven states reporting vaccination data (AK, AL, CA, CT, DE, MA, MD, MN, NC, VA, WI) now prioritize incarcerated populations in Phase 1 whereas the remaining states either have not include incarcerated populations in their vaccination plans or have included them at the lowest priority.

Lastly, vaccine hesitancy and the speed of vaccination distribution within carceral settings deserve attention. Staff members in prisons have reported high vaccine hesitancy. Additionally, structural racism and the historically unethical treatment of incarcerated persons by our nation’s public health and medical systems contribute to vaccine hesitancy among incarcerated individuals.

All data reported here comes from official dashboards reported by Departments of Correction. All data was pulled from state dashboards on April 15th except for Idaho, which was most recently pulled from the state dashboard on April 14th. Since our last post, in addition to updating the number of incarcerated individuals that have received vaccinations, we have updated our prison population counts for all states, which affects the rates and percentages of vaccination. Moving forward, we will use updated population data published by state systems. We do not publish data from the Federal Bureau of Prisons here as 1) it is unclear if they are reporting the population that is fully vaccinated as opposed to having received at least one dose 2) there is no relevant general population to compare this population to and 3) further inconsistencies have shown this to be a datasource of uncertain reliability. The COVID Prison Project also analyzes media reports to track vaccination plans for states that are not reporting public vaccination counts.

Reported COVID Vaccinations by State: April 5, 2021

There have been many calls to prioritize COVID-19 vaccinations among incarcerated populations given their high and disproportionate risk of COVID-19 infection and death. Despite this, few systems are reporting vaccination data and the majority of systems reporting data have vaccinated their incarcerated population at a far lower rate than the general population. Critically, vaccination is not a panacea in carceral settings given, among other things, COVID-19’s high reproduction number in these settings. Prisons and jails must prioritize COVID-19 vaccinations alongside social distancing measures and decarceration.

As of April 5, 2021, 14 states (AK, CA, CO, CT, DE, ID, MA, MD, NC, NH, TN, VA, WI) had reported vaccination numbers for their incarcerated population, which are illustrated below. The rate that has received at least one vaccine in prisons ranges from 2,998 per 100,000 (3%) in WI to 59,925 per 100,000 (60%) in MA. In nine of the states reporting data (CT, DE, ID, MD, MN, NC, NH, TN, WI) the vaccination rate in the general population exceeds that of the prison population. ID, MD, NC, and WI have vaccinated their incarcerated population at less than 0.15 times the rate of their general population. Similarly, DE and NH have vaccinated their incarcerated population around 0.35 times the rate of the general population. However, AK, CA, CO, MA, and VA have vaccinated their incarcerated populations at a higher rate than the general population with AK having vaccinated their incarcerated population at 1.69 times the rate of their general population. AK has vaccinated 60% of its incarcerated population and 35% of its general population.

We report the share of the total population that has received at least one vaccine dose. While an important public health metric, this does not equal the share that are fully vaccinated if the vaccine requires two doses. As states vary in the type of vaccines administered in prisons, the rate of the incarcerated population that is fully vaccinated varies across states. It is also possible that states’ rate of full vaccination varies between their general and incarcerated populations.

Another important aspect of vaccinations is the prioritization of vaccinations in prisons, which varies widely by state. Seven states reporting vaccination data (AK, CT, DE, MA, MD, NC, VA) prioritized incarcerated populations in Phase 1 whereas the remaining three states (CO, ID, NH) did not include incarcerated populations in their vaccination plans. The four states reporting a higher rate of vaccination among incarcerated than general populations all prioritized incarcerated populations in Phase 1.

Lastly, vaccine hesitancy and the speed of vaccination distribution within carceral settings deserve attention. Staff members in prisons have reported high vaccine hesitancy. Additionally, structural racism and the historically unethical treatment of incarcerated persons by our nation’s public health and medical systems contribute to vaccine hesitancy among incarcerated individuals.

All data reported here comes from official dashboards reported by Departments of Correction. The COVID Prison Project also analyzes media reports to track vaccination plans for states that are not reporting public vaccination counts. Both data sets are available through our website, here.

COVID-19 Case Watch

This graph shows confirmed positive cases of COVID-19 per 1,000 individuals in the prison and general populations in each state as of March 11, 2021. The left side (orange) refers to the prison population and the right side (blue) refers to the general population.

The rate of COVID in the general population is 87.33 per 1,000 individuals. In the prison population, the rate is 277.35 per 1,000 individuals. On average, the rate of COVID infections in prison populations remains over 3 times the rate of COVID infections in the general population. 

In 47 of the 50 US states, the burden of COVID among those imprisoned still exceeds that in the general population. In the last week, the largest increase in prison population case rates in the last week occurred in Vermont. While 218 of Vermont’s 1,369 incarcerated people had received a positive COVID test by last week, 236 had received a positive test by today. The highest case rate in the state prison systems remains in Michigan with 25,459 of its incarcerated population (688.45 per 1,000) having tested positive for COVID. Over half of the state’s prison population has tested positive for COVID in Alaska, Arkansas, Iowa, Kansas, Michigan, and South Dakota. 

Importantly, states have varying testing strategies within prisons and for their general population, indicating that these rates likely reflect a falsely low disease incidence with some states’ rates being more accurate than others.

COVID-19 Case Watch March 4, 2021

This graph shows confirmed positive cases of COVID-19 per 1,000 individuals in the prison and general populations in each state as of March 4, 2021. The left side (orange) refers to the prison population and the right side (blue) refers to the general population.

The rate of COVID in the general population is 86.81 per 1,000 individuals. In the prison population, the rate is 275.95 per 1,000 individuals. On average, the rate of COVID infections in prison populations remains over 3 times the rate of COVID infections in the general population. Hawaii and Michigan continue to have prison infection rates that are over 10 times that of the state general population. 

In 47 of the 50 US states, the burden of COVID among those imprisoned still exceeds that in the general population. In the last week, the largest increases in prison population case rates in the last week occurred in Montana and Vermont. While 90 of Vermont’s 1,369 incarcerated people had received a positive COVID test by last week, 218 had received a positive test by today. The highest case rate in the state prison systems remains in Michigan with 25,359 of its incarcerated population (685.75 per 1,000) having tested positive for COVID. Over half of the state’s prison population has tested positive for COVID in Alaska, Arkansas, Iowa, Kansas, Michigan, and South Dakota. 

Importantly, states have varying testing strategies within prisons and for their general population, indicating that these rates likely reflect a falsely low disease incidence with some states’ rates being more accurate than others.

COVID-19 Case Watch February 25, 2021

This graph shows confirmed positive cases of COVID-19 per 1,000 individuals in the prison and general populations in each state as of February 25, 2021. The left side (orange) refers to the prison population and the right side (blue) refers to the general population.

The rate of COVID in the general population is 85.49 per 1,000 individuals. In the prison population, the rate is 273.68 per 1,000 individuals. On average, the rate of COVID infections in prison populations is over 3 times the rate of COVID infections in the general population. Hawaii and Michigan continue to have prison infection rates that are over 10 times that of the state general population. 

Despite the continued surge of COVID cases in the general population in the last few months, in 47 of the 50 US states, the rate of COVID infections among those imprisoned still exceeds the rate of COVID infections among the general population. In the last week, case rates have continued to increase drastically in prisons in multiple states. The largest increases in prison population case rates in the last week occurred in Vermont and Wyoming. The highest case rate in the state prison systems remains in Michigan with 25,198 of its incarcerated population (681.40 per 1,000) having tested positive for COVID. Over half of the state’s prison population has tested positive for COVID in Alaska, Arkansas, Iowa, Kansas, Michigan, and South Dakota. 

Importantly, states have varying testing strategies within prisons and for their general population, indicating that these rates likely reflect a falsely low disease incidence with some states’ rates being more accurate than others.