When Keith Brown tries to describe the 25 years he spent in prison, he keeps coming back to one word: congested.
From the chow hall to the bathrooms, there’s no escape from the constant press of bodies — a feeling that “nobody should ever experience,” he said.
Last spring, Brown was incarcerated at Farmington Correctional Center in eastern Missouri, and as inmates began testing positive for the coronavirus, the 8-by-11 cell he shared with another man felt even more cramped.
“You and your cellie, you’re right there together,” he said. “He's touching everything; he’s breathing and coughing and blowing his nose. It’s really hard to break that cycle of infection.”
Compared to the general public, incarcerated people in the U.S. are about five times as likely to test positive for the coronavirus and twice as likely to die. Since March, at least 5,334 inmates have contracted the virus in Missouri prisons, and 42 have died.
State health officials hope to prevent future outbreaks by first vaccinating prison staff, but the majority of those incarcerated in Missouri prisons will be among the last in the state to be offered a vaccine.
On the front lines
Correctional workers “represent the most likely source of a facility outbreak,” according to the Missouri state vaccination plan, and vaccinating them will “vastly reduce” the risk of future viral spread. The plan prioritizes prison staff for receiving the COVID-19 vaccine, along with law enforcement, first responders and other essential workers.
That comes as a relief to Corey Moore, a captain at Missouri Eastern Correctional Center in Pacific who has already signed up to be vaccinated. “We worry about getting it and bringing it in or catching it here and bringing it home,” he said. “That’s always in the back of our minds as staff.”
Last year, as more inmates and staff began testing positive for the coronavirus at the Pacific prison, Moore’s wife and children left to stay with relatives for a few weeks. Once they returned, he started wearing a mask at home, and sometimes, he said, it’s hard to keep the anxiety at bay.
“There are days you wake up feeling funky and you just wonder,” Moore said. “Maybe you’ve got a sore throat and you’re like, ‘Man, is this from the weather? Is it from wearing a mask all the time?’ You’re constantly in that state of not knowing, and there’s many times where maybe you feel like you’ve got it.”
According to publicly available state data, 2,176 Missouri prison workers have tested positive for the coronavirus, and five have died.
Prison staff have been working on the front lines of this pandemic for months, and it makes sense the state is giving them the chance to be vaccinated early, said Tim Cutt, executive director of the Missouri Corrections Officers Association.
“You’re working there 16 or 18 hours a day [and] you can't get away from this thing,” Cutt said. “It's not a threat that we're used to dealing with. We're used to physical, tangible threats, but this virus is a scary deal.”
Despite the risk, Cutt said he has heard from officers who are reluctant to get vaccinated. Though he believes getting vaccinated is a “good idea,” especially for older workers and those with certain health conditions, he said the union will not make a recommendation either way.
“That’s where personal decisions come in,” Cutt said. “If they want to get the vaccination, they should get it. If not, they shouldn’t be mandated to have it.”
Employers can require workers to be vaccinated for COVID-19, according to federal guidance from the U.S. Equal Employment Opportunity Commission, but a spokesperson for the DOC said the department is not planning to mandate vaccinations for prison staff or inmates.
A shared risk
Officials have worked to slow the spread of the virus in Missouri prisons, suspending outside visits, implementing stricter requirements for testing and quarantining and installing air purification systems in the ventilation systems of all facilities.
Still, the daily flow of workers needed to keep prisons running has made it nearly impossible to prevent the virus from entering facilities, and prison workers who decide not to be vaccinated could fuel future outbreaks.
The Centers for Disease Control and Prevention recommends states vaccinate staff and incarcerated people at the same time whenever possible because of their “shared increased risk of disease.” Infectious disease experts at seven universities and the Johns Hopkins Center for Health Security have also urged state officials to prioritize prison workers and inmates.
Only eight states, including Illinois, are planning to follow these recommendations and vaccinate inmates early in the process, according to a report from the Prison Policy Initiative. Like Missouri, most have prioritized vaccinating corrections workers first.
The Missouri DOC was one of several stakeholders who helped develop the state’s vaccination plan, along with the Department of Health and Senior Services, the Missouri Health Care Association, the State Board of Nursing and BJC HealthCare.
The plan does not specify a timeline for vaccinating inmates, which has caused confusion, said Wanda Bertram of the Prison Policy Initiative.
“We're getting so many messages right now, from people who have a mother or a father or a son or a daughter in prison,” Bertram said. “They are wracked with anxiety, trying to figure out, is this vaccine going to get to my loved one in time to save them or is it not?”
In an email, a spokesperson for DHSS said inmates who are 65 or older or have certain health conditions that put them at higher risk will be vaccinated in the first phase of the rollout plan, just after essential workers.
About a third of the state’s prison population, or 8,000 inmates, fall into this high-risk vaccination category. So far, roughly 5,200 inmates in this group have indicated they want to be vaccinated, a DOC spokesperson said by email.
The majority of Missouri inmates, some 16,000, will be eligible for the vaccine in the final phase of the state’s plan, once it’s available to the general public.
‘You’re less than’
For Lashawn Casey, one of the first inmates to test positive for the coronavirus at Chillicothe Correctional Center, waiting to vaccinate the majority of prisoners sends the message “that some people’s lives are more valuable than others.”
“Everything in prison communicates that,” said Casey, who was released from Chillicothe in October. “From the moment you walk in there, you’re less than, you’re subhuman. You’re treated that way until the moment you walk out.”
But for some, the ethical implications of deprioritizing inmates for the COVID-19 vaccine may have an even longer-term impact on the criminal justice system nationwide.
Both mass incarceration and COVID-19 disproportionately impact people of color, said Marisa Omori, an assistant professor of criminology at the University of Missouri-St. Louis, and putting inmates at the end of the vaccination line may tip the scales even further.
“The confluence of those two factors is just huge for thinking about how racial inequality is maintained,” Omori said, who has been working with the COVID Prison Project, tracking cases of the illness in U.S. prisons and jails.
Keith Brown, who was released from Farmington Correctional Center in July, said he thinks vaccinating prison staff is a good first step. Though he feels lucky he was able to make it out of prison without contracting COVID-19, Brown worries about his friends and family who are still behind bars.
“The environment is very fragile, and it can turn violent quick,” he said. “It gets worse and worse, mentally and psychologically.”
Brown tells his friends to try to stay positive, that things will get back to normal soon — though truthfully, he doesn’t know when that will be.
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