COVID-19 AND VACCINE HESITANCY IN NEW YORK STATE PRISONS

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Correctional Association of New York

For more than 177 years, CANY has been the only independent organization in New York with authority under the law to monitor state prisons and report our findings to the legislature and the broader public. The past two years have demonstrated how critical that work is, as jails, prisons, and detention centers became and persist as hotspots for transmission of the COVID-19 virus. Since the outset of the COVID-19 pandemic in March 2020, CANY has been conducting monitoring work on the impact of the virus on people in prison. This work has continued since the development of effective vaccines against COVID-19, which prompted CANY to assess incarcerated people’s access to and attitudes toward vaccination in prison. What follows is one of only a handful of reports seeking to understand vaccine hesitancy from incarcerated people’s perspectives.

CANY conducted monitoring visits to eight prisons between July 2020 and June 2021 (i.e., CANY’s fiscal year): Fishkill Correctional Facility in July 2020, Sing Sing Correctional Facility in September 2020, Bedford Hills Correctional Facility in October 2020, Green Haven Correctional Facility in December 2020, Sullivan Correctional Facility in March 2021, Greene Correctional Facility in April 2021, Taconic Correctional Facility in June 2021, and Great Meadow in June 2021. CANY also distributed by mail a survey on vaccine hesitancy, presenting questions on sentiments about healthcare providers within and outside of prison; quality and accessibility of healthcare within the prison; sources of information, knowledge about, and experience with vaccines in custody and in the community; factors that have impacted or would influence vaccine uptake; and basic demographic information. CANY supplemented the vaccine hesitancy survey with independent questions on vaccine hesitancy during in-person monitoring visits to Sullivan, Greene, Taconic, and Great Meadow Correctional Facilities, during the first few months of vaccine distribution in the prisons.

The findings from CANY’s monitoring work focused on COVID-19 last fiscal year (i.e., CANY’s eight monitoring visits, the vaccine hesitancy survey, and supplemental vaccine questions) frame this report, uncovering key concerns about conditions of confinement in New York state prisons through the lens of vaccine hesitancy. Overall, CANY finds that vaccine hesitancy is rooted in incarcerated people’s prior negative experiences with the prison healthcare system. A systemic lack of trust in DOCCS administration and healthcare staff drives the hesitancy toward COVID-19 vaccination among incarcerated people in New York. Multiple factors contribute to this lack of trust: insufficient accessibility of healthcare in prison; poor quality of care; and lack of access to information about COVID-19 and the COVID-19 vaccine. Our findings highlight that this lack of trust contributes more broadly to a perceived lack of legitimacy on the part of the prison healthcare system. Survey respondents’ perception that prison healthcare staff do not prioritize their patients’ interests over those of the prison contributes to their hesitancy to get vaccinated. Additionally, findings reveal the effects of traumatic experiences on vaccine hesitancy in prison, specifically in how the difficulties of enduring the COVID-19 pandemic may affect the willingness of incarcerated people to accept the vaccine.

Based on these findings, CANY makes eight key recommendations to DOCCS and other key governmental stakeholders: (1) All avenues for decarceration – pretrial release, alternative sentencing, early release, medical parole, parole board release, commutation – be fully explored and acted upon by the Governor, the Legislature, the Judiciary, the Board of Parole, and DOCCS; (2) DOCCS adopt patient-centered response(s) to COVID-19 and infectious disease prevention and mitigation in prisons; (3) DOCCS continue to provide adequate information to incarcerated people about the COVID-19 vaccine, prioritizing patients’ concerns and overall well-being in their decision to accept the shot; (4) DOCCS alleviate gaps in the quality of medical services by improving preventative care through routine screenings, education, and outreach; (5) DOCCS expedite the procurement and implementation of an electronic medical record (EMR) and improve the way that requests for care (i.e., sick call) and the response are documented; (6) The Legislature conduct a comprehensive assessment of the quality and accessibility of healthcare provided in the prisons and identify reforms that would improve the quality of prison-based healthcare; (7) The Legislature pass a bill to ensure that health facilities and services within DOCCS and local correctional facilities are overseen by the New York State Department of Health; and (8) The Legislature pass a bill to designate an independent correctional ombuds to investigate and resolve complaints related to incarcerated persons’ health, safety, welfare, and rights.