Should prisoners and prison staff be among the priority groups for COVID-19 vaccination?
It was a question posed this week by the MP Zarah Sultana during a meeting of the House of Commons Science and Technology Committee.
"Prisons are a high-risk setting for transmission, as well as hospitals, nursing homes and schools", she said to the vaccines minister, Nadhim Zahawi. She continued:
There would be considerable challenges if there was an outbreak in this setting, and vaccinating detainees is both good for public health and a humane approach to a completely disenfranchised population.
Has the government considered prioritising vaccinating detainees, as well as those who work in prisons?
No, was the answer. The government would continue to vaccinate according to age cohorts, rather than prioritising any particular group or institutional setting.
This is short-sighted and elevates the risk of wider community infection and reinfection.
Every week, thousands of potential COVID-19 spreaders go in and out of prisons. Staff go to and from work. Hundreds of new prisoners arrive, hundreds at the end of their sentence are released.
Prisons act as 'epidemiological pumps', the public health expert Richard Coker pointed out last year, circulating COVID-19 from the community into prison and back out to the community.
Compared with the general population, those in prison are typically less healthy and have a greater prevalence of underlying health conditions that increase the risk of serious illness.
These considerations led Professor Seena Fazel of the University of Oxford to argue that "people in prison should be among the first groups to receive any COVID-19 vaccine to protect against infection and to prevent further spread of the disease".
On a practical note, vaccinating the entire prison population and all prison staff in a matter of weeks would be relatively easy. There are around 100,000 prisoners and prison staff across England and Wales. Last week the NHS delivered more than one million vaccines.
Vaccinating all prisoners and prison staff, and doing so now, would deliver disproportionate benefits in the fight against coronavirus.
With emerging evidence that coronavirus infections and deaths in prison are rising sharply, a government that claims to be guided by the science appears to be putting base political calculation ahead of decisive action to protect public health.