key: cord-0916003-l3j6r3wk
authors: Bellizzi, Saverio; Aidyralieva, Chinara; Al-Shaikh, Ala'a; Muthu, Nazeema; Al-Sadder, Anwar; Al-Raiby, Jamela
title: Inclusiveness of prisons in COVID-19 vaccination deployment: Evidence from Jordan
date: 2021-11-18
journal: Vaccine
DOI: 10.1016/j.vaccine.2021.11.022
sha: 8af0afe2f59e8ecae0f7e2ddaa6276e44247f4a3
doc_id: 916003
cord_uid: l3j6r3wk

nan

As the availability of COVID-19 vaccines has increased in a number of countries, advocacy for equitable access to vaccines among people living and working in detention centers has been continuing. 1 Specifically, in the WHO European Region, many Member States have been working to increase the vaccine coverage among people living in detention centers with this coverage varying between less than 15% to above 60% coverage, and others not reporting on vaccination rollout in detention centers. 2

Since the onset of the COVID-19 pandemic, the Government of Jordan (GoJ) adopted a wholeof-society approach targeting Jordanians and non-Jordanians irrespective of nationality, citizenship, and legal status. This was reflected in the National COVID-19 Preparedness and Response Plan and followed in the Jordan COVID-19 National Deployment and Vaccination Plan, which extended free-of-charge equitable access of all individuals in Jordan. Considering this inclusiveness principle, refugees (it is estimated that around 1.3 million Syrian and more than 2 million registered Palestine refugees live in Jordan) 3,4 started receiving their first dose of COVID-19 vaccine on 14 th January 2021, 5 next day after launching the national COVID-19 immunization drive making Jordan an example of equitable access to life-saving healthcare.

Access to COVID-19 immunization was also promptly offered to all inmates in the Jordanian prisons and as of June 13, 4,288 detainees have received at least one dose of the vaccine (25% of the detained population); 6 such a proportion was even higher than the percentage of the general population having received at least one dose in the same time-period (around 2 million individuals, equal to about 20% of the general Jordanian population). While no data are publicly available on uptake of vaccines among prison staff, they are considered in the overall population who has free access to COVID-19 vaccines since the onset of the vaccination campaign in Jordan.

Outbreaks of COVID-19 have been reported in prisons of at least 122 countries across the world. 7 Prisons indeed represent a very high risk environment for the transmission of pathogens like respiratory viruses due to overcrowding, high population density, and close contacts among detainees and guards. Specifically, it has been found that when prison capacity exceeds 85%, there is an increased risk of SARS-CoV-2 infection and death. 8 In an effort to reduce overcrowding, 109 countries took measures such as decarceration of nonviolent offenders, resulting in an average reduction of the prison population by 6%. 9 Prisons are also considered incubation areas that facilitate rapid viral transmission. In mid-March 2020, the first case of novel COVID-19 was diagnosed at Riker's Island, the main jail complex in New York City. Within 2 weeks, >200 cases were diagnosed within the facility, despite efforts to curb the spread. 10 Data on morbidity and mortality in prisons around the world are sparse and summarized in the 53 rd edition of the WHO epidemiological update on COVID-19 (17 August 2021) 11 : in the United States of America (USA) 42 107 cases of SARS-CoV-2 infection and 510 deaths have been detected among nearly 1.3 million people living in prisons, representing a 5.5 times higher incidence rate than that in people of the same age and sex in the general population across the same time period. 12 Similarly, the incidence rate among prison staff in USA reported up to November 2020 was 3.2 times higher than in community settings. 13 On the other hand, the estimated mortality rate among people in prisons was 39 per 100 000 compared to 29 per 100 000 for the general population of the USA. 12 England and Wales have observed a mortality rate 3.3 times higher in detention centers compared to people of the same age and sex in the general population between March 2020 and February 2021. 14 Such an approach is well summarized by Dr Ferreira-Borges, who in a recent Lancet publication stated that "People living in prisons should be included in national COVID-19 vaccination plans on the basis of their increased vulnerability, the principle of equivalence, and the duty of governments to protect those deprived of their liberty, leaving no one behind".

Geographic Multidimensional Vulnerability Analysis -Jordan. UNICEF

United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). Where We Work | UNRWA

UNHCR -Refugees receive COVID-19 vaccinations in Jordan

Prison Population Reductions and COVID-19: A Latent Profile Analysis Synthesizing Recent Evidence From the Texas State Prison System

COVID-19 outbreaks in prisons

COVID-19 Cases and Deaths in Federal and State Prisons

COVID-19 Cases Among Employees of U.S. Federal and State Prisons

High COVID-19 death rates in prisons in England and Wales, and the need for early vaccination

Prisons need to be included in global and national vaccinations effort against COVID-19. Lancet Reg Health Eur