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Health and Human Rights ; 22(2):321, 2020.
Article in English | ProQuest Central | ID: covidwho-1279206


The Siracusa Principles have had a good run over the past 35 years. The public health provisions of the principles, which contain criteria for limiting civil and political rights to advance various public purposes, have offered governments standards for acceptable restrictions on rights to reduce the spread of infectious disease. They require that restrictions be based on a legitimate aim, law, and necessity;evidence-based;the least-restrictive choice;non-discriminatory;and arrived at through a participatory and transparent process. In particular, restrictions must not disproportionately harm marginalized or vulnerable populations or discriminate against them. The standards have proven durable as a human rights approach to controlling outbreaks and sensible from a public health standpoint. Despite differing traditions and approaches, moreover, there has been convergence between Siracusa and approaches to restrictions on rights emerging from the field of bioethics.2 Standards of necessity, relevance, proportionality, equitable applications and least restrictive approach, along with procedural fairness, have dominated ethics approaches to restrictions on rights in pandemics.

PLoS One ; 16(6): e0253208, 2021.
Article in English | MEDLINE | ID: covidwho-1269921


BACKGROUND: Carceral facilities are epicenters of the COVID-19 pandemic, placing incarcerated people at an elevated risk of COVID-19 infection. Due to the initial limited availability of COVID-19 vaccines in the United States, all states have developed allocation plans that outline a phased distribution. This study uses document analysis to compare the relative prioritization of incarcerated people, correctional staff, and other groups at increased risk of COVID-19 infection and morbidity. METHODS AND FINDINGS: We conducted a document analysis of the vaccine dissemination plans of all 50 US states and the District of Columbia using a triple-coding method. Documents included state COVID-19 vaccination plans and supplemental materials on vaccine prioritization from state health department websites as of December 31, 2020. We found that 22% of states prioritized incarcerated people in Phase 1, 29% of states in Phase 2, and 2% in Phase 3, while 47% of states did not explicitly specify in which phase people who are incarcerated will be eligible for vaccination. Incarcerated people were consistently not prioritized in Phase 1, while other vulnerable groups who shared similar environmental risk received this early prioritization. States' plans prioritized in Phase 1: prison and jail workers (49%), law enforcement (63%), seniors (65+ years, 59%), and long-term care facility residents (100%). CONCLUSIONS: This study demonstrates that states' COVID-19 vaccine allocation plans do not prioritize incarcerated people and provide little to no guidance on vaccination protocols if they fall under other high-risk categories that receive earlier priority. Deprioritizing incarcerated people for vaccination misses a crucial opportunity for COVID-19 mitigation. It also raises ethical and equity concerns. As states move forward with their vaccine distribution, further work must be done to prioritize ethical allocation and distribution of COVID-19 vaccines to incarcerated people.

COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Health Care Rationing/organization & administration , Prisoners/statistics & numerical data , Vaccination/standards , Age Factors , Aged , COVID-19/epidemiology , COVID-19/transmission , Family , Health Care Rationing/standards , Humans , Middle Aged , Pandemics/prevention & control , Police/statistics & numerical data , Risk Factors , United States/epidemiology , Vulnerable Populations/statistics & numerical data