CT’s strict vaccine mandate for medical staff doesn’t apply to prisons
More than 600 employees at the Department of Correction may opt to test weekly in lieu of being vaccinated against COVID-19, a CT Mirror analysis has found, because the state is not requiring prison medical staff to apply for medical or religious exemptions.
That policy is inconsistent with rules for the majority of health care workers at the departments of Veteran’s Affairs, Children and Families, Mental Health and Addiction Services, and Developmental Services. About 3,700 workers at those agencies must have exemptions approved by the state if they want to test weekly instead of getting vaccinated, as per Gov. Ned Lamont’s executive order. The governor’s office confirmed that correctional employees are not bound by this rule.
The administration’s restrictive mandate for most health care employees is similar to practices in private hospitals in Connecticut, which also require workers to apply for exemptions if they do not want to be vaccinated. The governor’s vaccine mandate for long-term care facilities also requires staff to submit requests for medical and religious exemptions.
“That policy should be employed for corrections,” said Arthur Caplan, professor of bioethics at New York University’s Grossman School of Medicine. That would signal that “we mean business here, we’ve taken seriously the dangers that prisons and enclosed housing cause to the prisoners, the guards and the communities where they’re located.”
Workers at state-run hospitals and long-term care facilities were required to get vaccinated — or submit exemption requests — before the governor’s vaccine mandate was expanded to other state employees, said Lora Rae Anderson, the director of communications for the state’s chief operating officer.
“Those in hospitals and in long-term care facilities remained the most at risk throughout the pandemic, which is why the Governor, in partnership with hospitals across the state, acted swiftly to implement vaccination and testing requirements for those workers,” Anderson said in an emailed response to questions.
But Anderson estimated that 1,850 health care workers in the executive branch weren’t included in either of those groups, around a third or a fourth of whom work at the Department of Correction. When the governor issued his vaccination mandate for state employees more broadly, he allowed them to test weekly at-will if they did not want a shot. The state is covering the cost of weekly testing for unvaccinated employees for the duration of the public health emergency, which presently extends though mid-February.
“We did not want to walk back those previous orders, so that’s why some folks are required to submit exemption requests, and others are not,” Anderson wrote. “Requirements for all state employees were made hand-in-hand with state employee unions, medical professionals and agency leadership with safety as the highest priority.”
The state’s relationship with many advocates for the incarcerated has been strained during the pandemic. Claudine Fox, public policy and advocacy director for the ACLU of Connecticut, which twice sued the state for its handling of COVID-19 in prisons and jails, said the "lax approach to vaccines for DOC health care workers only underscores the DOC’s cavalier attitude toward people’s health inside."
Fox faulted what she called a “double standard” of having strict rules for medical workers in some health care settings but not others.
"Prisons are congregate living settings. If we’re treating certain congregate living settings one way, they need to all be treated the same way. People in prisons are people, and they deserve to be protected, too,” she said. “This notion that providing health care in Connecticut’s prisons and jails is somehow different from other health care settings, again, just demonstrates how people see prisons, and people in prisons, as completely different from the rest of society.”
More than 280 prisoners had tested positive for the virus as of Dec. 7. If the numbers continue to increase, advocates worry the prison system will rely on isolation to contain an outbreak, as officials did with the state’s youth prison, which was placed on partial lockdown on Nov. 19.
The governor's office makes public department-level data for executive branch agencies with more than 100 employees, and the Department of Correction has the lowest vaccination rate among them at 65%, according to data published Nov. 22. It also has the highest rates of testing and non-compliance, the Mirror previously reported.
A CT Mirror analysis of Office of State Comptroller data from December 2021 found 667 medical staff employed at the Department of Correction, including nurses, physicians, psychiatrists, clinical social workers and medical records specialists. The agency had about 5,400 employees total in November, according to the governor's office.
The governor’s office would not break out vaccination, testing and non-compliance rates for health care workers within the Department of Correction. The Department of Correction referred questions to the governor’s office. In a statement, Karen Martucci, the Department of Correction’s director of external affairs, said the agency’s job is to "ensure compliance with the Executive Order as it relates to the Department of Correction.”
The governor's office does break out vaccination and testing data for medical staff who are required to submit exemption requests. Those health care workers generally reported slightly higher rates of vaccination and slightly lower rates of testing than other employees within the same agency, November data show. The state had approved the vast majority of exemption requests it had adjudicated last month, the Mirror previously reported.
It’s likely that health care workers within the Department of Correction also have higher vaccination rates than the departmental average, but that doesn’t mean that a more restrictive mandate couldn’t have pushed those rates even higher, Caplan said. “That's the place I would start in order to try and drive more responsible behavior on the part of the corrections side of the street.”
All correctional staff should have to apply for exemptions to test in lieu of vaccination, not just health care workers, Caplan added.
In general, “mandates are extraordinarily effective at increasing uptake. You only have to look as far as any health care facility to see that mandates do work,” said Jaimie Meyer, a Yale School of Medicine infectious disease physician and epidemiologist who focuses on prisons. “And they do work also in terms of preventing future outbreaks,” which is important in correctional facilities because “people who are forced to reside (in prisons) and people who work in this business often have underlying medical conditions that put them at increased risk of severe disease,” she said.
Data released in December show that one-in-four incarcerated individuals are over the age of 45, and 5% are over the age of 60.
"Connecticut continues to have among the highest vaccination rates in the nation, and we have confidence our residents, including state employees, will continue to take actions that protect their neighbors," Anderson wrote. In addition, the Department of Correction required staff to test weekly “long before the state's requirements were rolled out more broadly."
“Connecticut, actually, for a number of reasons, took a fairly aggressive stance in terms of testing both their employees, including their health care workers, and people who are incarcerated … in order to respond rapidly to potential outbreaks,” Meyer said. “That was after some harsh lessons learned in the beginning of the pandemic.”
But Caplan argued that weekly testing was insufficient, advocating for daily testing instead.
Vaccination and testing serve different purposes when it comes to infection control, Meyer said. Testing helps with the identification of carriers of disease, particularly those who are asymptomatic, whereas vaccination is “really the most effective tool that we have to … prevent infection, to reduce the risk of transmission and to prevent severe disease in this highly vulnerable population.”
Testing “is a strategy to prevent an outbreak inside a facility. It’s not an alternative to vaccination,” Meyer said.