A Tennessee advisory panel charged with determining in what order people could receive the COVID-19 vaccine recognized that prisoners in the state were at high risk, but concluded that doing so would be a “public relations nightmare.”

The result: Prisoners are the last group in the state to receive vaccines, despite the fact that the Pandemic Vaccine Planning Stakeholder group agreed that “if untreated, they would be a source of general population transmission,” according to documents collected by The Associated Press from the panel’s closed-door meetings. There is currently no set timetable for the introduction of vaccines in prisons.

The debate in Tennessee represents a national question that states are grappling with as they carry out life-saving vaccines: whether to prioritize a group that many regard as an afterthought, isolated from the general public, and at worst, undeserving. Medical experts have argued since the beginning of the pandemic that prisoners are at exceptionally high risk of infection because they live in close quarters with one another and have no opportunity to socially distance themselves.

“It demonstrates a lack of humanity and empathy to encourage someone to die or be exposed to greater danger simply because they are incarcerated….” “Before they were ever incarcerated, they were someone’s infant, mother, brother, parent, or sister, and they should be considered, cared for, and seen as such,” said Jeannie Alexander, executive director of the No Exceptions Prison Collective, a grassroots organization based in Nashville.

The Associated Press and The Marshall Project counted cumulative rates of infection among prison populations only a few months ago, as COVID-19 cases soared throughout the United States. According to the report, one in every five state and federal prisoners in the United States tested positive for the coronavirus by mid-December, a rate more than four times higher than the general population. Cases have decreased since then, but they are still higher than the general population.

Tennessee is ranked 24th in the country for COVID-19 prisoner cases. Since the outbreak began nearly a year ago, nearly one-third of the state’s inmates — more than 38,800 in total — have tested positive for the virus. COVID-19 has claimed the lives of over 40 prisoners.

So far, the state has vaccinated an undetermined number of correctional officers — Tennessee does not make this information public like other states — but no inmates. According to AP and Marshall Project statistics, 24 states have required at least some of their inmate population to be vaccinated, including those that met the state’s age requirements or had preexisting health conditions.

Over the last year, Tennessee’s jails have been home to some of the country’s largest coronavirus outbreaks, with hundreds of active cases spread through several facilities.

Over the spring, about half of the 2,444 inmates at Trousdale Turner Correctional, a private prison operated by Tennessee-based CoreCivic, tested positive for the coronavirus, while over 1,100 inmates at the 1,700-capacity South Central Correctional Facility contracted the virus. As of Friday, the state had only registered 17 positive inmate cases. For months, visitation has been halted. The state’s inmate population is about 30,000, with around 19,000 people housed in local jails.
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In reality, documents from the Pandemic Vaccine Planning Stakeholder group’s meetings emphasized the importance of the general public understanding that inmates “are individuals” who should be regarded as “part of the society,” and that “if untreated, they would be a vector of general population transmission.” Despite this, the documents admit that giving the vaccine to inmates would result in “a lot of media attention.”

Around 40 public health departments, politicians, health care coalitions, emergency management, and other groups make up the panel. According to the Department of Health, it is not mandated by Tennessee law to meet publicly because it operates in an advisory capacity, and no audio records of the meetings exist. The meeting minutes were collected by the Associated Press via a public records request.

The group first met virtually on Sept. 22, before vaccines were available, according to the records. At that meeting, the committee discussed demographics that might have been neglected, and Tennessee’s imprisoned population came up.

One text, which is not credited to someone by name, says, “Understand it will be a (public relations) nightmare but a potential liability to the state.”

When the community met again in December to discuss moving up those age ranges and teachers, inmates were once again considered.

“When we are severely punished in prison, it affects the whole society. “As prisoners cycle out of their sentencing, illness escapes correctional facilities and reenters general society,” the document states, noting that when inmates contract the disease, “it is the taxpayers who must absorb the bill for treatment.”

Corrections officers and jailers were eventually moved to one of the first positions, alongside first responders. Meanwhile, prisoners were among the last group of people who could vote. And now, senior inmates who meet the state’s age requirements are not receiving vaccinations.

Tennessee is currently ranked 47th among states in terms of the total number of citizens who have been vaccinated. According to statistics from the Centers for Disease Control and Prevention, more than 14 percent of the state’s 7 million residents have received at least one dose of the vaccine, and more than 7% have received both vaccines.

Over the last few weeks, the state has been expanding vaccination eligibility. People aged 16 and up with preexisting conditions such as cancer, asthma, obesity, and pregnancy, as well as caregivers and residents of households with medically vulnerable infants, will be eligible to get the vaccine starting next week.