As of the end of January 2022, only 43% of people incarcerated at the Ottawa jail have received a dose of a COVID-19 vaccine. This, despite reassurances from the Ministry of Solicitor General (SolGen) that there is a large on-site supply of COVID-19 vaccines, is especially worrisome when compared to the overall vaccination rate in Ontario of 84%. However, vaccine hesitancy at OCDC hasn’t appeared out of nowhere.
 
First, prisoners’ rights activists and incarcerated people at OCDC have reported information about COVID-19 vaccines – their dosage, contents, side-effects, interactions with pre-existing illnesses and medications, etc. – is nearly non-existent. The lack of information about the COVID-19 vaccines is not only incompatible with the principles of informed consent, it also leaves incarcerated people – many of whom have chronic health issues – with unanswered questions about how vaccination will affect their health. Unlike those of us in the community, people in jail have been unjustifiably denied information that could not only save their lives, but also keep our community healthy. 
            
Second, many incarcerated people are hesitant to become vaccinated because of a deeply-rooted distrust of prison authorities – especially prison health staff – as a result of historical harms against criminalized people and their communities. Historically, public health experts and prison authorities have often collaborated in ways that actively oppress Black, Indigenous, and other people of colour, women, people with disabilities, and other marginalized communities. For example, the infamous Tuskegee syphilis study (where Black men in Alabama, US were experimentally infected with, and deliberately not treated for, syphilis), the forced sterilization of Indigenous women in Canada, and many other instances of scientific experimentation on people of colour, both in and out of prison, have resulted in incarcerated people’s cynicism, and justifiably so, towards health experts and prison staff. 
 
Incarcerated people’s distrust of medical authorities at OCDC has intensified throughout the COVID-19 pandemic. For example, the Jail Accountability and Information Line (JAIL) has received multiple reports of limited access to PPE, periods with no heat and/or hot water in their cells, terrible food, poor ventilation, repeated lockdowns with inadequate mental health support, few medical staff, and staff not following COVID-19 public health guidelines. It’s no wonder, then, that incarcerated people at OCDC do not trust jail staff, SolGen, or OPH to act in their best interests.
 
It is unfortunate that no substantial effort has been made by SolGen or Ottawa Public Health (OPH) to address these two primary reasons for vaccine hesitancy amongst criminalized people living at OCDC, especially considering that both phenomena are well-known in public health literature writ large as principal causes of vaccine hesitancy amongst marginalized communities. Vaccine hesitancy at OCDC was nothing short of predictable. Had this issue been addressed collaboratively from the beginning of the pandemic – with involvement from OPH, SolGen, and the wider community – the three large outbreaks at OCDC may have been significantly mitigated, if not completely avoided.
 
Despite all of this, it is not too late to facilitate the equitable education and distribution of COVID-19 vaccines at OCDC. Our institutions not only have the skills and resources to increase vaccine uptake amongst incarcerated people, but also access to a diverse and passionate community of prisoners’ rights organizations to draw on to address vaccine hesitancy at OCDC. What’s more, public health literature on vaccine hesitancy – and health care hesitancy more broadly – puts forward a number of recommendations to foster health equity amongst communities pushed to the margins, such as those people incarcerated at OCDC. 
 
With all of this in mind, we recommend the following actions:

First, SolGen and OPH should collaborate with incarcerated people at OCDC as well as community organizations – such as Health Providers Against Poverty (HPAP), the Disability Justice Network of Ontario (DJNO), and/or the Criminalization and Punishment Education Project (CPEP), etc. – to author and distribute more information about COVID-19 and approved vaccines from trusted, community-based sources that are independent from SolGen and prison staff at OCDC. This information should be immediately distributed to people incarcerated at OCDC in multiple formats (print, video, one-on-one consultations, presentations, etc.) to increase the accessibility and uptake of this information.

Second, SolGen and OCDC staff should implement more public-facing accountability and transparency mechanisms regarding pandemic procedures, vaccine distribution strategies, and better access to health care provision more broadly. 

Third, OPH and OCDC staff should facilitate community vaccination clinics at OCDC, where OPH staff and/or health care providers from outside the jail come in and perform vaccinations for people living at OCDC. Not only would such an intervention create important opportunities for vaccine-related education, but also begin to address incarcerated people’s feelings of betrayal and distrust as a result of both historical and contemporary traumas perpetrated by prison and public health authorities.

Finally, SolGen, OPH, and OCDC staff should acknowledge past harms perpetrated against criminalized people and their communities and apologize for their part in failing to address the ongoing mistreatment and neglect of incarcerated people and their wellbeing at OCDC.
 
SolGen and OPH need to take their responsibility to care for people living at OCDC seriously. After all, prison health is public health; most people living at OCDC will be rejoining us as members of the general public sooner rather than later, and the healthier they are when they are released, they healthier we are as a community.