May 29, 2013
On May 7, a San Diego grand jury filed a report arguing that the sheriff's department ignored the essential immunization guidelines of the county's public health department and of CDC. By doing so, the department put prisoners and the public at risk.
According to the report, the county's Detention Services Bureau (DSB) currently fails to screen inmates for HIV and hepatitis A, B, and C; does not administer tetanus, diphtheria, pertussis (Tdap) boosters (DSB does provide vaccinations for tetanus/diphtheria but not for pertussis); does not screen or immunize pregnant inmates for hepatitis B or Tdap; and fails to screen or immunize women of child-bearing age for measles/mumps/rubella. The report stated, "DSB's current policy and practice fails to meet accepted national immunization standards, including those of the CDC and Federal Bureau of Prisons guidelines for inmates. DSB does not follow the most basic and widely accepted public health standards for women in developed counties."
The county jail system incarcerates approximately 90,000 inmates per year. Inmates can request to be immunized, or a physician can recommend it; however, the jail offers limited immunizations. Between July 1, 2008, and June 30, 2012, the jail provided a total of 2,022 flu vaccines, five hepatitis A vaccines, 19 hepatitis B vaccines, and 1,175 tetanus/diphtheria vaccines. The jail offered no other vaccines. Vaccines are expensive -- up to $689 per inmate -- and are not legally mandated. Nonetheless, offering and encouraging inmates to get vaccinated could prevent disease outbreaks, both in the community and in the jails. Screening for hepatitis and HIV also is expensive, but jails need to be part of the public's health concerns to prevent and control those diseases.
The grand jury recommended that the county create a "catch-up" inmate program for those who lack basic immunizations; seek CDC funding to help cover hepatitis A, B, and C screening; counsel inmates on the benefits of getting screened and immunized; and provide a Tdap vaccine or booster to inmates who lack immunity to the three illnesses. California state law requires that any public agency targeted in a grand jury report respond to the findings within 90 days.
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