Advocates say inmates should have speedy access to the COVID-19 vaccine, given how susceptible prisons and jails have been to outbreaks and how prevalent chronic disease is in that population.
"I don't think they should go to the front of the line, but I certainly don't think they should be denied their rightful place in the priority line simply because they're prisoners," said Catherine Latimer, executive director of the John Howard Society of Canada.
The Correctional Service of Canada said that, as of Tuesday, there were a total of 276 active COVID-19 cases in federal prisons. The bulk were at Joyceville Institution near Kingston, Ont., Stony Mountain Institution near Winnipeg and the Saskatchewan Penitentiary near Prince Albert, Sask.
There have also been several outbreaks in provincially run jails.
Martha Paynter, a registered nurse in Halifax who advocates for the health of people behind bars, said hygiene and ventilation in correctional institutions are issues at the best of times.
There is also high turnover in remand centres and staff are constantly coming and going, she added.
Inmates are "living in this incredibly restrictive experience, but also facing very grave risk of illness transmission," said Paynter, a doctoral candidate at Dalhousie University.
Inmates 50 and older account for one-quarter of the federal prison population. Advocates note people age faster behind bars and are in poorer health than the general public.
"Of course this population should have very quick access to the vaccines," said Paynter, who added that some might not trust the shots due to bad experiences with health care behind bars.
She said the bigger issue is why there are so many people incarcerated in the first place.
"What are we choosing to police? What are we choosing to criminalize?"
Anita Ho, associate professor in bioethics and health services research at the University of British Columbia, noted Indigenous people are disproportionately represented in the corrections system.
"In general, health among Indigenous peoples in Canada, because of various social determinants of health, are poorer to start with," she said.
The National Advisory Committee on Immunizations recommends adult Indigenous communities be included in Stage 1 of vaccine delivery. It recommends congregate settings, including correctional facilities, be included in Stage 2.
The Correctional Service of Canada, which is responsible for providing health services for inmates in its care, says in a statement it is aligning its strategy with the national guidelines.
"CSC has worked very closely with the Public Health Agency of Canada to respond to every aspect of the pandemic, including the provision of vaccines to inmates."
Priority groups such as long-term care residents and health-care workers began receiving doses earlier this month.
Dr. Joss Reimer, medical health officer for the Winnipeg Regional Health Authority, said criteria for who gets the vaccine in Manitoba in the new year will be expanded to include “correctional facilities," but did not specify whether that would be inmates, staff or both.
Other provinces have not detailed their plans.
Ontario's Ministry of the Solicitor General said it will be looking at the availability of doses and would carry out immunizations "based on the latest medical advice and scientific evidence."
Saskatchewan Health Minister Paul Merriman said: "We will consider based on what the needs are at that specific time and ... the amount of vaccines that we have flowing into the province."
In Alberta, chief medical health officer Dr. Deena Hinshaw said, "We'll have a clear ethical dimension that we need to make sure we're considering."
University of Toronto bioethicist Kerry Bowman said there was a consensus about who would receive the first batch of vaccines, but determining who should be next is trickier.
He said it's not clear whether the goal of the second phase will be to boost the economy or to reach more vulnerable people.
In the United States, there has been some pushback against inmates getting dibs earlier.
"There’s no way it’s going to go to prisoners before it goes to the people who haven’t committed any crime," Colorado Gov. Jared Polis said after the state's vaccination rollout plan was criticized.
Bowman said that kind of argument is neither scientifically nor ethically sound.
"It's a very dangerous precedent in any society when you start saying these lives are more valuable than those lives."
This report by The Canadian Press was first published Dec. 24, 2020.
— With files from Fakiha Baig in Edmonton and Shawn Jeffords in Toronto
Lauren Krugel, The Canadian Press
Note to readers: This is a corrected story; a previous version said Paynter provides reproductive care to inmates.
