My Day in Jail
(With a Vaccination Strike Team)
By Tiffany Dent, STC’s Executive Director for Public Health
That’s me in the photo, smiling for the camera before heading into the jail. I won’t be smiling for long. There’s that scene you see in movies all the time, the one where the big iron bars bang behind you, locking you in. But as this was my first time in a jail, I was startled to find just how final that echoing clang could feel. “I’m in here,” I thought.
Once in, we were on one side of a glass wall and on the other, dozens of convicts stared at us. As we went in, it didn’t help my sense of anxiety that we had our little team of nurses was accompanied by just one guard. One guard, with hundreds of prisoners. That felt wrong, but then it got worse… We reached the area with padded cells just as they were bringing out one particularly surly-looking prisoner. The guard leaned in and said, “We just booked him last night for murder.” Murder? Yeah, first degree, accused of killing a 19 year-old girl who worked at Hardee’s. Here’s his mugshot:
So let me back up and explain what I was doing at the Jackson County Jail in Brownstown, Indiana. I’d come to town to attend a regional coalition meeting and to discuss a project with the CHIRP team (Children and Hoosiers Immunization Registry Program). The Indiana Immunization Division Director, Dave McCormick, mentioned, “If you want to see the IIS in action, we have a strike team going to the jail tomorrow. Wanna go?” Oh yeah. Count me in!
There’s been an outbreak of Hepatitis A in Indiana. That led to the formation of strike teams, each with three nurses, visiting jails and homeless shelters.
Our strike team went pod by pod, first on the men’s side, then women’s, and in each group of cells one of the nurses would explain the situation and offer vaccinations. Most agreed, and when they did, we would look them up in iWeb/CHIRP. (We found many of the prisoners in the system and we could see that for some, their parents had taken them for their childhood shots.)
Some surprises: As we worked with the men, I learned that many large, intimidating guys were unabashedly afraid of needles. At the same time, I was pleased to find that all were unfailingly polite and we heard many a “Thank you, ma’am.” There was also an uncommon willingness to ask, “Can I get tested for HIV?” (They were referred for testing.) And there was one man who asked of the vaccination, “If I already have hepatitis, will this cure it?”
Overall, my biggest takeaway from my day was how impressive it is to see public health in action – to see people making a difference, responding quickly and professionally to a crisis. It makes you proud to play a small role in the battle against disease.
As for progress in this current battle, please visit the Indiana State Department of Health’s website for updates on the outbreak. You can find it at
At the time of this writing, there were 518 recorded cases of Hepatitis A, with 231 hospitalizations and one death.
Finally, let me add that after I’d left and had time to reflect on it, I realized that visiting a prison was a “bucket list” item, one I should have had on my list.
Challenges in Immunizing Institutional Groups*
By Bill Davenhall
Looking toward 2023 we can see that all states will experience challenges in protecting “institutionalized populations” (like prisons and shelters – full definition below) from infectious diseases. That also includes the people working in these institutions and the families they return to each day. You can see that the significant populations that are estimated to be housed in group quarters are clustered into a half-dozen regions across the US. This is largely due to the higher population densities of the total populations in these areas. However, upon closer examination, you realize that many states will have a greater responsibility than perhaps their neighboring states. Detailed census data is available that can be used to further explore the various types of institutions that must be serviced by immunizers and to examine the impact on a community’s existing immunization coverage rate.
* What is an “Institutional Group”? Institutional Groups are “where people usually live and sleep” and outside of the “household.” This includes correctional facilities (adult and juvenile) at federal, state and local levels, college dormitories, military barracks, group homes, nursing homes and mental hospitals. This definition has changed since 2006 with the addition of the American Community Survey. Census data is available by type of institution, three age groups, and sex.
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