A San Diego Grand Jury report filed on May 7 argues that the Sheriff's Department has ignored basic immunization guidelines established by the Centers for Disease Control and the county's own Public Health Department and, in doing so, put inmates and the public at risk.
Among the findings in the report, the county's Detention Services Bureau (DSB),
* Fails to screen inmates for HIV, and Hepatitis A, B, and C
* Doesn't administer Tdap (tetanus, diptheria, pertussis) boosters. (DSB does, however, provide tetanus / diptheria vaccinations—but not pertussis. The Grand Jury found this perplexing: "It is difficult to understand why no Tdap immunizations occurred when the County experienced an increasing number of pertussis cases").
* Doesn't screen or immunize pregnant inmates for Hepatitis B or Tdap
* Fails to screen or immunize women of child-bearing age for measles / mumps / rubella
"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 report says.
The county jail system takes in roughly 90,000 inmates a year, the report notes. Inmates can ask to be immunized, or a doctor can recommend it. Even then, what's offered is limited. 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 / diptheria vaccines. No other vaccines were made available, the report says.
The report notes that vaccines are costly (up to $689 per inmate) and aren't legally mandated, but offering—and encouraging—inmates to take advantage of them could prevent disease outbreaks, both in the jails and the community. Screening for HIV and hepatitis is also costly, the report acknowledges, but jails need to be part of the larger public-health effort to control and prevent those diseases.
Among the Grand Jury's recommendations are that the county develop a "catch-up" program for inmates who lack basic immunizations, counsel inmates on the benefits of getting screened and immunized, seek CDC funding to help cover hepatitis A, B and C screening and provide a Tdap vaccine or booster to inmates who lack immunity to the trio of illnesses.
State law requires that any public agency targeted in a Grand Jury report respond to the fundings within 90 days.
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