While more than half the country has opened up vaccine eligibility, vastly expanding the ability for most Americans to get the shots whatever their age or medical conditions, according to data collected by The Marshall Project and The Associated Press less than 20 percent of state and federal prisoners have been vaccinated nationwide, reports the Associated Press. Since the pandemic first reached prisons in March 2020, about 3 in 10 prisoners have tested positive and 2,500 have died. In some facilities, basic supplies like soap and toilet paper have been scarce, and mask-wearing is inconsistently enforced among both prisoners and guards. Prisoners spend time in communal spaces, and open-bar cells do little to contain the virus. Prisoners describe entire dormitories’ occupants being sick with COVID-19 symptoms. In two-thirds of states, vaccination rates behind bars still trail the general population. In some states, prisoners and advocates have resorted to lawsuits to speed up the pace of vaccinations. Many inmates are also refusing vaccinations due to distrust and fear of prison medical staff. In a Marshall Project survey of 136 prisoners earlier this year, many respondents expressed a deep distrust of prison medical systems, citing misinformation spread by staff and previous experiences of not receiving care. Prisoners seeking information about the COVID-19 vaccine must rely on limited news sources, personal correspondence and corrections staff, who prisoners say are not always willing to answer questions. To encourage prisoners to receive the vaccine, some states have turned to incentives, ranging from $25 in commissary credit in Pennsylvania, to “a little bag of Famous Amos cookies” in Mississippi. Complicating the equation are concerns about prison staff refusing vaccines in high numbers.