New York State officials have expanded vaccine availability to all incarcerated people in New York, more than three months after people living in other types of congregate settings became eligible. The reversal came Monday evening, hours after a state judge ordered the change, arguing that withholding vaccines from incarcerated people violated the 14th Amendment, which guarantees equal protection under the law.

“We will expand eligibility to include all incarcerated individuals whether in state or local facilities,” Beth Garvey, acting counsel for Governor Andrew Cuomo, said in a statement. “Our goal all along has been to implement a vaccination program that is fair and equitable, and these changes will help ensure that continues to happen."

The judge’s decision came after Cuomo’s administration had repeatedly broadened vaccine access to the general public without making parallel moves for prison populations. The governor, for example, opened up eligibility to those older than 65 or with pre-existing conditions on January 12th—about a month before allowing the same practices for state prisoners.

Despite the incarcerated population in state prisons (34,000) being about the size of Poughkeepsie, only about 1,300 inmates who are senior citizens or with pre-existing conditions are fully vaccinated, according to Garvey. Another 2,600 have received one dose compared to at least 7,500 staff members who’ve received shots.

Judge Alison Y. Tuitt ordered the Cuomo administration to offer vaccines to all incarcerated people in its custody immediately, not just older inmates or those with pre-existing conditions, citing violations of equal protection clauses in New York State laws and the U.S. Constitution. The state could fully inoculate the remainder of its entire prison population with just 4% of the doses it receives this week. The judge’s order didn’t include a timeline.

New York officials had “irrationally distinguished between incarcerated people and people living in every other type of adult congregate facility, at great risk to incarcerated people’s lives during this pandemic,” she wrote in her decision. “There is no acceptable excuse for this deliberate exclusion as COVID-19 does not discriminate between congregate settings.”

COVID-19 continued to rip through state prisons after the first COVID-19 vaccines were authorized in December, sickening more than 3,000 incarcerated men and women and killing eleven of them since the beginning of the year. Data shows the outbreaks slowing in recent weeks, alongside the dampening of the state’s second surge. But a handful of prisons are still reporting dozens of new infections.

Meghna Philip, the staff attorney for Neighborhood Defender Service of Harlem, the group that sued the state on behalf of two men incarcerated at Rikers Island, said she was glad the state had finally committed to vaccinating people in its custody but pushed back on Garvey’s statements about the vaccine rollout being “fair and equitable.”

“The state has been opposing this at every turn,” she said. “We had to actively litigate this issue and get a judge to order them to comply with the constitution and offer the vaccine to incarcerated people.”

As congregate settings, prisons are considered a high-risk environment for the spread of COVID-19 by the Centers for Disease Control and Prevention because of their limited capacity for social distancing. Residents of other group arrangements—such as homeless shelters and juvenile detention centers—were deemed eligible for vaccination by the state on January 11th, regardless of age or pre-existing conditions. Corrections officers also became eligible that day.

When asked at a press conference in February why the state didn’t consider prisons congregate settings, Governor Andrew Cuomo said he didn’t “know the specific definition of congregate.”

A recent report found overcrowding on Rikers Island, which the city oversees, contributed to three men's deaths from COVID at the height of the pandemic last year. While the city jail population decreased to below 4,000 people during COVID, it’s inched steadily upward now to approximately 5,600 people being detained, according to the latest tallies from the city. Rikers Island reported 63 active COVID-19 infections in mid-March.

In court papers, attorneys for the state argued the limited supply of vaccine had justified the delays, to which the judge disagreed.

“A limitation on the supply of vaccines does not justify the differential treatment of incarcerated people,” Judge Tuitt wrote. “The numbers of persons eligible for vaccination consistently has exceeded the reported supply of vaccines in New York State. Respondents nonetheless have continued to expand eligibility categories beyond available supply for groups other than incarcerated adults.”

The City’s Correctional Health Services had moved more quickly than Cuomo’s officials to vaccinate detainees in its custody. But their efforts were stymied by the state guidance. City officials had repeatedly urged the state health department to widen access.

Jeanette Merrill, a spokesperson for the city’s Correctional Health Services, welcomed the state’s change in rules.

“We have advocated that every person in custody should have access, not based on health or age, but due to the very nature of the congregate carceral setting,” she said. "We're thrilled to finally be able to offer the vaccine to all of our patients.”

Editor's note: This story was updated to correct the current inmate population at Rikers Island.