A Florida correctional officer polled his colleagues earlier this year in a private Facebook group: “Will you take the COVID-19 vaccine if offered?”

The answer from more than half: “Hell no.” Only 40 of the 475 respondents said yes.

In Massachusetts, more than half the people employed by the Department of Correction declined to be immunized. A statewide survey in California showed that half of all correction employees will wait to be vaccinated. In Rhode Island, prison staff have refused the vaccine at higher rates than the incarcerated, according to medical director Dr. Justin Berk. And in Iowa, early polling among employees showed a little more than half the staff said they’d get vaccinated.

As states have begun COVID-19 inoculations at prisons across the country, corrections employees are refusing vaccines at alarming rates, causing some public health experts to worry about the prospect of controlling the pandemic both inside and outside. Infection rates in prisons are more than three times as high as in the general public. Prison staff helped accelerate outbreaks by refusing to wear masks, downplaying people’s symptoms, and haphazardly enforcing social distancing and hygiene protocols in confined, poorly ventilated spaces ripe for viral spread.