HAMPTON ROADS, Va. - As we wait for vaccine distribution for COVID-19, one big question is who should get the vaccine first - and last.
One highly accomplished Health Security Expert at Johns Hopkins University co-authored a report on that subject. One of his main concerns is prisons.
"We aren't sure we have all the right answers but we have important things to say," said Dr. Eric Toner.
Inmates live in crowded conditions, share bathrooms and common areas and are virtually unable to be socially distanced. It is safe to say prisons and jails are a hot bed for the spread of coronavirus.
"These become incubators of disease, so it's in all of our interest to try to stop spread within prison walls," Toner said.
Toner is the co-author of a report on Vaccine Allocation published by the Johns Hopkins center for health security.
"We put together a group to think through basic ethical principles everyone would agree to, such as do the most good for greatest number and to treat everyone fairly," Toner said. "Then we sent our recommendations to the Advisory Committee on Immunization Practices (ACIP)."
For months after coronavirus ramped up in the U.S, he and several other health security experts worked to establish tiers for vaccine allocation for once it is available.
"Tier 1 would be health care workers, they define that broadly, and residents of nursing homes," Toner said.
Toner and others recommended that prisoners or detainees be in Tier 2.
"One of the basic tenets of public health is to stop outbreaks at their source, and in many communities, outbreaks are coming out of prisons," Toner said. "They are at higher risk than the general population of getting infected."
In Hampton Roads, nearly every jail has seen a large outbreak of COVID-19. Just last week at the Chesapeake Correction Center, 232 inmates tested positive out of about 1,000 in that jail. The huge outbreak prompted the sheriff to open an isolated COVID-19 unit.
While some may disagree to give prisoners the vaccine, Toner says we have a legal and ethical obligation to safeguard the health of those incarcerated.
"If someone were to argue they shouldn't get a vaccine, I would say, that is not part of their sentence. It's to be in prison, not to be deprived of healthcare," Toner said.
This week Governor Ralph Northam announced that Virginia is expected to get 70,000 vaccines from Pfizer in the first wave. The CDC recommended those go first to healthcare workers and the elderly.