Should a child molester, rapist, or murderer get the COVID-19 vaccine before your grandfather does? For that matter, should convicts get the shot before the rest of us law-abiding Coloradans?

Did these provocative rhetorical questions and subsequent outrage cause the governor and the Colorado Department of Public Health and Environment to alter the states vaccine distribution plan to exclude incarcerated persons from receiving priority? Thats unfortunate.

If were going to frame complex public health decisions this way then we should also ask whether a 50-year-old obese diabetic should get the vaccine before a 62-year-old with a healthy lifestyle. Or, should a 90-year-old with advanced dementia living in a nursing home get the shot before a mother with leukemia who is raising five young children? Or, should a 60-year-old chain smoker with emphysema get the shot before a rehabilitated 34-year-old who is eager to rejoin society?

If these questions make you uncomfortable, they should. Who is in a position to weigh the value of anothers life? This is why the Colorado state vaccination distribution plan cannot be based on who deserves a vaccine as an individual but on what will achieve the greatest harm reduction for the whole community. It should prioritize protecting the most vulnerable to severe infection, shielding the health of indispensable workers like medical personnel, and preventing outbreaks among the most at-risk of catching and spreading the disease.

The initial plan released in October had six phases that balanced these priorities to ensure that the aged, the chronically ill, essential workers, and those living and working in close-quartered, transmission-prone environments such as prisoners received the vaccine before the general public.

The final plan now has four phases: this winter, medical personnel who work with COVID patients as well as staff and residents of long-term care facilities will get the vaccine followed by other health professionals, first responders, and correctional workers. In spring, vaccines will be available to people aged 65 or older and those with chronic conditions that make them more vulnerable to severe infection followed by people who work directly with the public and those who work in high-density settings such as meat-processing plans. Finally, the public will be vaccinated.

Whos missing from the final list? People in congregate housing such as prisons and college dorms were not included even though 14 of Colorados 15 largest coronavirus outbreaks to date were at correctional institutions or college campuses. This omission needs to be addressed.

The state has a legal obligation to provide medical care for the incarcerated under the U.S. Constitution and according to the 1976 U.S. Supreme Court case Estelle v. Gamble. Incarcerated people are four times more likely to contract COVID-19 as the general population because they live in close proximity according to a study by the Criminal Justice Commission, and they have higher mortality rates from the disease.

Because inmates are more vulnerable to catching and transmitting the disease they should receive a higher priority than the general public. They shouldnt be at the head of the line but they should be in line ahead of people like me who can effectively socially distance and are at lower risk.

Most people in Colorado prisons and jails are not child molesters, rapists, or murderers but regardless of their crime, a court and jury have already determined their penalty and they are serving it. We cannot deny this vulnerable population priority in the vaccine plan in order to punish them and confer their vaccine access upon a worthier group. We are not their judge and jury.

The Colorado Department of Public Health and Environment should revise the latest vaccine distribution plan to include a priority for inmates. Gov. Jared Polis should articulate why public health policy demands an unbiased risk assessment and response and how that will benefit all of us.

Krista L. Kafer is a weekly Denver Post columnist. Follow her on Twitter: @kristakafer.

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Kafer: Colorados vaccine distribution must prioritize those in crowded living conditions - The Denver Post