As the COVID vaccine rollout gets underway, different states are taking drastically different measures to vaccinate incarcerated Americans.
The CDC recommends prison or jail staff and inmates should be vaccinated after front-line health care workers and long-term care residents, but before the general public.
In Chicago, a retired local judge wrote, "Adults with high-risk medical conditions should not have to wait in line behind criminals."
And an Illinois Senate Republican called the prioritization of inmates "immoral."
Dr. Josiah Rich said: "As a society, we have this deal: If you break the rules, we can incarcerate you, we can take away your freedom. But along with that is the guarantee that we take over responsibility for what you can't do now, your housing, your clothing, your food and your health care."
Dr. Josiah Rich has worked specifically on preventing infectious diseases behind bars for the last 25 years.
Rich said: "In Rhode Island, we were able to keep it out of our correctional facility for over eight months. … And then it got into maximum security. And within two weeks, 95% of the people there were infected. It's just, boom. It just spreads, it doesn't matter what you do."
Chicago's county health service told Newsy it started vaccinating detainees in jail this week and 150 inmates have received a first dose, while vaccinations for employees started a few weeks ago and more than 900 staff members have been vaccinated.
But while Illinois is moving forward with the CDC's recommendations, several other states have changed course.
In Texas, the Department of Criminal Justice has administered more than 5,500 doses of the COVID vaccine, but none has been given to inmates.
The governor of Colorado bucked plans his own health department recommended by moving inmates further back in the distribution plan.
Dr. Carlos Franco said, "I think it shows a lack of moral courage of the governor, in my opinion."
Dr. Carlos Franco is an infectious disease specialist in Boulder who has gone around the state inspecting county jails and advising state prison leaders how to combat COVID behind bars.
Franco said: "It's a high-yield public health intervention that has nothing to do with, you know, advancing any agendas by the ACLU or civil rights groups. It's just doing the right thing from a public health perspective."
According to the Colorado Health Institute, 15 of the 20 largest outbreaks in the state came from Colorado prisons and jails.
There's a similar pattern in Illinois, where a recent study found nearly 16% of all documented COVID cases in the entire state stemmed from the outbreak at Cook County Jail.
Jamal Andress, Newsy, Chicago.