December 16, 2020: The U.S. and U.K. have already started to roll out their national coronavirus vaccination programs to curb the spread of the virus, but health experts and campaigners alike are deeply concerned about the notable absence of prison populations in existing guidance.

The U.S. Centers for Disease Control and Prevention has not yet made any decisions about prisoners regarding vaccine access, though individuals’ chances may be included in the second phase of allocation.

In the U.K., the Joint Committee on Vaccination and Immunisation has said the top priority for the Covid-19 vaccination program should be to prevent death and support the maintenance of health and social care systems. There is no specific mention of prisons.

The U.S. CDC and Public Health England, which oversees JCVI, were not immediately available to comment when CNBC contacted.

Both countries have administered the first shots of the Pfizer-BioNTech vaccine outside of trial conditions in recent days.

However, as coronavirus cases and related deaths continue to surge, experts are questioning the ethics of how governments plan to distribute the first vaccines.

“We are facing a real big dilemma here,” said Deanna Hoskins, president, and CEO of JustLeadershipUSA, a national justice reform organization that seeks to cut the U.S. correctional population in half.

Health officials have been warning about the dangers of epidemics for those incarcerated for years, citing an inability for people to maintain safe physical distancing in correctional facilities because of their confinement in small shared spaces.

The coronavirus pandemic has seen America’s jails and prisons become COVID-19 hotspots. According to a study by a criminal justice commission, incarcerated individuals are almost four times more likely to become infected than people in the general population and twice as likely to die.

“If the biggest hotspots for COVID-19 are prisons, doesn’t it make sense to inoculate everyone from the guards to the prisoners?” said Ashish Prashar, a justice reform advocate and senior director of global communications at Publicis.