<div itemscope itemtype=”http://schema.org/Article”>
<h3 itemprop=”name”>
<!–ARTICLE TITLE START–>
Why Is the U.S. Denying Detained Border-Crossers Flu Shots?
<!–END ARTICLE TITLE–>
</h3><h4><i>by <a href=”http://discuss.ilw.com/articles/articles/392632-article-filing-under-the-fy-2021-h-1b-cap-how-will-h-1b-registration-work-by-cora-ann-pestaina#bio”>
<span itemprop=”author” itemscope itemtype=”http://schema.org/Person”>
<span itemprop=”name”>
<!–AUTHOR NAME START–>
Kristie De Peña
<!–END AUTHOR NAME–>
</span></span>
</a></i></h4><br/>
<span itemprop=”articleBody”>
<img
src=”https://thebulwark.com/app/uploads/2020/01/GettyImages-1186995737-1024×668.jpg”
alt=”Featured Image”
/>
<div>
Guatemalan Lesbia Garcia, friend of Carlos Hernandez Vasquez, the
sixteen-year-old migrant who died in May in immigration custody in Texas,
visits the cemetery where his is buried in San Jose El Rodeo village, in
the municipality of Cubulco, Baja Verapaz Department, northwest of
Guatemala City, on December 7, 2019. – Seven months after the death of
Carlos under the custody of the US border patrol, a video of the security
cameras was released showing the teenager dying at the detention center.
Carlos Hernandez had been detained by US border patrol agents in May after
crossing the border from Mexico. He was seen by a nurse who determined he
had the flu and was moved from the McAllen centre to a nearby facility to
avoid other detainees getting sick. Just a week after being apprehended, he
was found unresponsive during a welfare check. (Photo by ORLANDO ESTRADA /
AFP) (Photo by ORLANDO ESTRADA/AFP via Getty Images)
</div>
<div>
<div>
<div>
<a
href=”https://twitter.com/intent/tweet?text=Why%20Is%20the%20U.S.%20Denying%20Detained%20Border-Crossers%20Flu%20Shots%3F&url=https%3A%2F%2Fthebulwark.com%2Fwhy-is-the-u-s-denying-detained-border-crossers-flu-shots%2F&via=BulwarkOnline”
>
Share on Twitter
</a>
<a
href=”mailto:?subject=Why%20Is%20the%20U.S.%20Denying%20Detained%20Border-Crossers%20Flu%20Shots%3F&body=Check%20it%20out%3A%20https%3A%2F%2Fthebulwark.com%2Fwhy-is-the-u-s-denying-detained-border-crossers-flu-shots%2F”
>
Share via email
</a>
<a
href=”https://thebulwark.com/why-is-the-u-s-denying-detained-border-crossers-flu-shots/#”
>
Print
</a>
</div>
</div>
<div>
<div>
<p>
It’s flu season again, but most Americans are fortunate to have
ample access to flu shots (it’s still not too late!) at a
relatively low price. Without the immunization, the flu can
kill even a healthy adult, but the disease disproportionately
claims the lives of children and the elderly. While the flu is
generally considered a manageable epidemic disease, it can
still cause astonishing harm in places where vaccines are
limited and people are crowded together – places like immigrant
detention camps at the southern border, where an epidemic
crisis now looms.
</p>
<p>
Recent advances in
<a href=”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139605/”>
immunization techniques
</a>
have significantly enhanced the vaccine’s efficacy, reduced
adverse effects, and made administering it possible in nearly
any conditions. But the flu virus is still a dangerous disease.
In the winter of 2017-18, the flu and its complications killed
<a
href=”https://www.statnews.com/2018/09/26/cdc-us-flu-deaths-winter/”
>
80,000 Americans
</a>
(646,000 people worldwide), leading to almost frantic calls for
annual immunization.
</p>
<p>
According to the Centers for Disease Control (CDC), children
should be vaccinated every flu season. Children under 9 who
have never had a flu vaccine require
<a
href=”https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/flu-shots/faq-20058448″
>
two doses
</a>
, given four weeks apart, to ensure they are adequately
protected against the flu during peak months between October
and February.
</p>
<p>
Despite fervent warnings from the CDC about the need to
immunize children seeking asylum at the border against the flu,
border authorities will not allow flu immunizations. Even more
irresponsibly, offers by private individuals to do so <em>at no cost to the government</em> have been spurned for no
discernible reason.
</p>
<p>
Many children waiting with their parents to make an asylum
claim in the U.S. come from countries in Latin America that do
not have adequate access to an effective influenza
<a href=”https://www.ncbi.nlm.nih.gov/pubmed/30975568″>
immunization
</a>
, often because available vaccines are a mismatch to the
circulating strains of the flu that vary annually or because of
misconceptions and poor awareness among the public about the
effectiveness of the immunization. Providing the vaccine is
critical to the populations arriving at our southern border
from these parts of the world, as well as greatly beneficial to
herd immunity in the United States.
</p>
<p>
Generally speaking,
<a
href=”https://www.cdc.gov/immigrantrefugeehealth/exams/medical-examination.html”
>
medical examinations
</a>
are mandatory for all refugees coming into the country and all
applicants outside the U.S. applying for an immigrant visa, in
accordance with our immigration laws.
<a
href=”https://www.uscis.gov/portal/site/uscis/menuitem.eb1d4c2a3e5b9ac89243c6a7543f6d1a/?vgnextoid=f3829c7755cb9010VgnVCM10000045f3d6a1RCRD&vgnextchannel=f3829c7755cb9010VgnVCM10000045f3d6a1RCRD”
>
Section 212(a)(1)(A) of the Immigration and Nationality Ac
</a>
<u>t</u>
states that the U.S. may not admit individuals that have a
communicable disease of public significance, who fail to
present documentation of having received vaccination against
<a
href=”https://www.cdc.gov/immigrantrefugeehealth/exams/diseases-vaccines-included.html#vaccine”
>
vaccine-preventable diseases (like the flu)
</a>
, who either have or have had a physical or mental disorder
with associated harmful behavior, or who are drug abusers or
addicts. If a vaccine is not available, a civil surgeon or
panel physician
<a
href=”https://www.cdc.gov/immigrantrefugeehealth/laws-regs/vaccination-immigration/revised-vaccination-immigration-faq.html”
>
refers
</a>
the applicant to a place where the vaccine is provided, or
grants a waiver to provide the vaccine in the U.S.
</p>
<p>
Both Immigration and Customs Enforcement (ICE) and the Office
of Refugee Resettlement (ORR)
<a
href=”https://www.washingtonpost.com/immigration/cdc-recommended-that-migrants-receive-flu-vaccine-but-cbp-rejected-the-idea/2019/11/25/8aba198e-0fb8-11ea-b0fc-62cc38411ebb_story.html”
>
provide flu vaccines
</a>
to children (and adults) in their custody. CBP has <em>never</em> provided immunizations for detained migrants due
to the short-term nature of CBP holding.
</p>
<p>
Now, however, susceptibility to the flu has been magnified by
conditions at the border resulting from the Migration
Protection Protocols (MPP) and the resulting unofficial border
camps – and crowded CBP facilities. The sheer number of
children living in tents along the border and held for extended
periods in CBP facilities increases the spread of the flu virus
and complicates treatment.
</p>
<p>
At least three children – aged 2, 6, and 16 –
<a
href=”https://www.propublica.org/article/inside-the-cell-where-a-sick-16-year-old-boy-died-in-border-patrol-care”
>
have died
</a>
in CBP custody since December 2018 of flu-related illness. In a
<a
href=”https://www.washingtonpost.com/context/doctors-letter-to-congress-urging-investigation-into-child-migrant-deaths/22742b78-f091-47b1-b82d-b4d7750432a5/”
>
letter
</a>
to Congress, doctors cite poor conditions at CBP facilities for
amplifying the spread of influenza and other infectious
diseases. Health care professionals also suspect that DHS and
the Department of Health and Human Services (HHS) may not be
following the best practices with respect to screening,
treatment, isolation, and prevention of influenza, and
<a
href=”https://www.washingtonpost.com/context/doctors-letter-to-congress-urging-investigation-into-child-migrant-deaths/22742b78-f091-47b1-b82d-b4d7750432a5/”
>
asked
</a>
Congress to investigate.
</p>
<p>
As a result, parents in MPP are forced to send a child who
falls ill back to border officials as an unaccompanied minor –
who are never placed in the queue to wait in Mexico – in order
to ensure that the child will be given medical care by ORR.
</p>
<p>
To make matters worse, when a child reaches the border, CBP
officials are often the only government officials who interact
with children of asylum-seeking families prior to their return
back to Mexico to wait for admission under MPP. The MPP
guidelines give CBP officers
<a
href=”https://www.cbp.gov/sites/default/files/assets/documents/2019-Jan/MPP%20Guiding%20Principles%201-28-19.pdf”
>
full discretion
</a>
to assess the physical and mental health of an individual for
the purpose of deciding whether they are fit to wait in Mexico
– a task for which they are manifestly unqualified.
</p>
<p>
Essentially, CBP officers are charged with eyeballing children
and determining how healthy they are, without the aid of any
health care background or knowledgeable assessment. Children
placed in MPP are likely to never get any care until they get
desperately ill – and even then, probably not. Prophylactic
vaccination could help resolve the problem.
</p>
<p>
In an early April
<a
href=”https://www.cbp.gov/newsroom/speeches-and-statements/transcript-march-fy19-year-date-statistics-press-call”
>
press call
</a>
last year, Border Patrol Chief of Operations Brian Hastings
said that the agency then sent an
<a
href=”https://www.theatlantic.com/family/archive/2019/07/border-crisis-reaches-emergency-rooms/594160/”
>
average
</a>
of 63 people per day to get additional medical treatment – the
highest number it has seen since it began tracking.
</p>
<p>
In defense of the agency’s rejection to provide flu
vaccinations, CBP spokeswoman Kelly Cahalan
<a
href=”https://www.washingtonpost.com/immigration/cdc-recommended-that-migrants-receive-flu-vaccine-but-cbp-rejected-the-idea/2019/11/25/8aba198e-0fb8-11ea-b0fc-62cc38411ebb_story.html”
>
said
</a>
:
</p>
<p>
CBP has significantly expanded medical support efforts, and now
has more than 250 medical personnel engaged along the Southwest
border. To try and layer a comprehensive vaccinations system on
to that would be logistically very challenging for a number of
reasons. The system and process for implementing vaccines — for
supply chains, for quality control, for documentation, for
informed consent, for adverse reactions — is complex, and those
programs are already in place at other steps in the immigration
process as appropriate.
</p>
<p>
But many argue these reasons are pretextual.
<a
href=”https://www.latimes.com/california/story/2019-12-10/cbp-denies-access-doctors-vaccinations-migrant-children”
>
According to one physician
</a>
, it would take less than half an hour to administer the
vaccine to more than 100 children via a free mobile flu clinic.
Groups of physicians and health care providers continue to
<a
href=”https://www.latimes.com/california/story/2019-12-10/cbp-denies-access-doctors-vaccinations-migrant-children”
>
protest
</a>
the government’s refusal to allow them to administer flu shots
to the willing. If CBP were to administer immunizations itself,
the cost would be minimal; about $
<a
href=”https://www.cdc.gov/vaccines/programs/vfc/awardees/vaccine-management/price-list/index.html”
>
1.40. per immunization
</a>
, and would likely prevent costly hospitalizations that result
from complications of preventable disease.
</p>
<p>
Vaccinating children against the flu common across agencies in
DHS and HHS, and is a practice (seemingly) easily translated to
CBP facilities. Allowing physician volunteers access to the
populations in the interim to administer immunizations at such
low or no cost, with such obvious positive consequences, is a
no-brainer.
</p>
</div>
</div>
</div>
<p>This post originally appeared on <a href=”https://thebulwark.com/why-is-the-u-s-denying-detained-border-crossers-flu-shots/” target=”_blank”>The Bulwark</a>. Reprinted with permission.</p>
</span>
</div>
<hr/><h4>
<a name=”bio”></a>
About The Author<br/>
</h4>
<!–AUTHOR BIO START–>
<b><a>Kristie De Peña</a></b> is the vice president of policy and director of immigration at the Niskanen Center. She focuses on immigration and national security law and policy and earned her J.D. from the University of Iowa College of Law, and a Master of Laws in national security and foreign policy from George Washington University School of Law.
<!–END AUTHOR BIO–>
<p><hr/>
<div class=”ilwFinePrint”>The opinions expressed in this article do not necessarily reflect the opinion of <span itemprop=”publisher” itemscope itemtype=”http://schema.org/Organization”>
<span itemprop=”name”>ILW.COM</span></span>.</div></p>
{$inline_image
