The world’s top infectious disease experts say the U.S. government has a responsibility to provide preventative care such as flu vaccines to migrants immediately after they are taken into custody, but the federal agency involved says disease prevention is not its job.
“The introduction of the Influenza vaccine and other vaccines … is something we need to start thinking about from day one when these people come into our responsibility,” Dr. William Schaffner, an infectious diseases specialist at Vanderbilt University Medical Center in Nashville, told the Washington Examiner.
“As a law enforcement agency, and due to the short term nature of CBP holding and logistical challenges, operating a vaccine program is not feasible,” the U.S. Customs and Border Protection said in a statement to the Washington Examiner. “Both ICE and HHS have comprehensive medical support services and can provide vaccinations as appropriate to those in their custody,” a CBP spokesperson wrote in an email, though without providing details.
Recently released autopsies show three of six deaths of children who were in or had passed through CBP custody died from the flu, prompting some disease experts to say more must be done proactively. It is unknown at what point the children picked up the flu or if a vaccine while in CBP care would have prevented the deaths.
Dr. Paul Offit, who oversees the Vaccine Education Center and is a professor of pediatrics in the infectious diseases division at the Children’s Hospital of Philadelphia, noted the three flu-related deaths of children who passed through CBP facilities.
“If Customs and Border Protection is going to choose to take those children into their care, they need to care for them and give them the flu vaccine, otherwise it’s a choice not to care for them,” said Offit.
The Infectious Diseases Society of America wrote in a statement that not providing this type of preventive tool puts the government in “violation of the most basic principles of public health and human rights.”
Schaffner said the well-documented types of packed holding rooms and longer-than-normal detention rates are “ideal” breeding grounds for the transmission of a variety of acute communicable diseases.
“We’re taking people who come from under-served areas. They probably have nutritional problems. They may have other underlying health issues. They now come into custody,” said Schaffner. “We now have this responsibility and we need to institute, first of all, appropriate medial screening to look for an array of potentially serious problems. And then we need to provide them shelter and comfort and support, but reasonable preventive health services.”
When a person illegally crosses the international border, he or she will be apprehended by Border Patrol, a component within CBP, and transported to a Border Patrol station. While there, they will be interviewed and then will wait for a bed to open up at an Immigration and Customs Enforcement facility, the next stop.
Border Patrol is supposed to hold people for three days but has held them longer due to the dramatic uptick in the number of people crossing. Agents are forced to overcrowd stations while they wait for ICE, whose detention centers are largely run by a private company that has the ability to refuse transfers if it lacks space for new arrivals.
Schaffner said CBP is looking at the issue in a “very narrow bureaucratic way” when they should be thinking comprehensively. Providing vaccines within hours or a day of someone’s arrival could spare people further down the line from contracting the flu, either from someone in ICE custody or after they have been released into the U.S.
“Administratively, it’s easy. Medically, it’s important. It’s irrelevant whether they stay there three days or 100 days. It’s still a value for them to get the vaccine,” said Schaffner.
Offit, who advises government entities about which flu vaccines to use each year said the flu strain in Central America is likely the same strain in the U.S. and elsewhere, making the vaccine just as critical to be used on people at the border, 75% of whom are from El Salvador, Guatemala, and Honduras.
The CDC would not comment on whether it has made recommendations to CBP about immunization practices in light of the recent deaths and start of the flu season in the midst of crisis-level apprehension rates at the southwest border.
More than 57,000 people in the U.S. died from the flu during the 2018-2019 winter flu season. The vaccine is typically successful at preventing 40%-60% of infections.
Schaffner said the flu is the tip of the iceberg in terms of vaccines that detainees could and should be but are not receiving, putting them and those they will come into contact with at unnecessary risk.
