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By Gary Evans, Medical Writer
The U.S. Customs and Border Patrol’s (CBP) decision to not vaccinate migrants in detention facilities against flu and other infections is being slammed by leading clinicians and public health officials.
Closely confining people who may be weak and malnourished from an arduous journey sets the stage for an outbreak if flu or other infectious agents are introduced by a new arrival or perhaps a facility employee.
“You could not design a more ideal circumstance for the transmission of respiratory viruses and intestinal pathogens because of the close, sustained person-to-person contact they have within an enclosed environment,” says William Schaffner, MD, a leading vaccine expert and professor of preventive medicine at Vanderbilt University in Nashville.
A letter submitted to Congress by clinicians at Harvard University and Johns Hopkins Hospital said autopsy results show that three children have died in U.S. custody in part as a result of influenza since December 2018. In addition to influenza, the Centers for Disease Control and Prevention recently reported that from September 1, 2018 to August 22, 2019, there were 898 confirmed and probable cases of mumps in detained migrants.
The CBP has issued a widely quoted statement that "due to the short-term nature of CBP holding and the complexities of operating vaccination programs, neither CBP nor its medical contractors administer vaccinations to those in our custody." There is some speculation that medical care and vaccinations may occur at a later stage of the immigration process, but that could not be confirmed as this report was filed.
Several major infectious disease groups also issued a joint statement calling the inaction on immunizations “a violation of the most basic principles of public health and human rights.” The statement was issued by the presidents of the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the Pediatric Infectious Diseases Society, the HIV Medicine Association, and the American Society of Tropical Medicine and Hygiene.
“The CBP’s decision to withhold vaccinations against seasonal influenza from migrants in border detention facilities … runs directly counter to the imperative that no individual should be harmed as a result of being detained, and that the community standard of medical care be available to persons in the custody of the U.S. government,” the joint statement said.
For more on this story see the October 2019 issue of Hospital Infection Control & Prevention