Lauren Witty

Word Count: 650

The US’s Hypocritical Approach to Influenza Immunization Coverage: Examining Vaccination within
Detained Immigrant Populations

As a university student, I am at high risk for contracting influenza. Therefore, I choose to get vaccinated

annually in order to protect myself. Nationally, only 63% of children and 45% of adults also protect

themselves from an illness that claims the lives of 500,000 people annually.​1,2​ The US government has

attempted to increase this vaccination coverage, as entities such as the CDC and the Department of

Health and Human Services constantly reaffirm the importance of vaccination.​3​ However, even in the

US, there is a population that does not have this privilege of medical autonomy. Immigrants within

Customs & Border Protection custody are not given the influenza vaccine, increasing their likelihood of

contracting the illness.

Some US citizens may ask, “why should we care about the health of unauthorized immigrants?” Well,

three important people we wish that we could ask are Carlos, Felipe and Wilmer. These 3 children were

the first to die within CBP custody for a whole decade. Each of them contracted and died from influenza

within CBP custody during the 2018/2019 flu season.​4​ Ultimately, the conditions within CBP custody led

to their infection and preventable deaths. Overcrowding, lack of access to sanitary products, and close

contact with unvaccinated people made it extremely easy for this virus to spread.​5​ Additionally, the

stress that inherently comes with detention, lowers immune system activity, increasing the likelihood of

infection.​6​ All of these factors combine to create facilities that are prime for outbreaks, increasing the

probability of influenza related death.

In January of 2019, just after the death of 8 year old Felipe, the CDC recommended that CBP offer

influenza vaccines to all detained immigrants. However, CBP claimed that it was too “logistically
difficult” to instate such a program, and declared that vaccination is unnecessary due to the maximum

72 hour stay within these facilities.​1​ However, CBP failed to mention that most migrants remain within

custody for more than 72 hours. Studies have found that at least ⅓ of all children remain in custody for

longer than 72 hours, and almost ½ of adults are detained for at least 10 days.​5​ These extended stays

within poorly sanitized centers increases the risk of transmission and death from influenza.

Generally, influenza vaccines are only offered to immigrants once they are transferred to ICE custody.

However, CBP detention puts these migrants at high risk for contracting influenza, making ICE’s efforts

to vaccinate futile. Immunization at the beginning of the immigration process would decrease the

overall incidence and burden of influenza within the detained immigrant population. With more people

vaccinated, less people will get sick, decreasing the health and financial burden of this illness.​7

Therefore, even though it may be “logistically difficult” to vaccinate migrants, an opt-out influenza

vaccine program would likely make CBP and ICE operations less complicated and more cost-efficient in

the future.​6

The US government continually calls for higher vaccination coverage. However, without providing

detained immigrants access to influenza vaccines, they are ignoring a huge population. This hypocritical

thinking and exclusion from health campaigns highlights a major gap in the US healthcare system. All

humans deserve the right to health, no matter what their immigration status may be. The US healthcare

system must support this population in order to advance their own vaccination campaigns and improve

health within the whole country. This proves essential now more than ever, as this upcoming influenza

season will potentially be accompanied by a resurgence of COVID-19.​8​ These two illnesses can be deadly,

and CBP must be proactive and attempt to reduce influenza prevalence to protect the health of these

immigrants.
The US government and healthcare system must end this hypocrisy and provide vaccination

opportunities to all people so that no one is forced to die from preventable illnesses. Call your

representatives, inform them of this disparity and hypocrisy and demand vaccination opportunities for

all populations.
 REFERENCE LIST

1. Moore, R. CDC Recommended that Migrants Receive Flu Vaccine, but CBP Rejected the Idea. ​The
Washington Post. ​2019. Retrieved from
https://www.washingtonpost.com/immigration/cdc-recommended-that-migrants-receive-flu-va
ccine-but-cbp-rejected-the-idea/2019/11/25/8aba198e-0fb8-11ea-b0fc-62cc38411ebb_story.ht
ml. Accessed May 24, 2020.
2. Ghebrehewet, S., MacPherson, P., Ho, A. Influenza. ​BMJ​. 2016; 355, i6258.
doi:10.1136/bmj.i6258
3. Key Facts About Seasonal Flu Vaccine. ​Centers for Disease Control and Prevention.​ 2020.
Retrieved from https://www.cdc.gov/flu/prevent/keyfacts.htm. Accessed May 30, 2020.
4. Sunderji, A., Narvaez Mena, K., Winickoff, J., et al. Influenza Vaccination and Migration at the US
Southern Border. ​American Journal of Public Health. 2 ​ 020; 110(4), 466-467.
doi:10.2105/AJPH.2019.305547
5. Aguilera, J. 'Ticking Time Bomb': New Government Report Details Overcrowding, Prolonged
Detention and Security Risks at Border Patrol Facilities. ​Time. 2​ 019. Retrieved from
https://time.com/5619407/dhs-report-overcrowding-border-patrol/. Accessed May 24, 2020.
6. Foppiano Palacios, C., Openshaw, J.J., Travassos, M.A. Influenza in the U.S. Detention
Centers-The Desperate Need for Immunization. ​The New England Journal of Medicine. 2 ​ 020;
382(9), 789-791. doi: ​10.1056/NEJMp1916894
7. Migrants Detained at Border will not be Vaccinated Against Flu. ​Infectious Diseases in Children.
2019; 32(9):4. Retrieved from
https://search.proquest.com/openview/ca91309c5936896b11dc90c595c229c2/1?pq-origsite=g
scholar&cbl=29327. Accessed May 24, 2020.
8. Strazewski, L. What's ahead on COVID-19? Expert offers forecast for summer, fall. ​American
Medical Association. 2 ​ 020. Retrieved from
https://www.ama-assn.org/delivering-care/public-health/what-s-ahead-covid-19-expert-offers-f
orecast-summer-fall. Accessed May 30, 2020.