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Lack of flu shots at US detention centers threatens lives, doctors say

The Trump administration confirmed it is not providing influenza shots to undocumented migrants, including children, at U.S. Customs and Border Patrol detention centers, which doctors said creates a situation ripe for an outbreak that could spread to the outside community.

That lack of providing flu vaccinations threatens lives, a group of infectious disease experts and doctors from Harvard and Johns Hopkins Universities told members of Congress.

Flu shots should be offered to all of the detainees promptly on their arrival to maximize protection for the youngest and most vulnerable, the doctors said in a letter to Reps. Rosa DeLauro, D-Conn., and Lucille Roybal-Allard, D-Calif., who lead two House subcommittees.

Federal border workers and contractors should also be required to be vaccinated against the flu to reduce the chance of an outbreak in the broader community, the doctors added.

Three migrant children have already died of the flu in recent months while being held in U.S. custody, the doctors said. Three other detained children died of other causes.

Poor conditions at the detention facilities may be amplifying the spread of influenza and other infectious diseases, increasing health risks to children, they said.

The doctors called for a congressional investigation into the medical care of the detained migrants.

DeLauro and Roybal-Allard provided a copy of the doctors' letter to Acting Homeland Security Secretary Kevin McAleenan and Health and Human Services Secretary Alex Azar. The lawmakers said they were concerned about the threat of infectious diseases, including influenza, inside the migrant detention facilities run by DHS, which oversees CBP, and HHS.

The news about the administration's policy of not providing vaccinations to CBP-detained migrants, first reported by CNBC, comes as President Donald Trump is preparing to make combating influenza a key part of his overall healthcare plan, as he seeks to hold onto the White House.

In an Aug. 20 statement to S&P Global Market Intelligence, CBP said it does not offer the flu shot in general to undocumented migrants at the agency's detention centers because those people are intended to be held for a short time, operating immunization programs is complex and the vaccine takes up to 10 days to be effective.

Prolonged detentions

Under U.S. government rules, detainees are not supposed to be held longer than 72 hours at CBP facilities.

But a July 2 report by the Office of Inspector General for the U.S. Department of Homeland Security found that 3,400 undocumented migrants had been held longer than the time permitted, with at least 1,500 of those people held for more than 10 days.

"Most single adult detainees were wearing the clothes they arrived in days, weeks and even up to a month prior," the DHS OIG investigators reported.

They said 826 children at the CBP facilities had been held longer than 72 hours, with 165 of those minors in custody for longer than a week.

The Harvard and Johns Hopkins doctors warned that the "revolving-door" environment where there is a rapid turnover of some people being held, while others are in custody long term, increases the chances for the flu to spread inside and outside the detention centers.

Migrant children are transferred to facilities run by HHS when the agency has room for them, while the adults are sent to facilities operated by the U.S. Immigration and Customs Enforcement when space permits, the OIG investigators noted.

But because the HHS and ICE facilities have been operating at or above capacity, CBP has experienced increasing instances of prolonged detention in its facilities, they said.

Before children can be moved from a border patrol station to an HHS-funded care facility, they must be considered "fit to travel," an HHS spokesperson told S&P Global Market Intelligence.

CBP said it has about 200 medical personnel engaged along the U.S. Southwest border and said most of its facilities have 24-hour-a-day medical support available onsite.

If CBP determines a detainee may need a vaccination, that person is referred to the local health system where they may receive the shot from medical personnel there, if deemed necessary by that health professional, the agency spokesperson said.

The agency coordinates with local health officials and the U.S. Centers for Disease Control and Prevention if there are public health issues that need to be considered, the spokesperson added.

Once children are transferred into HHS' care, they receive medical and mental health screenings and initial vaccinations within 48 hours of arriving, the HHS spokesperson said.

If a vaccination record is not located or a child is not up-to-date, the child receives all vaccinations recommended by the CDC, the spokesperson added.

If health issues arise, the children in HHS' care receive prompt medical attention, the spokesperson insisted.