番茄社区

Physician groups and policymakers continue to press U.S. Customs and Border Patrol (CBP) to vaccinate detainees against influenza, as three children in custody died from complications of the flu in the last year.

In August, the Infectious Diseases Society of America and four other professional societies decried CBP's decision to deny detainees flu shots, despite urging from CDC leadership to provide them.

Then, in September, three doctors in the House Democratic Caucus -- Kim Schrier (D-Wash.), Ami Bera (D-Calif.), and Raul Ruiz (D-Calif.) -- criticized the policy in a letter to Acting Homeland Security Secretary Kevin McAleenan and CDC director Robert Redfield for

And last month, Mark Travassos, MD, of the University of Maryland, published a detailed report on the death of 8-year-old Guatemalan immigrant Felipe Gómez Alonzo, whose incorrect treatment for the flu led to his death on Christmas. Though Gómez Alonzo was quickly , he was sent off with antibiotics instead of an antiviral, and he died later that night.

"You have to have effective surveillance in order to pick up on illness and to take them to appropriate medical facilities," Travassos told 番茄社区. "With a sick child, it should be a facility where there is pediatric-specific care available ... such as a pediatric intensive care unit."

Travassos' report and an accompanying editorial were an attempt to rally physicians together to advocate for children in detention centers and volunteer medical care for undocumented migrants who have limited access to care.

Indeed, frustrated providers are taking matters into their own hands. Earlier this month in California, a group of seven physicians offered to administer 100 donated flu shots to migrants in a detention center in San Ysidro, according to the . This followed another attempt by a group of nurses and advocates who were in October.

Influenza-related mortality among children in U.S. custody was nine times higher than that of the general pediatric population last year, the group wrote in .

"In our professional medical opinion," the doctors wrote, "this alarming mortality rate constitutes an emergency which threatens the safety of human lives, particularly of children."

Some of those doctors are mounting a protest in San Ysidro next week to "demand CBP allow a pop-up flu vaccine clinic in order to provide vaccinations for families being held in detention," according to a flyer advertising the event.

Bonnie Arzuaga, MD, of Boston Children's Hospital, a protest organizer, said one goal is "to have CBP acquiesce and allow volunteer physicians to provide standard medical care, and in this case that means flu vaccinations for people in detention. We will be coming with all the equipment we need for a pop-up flu clinic and we will have 100 vaccine doses available that we've purchased with donations."

But "being realistic about the fact that CBP will likely not let us in," Arzuaga said, the group hopes to create "more awareness and keeping the pressure on CBP."

Last week, the that CDC director Redfield recommended last winter that CBP vaccinate detained migrants, which came to light in a Nov. 7 letter from Redfield to Rep. Rosa DeLauro (D.-Conn.), chair of the House Appropriations subcommittee, which oversees funding for the Department of Health and Human Services.

"CDC recommends that priority should be given to the screening and isolation of ill migrants, early antiviral treatment, and flu vaccinations for all staff," Redfield wrote to DeLauro. "CDC further recommends influenza vaccination at the earliest feasible point of entry for all persons at least six months of age, which is in concurrence with our general influenza vaccine recommendations."

CBP did not comply with any of their requests, citing the "short-term nature of CBP holding" and the "complexities of operating vaccination programs" as factors for their decision, which was . Migrants are not supposed to be held in border patrol custody for more than 72 hours, but in many cases they are not processed by ICE in that time and are required to stay longer -- for weeks, in some cases.

Felipe Gómez Alonzo is one of seven children to die while in CBP care in the last year, and the third to die from influenza, alongside 16-year-old Carlos Hernandez Vásquez and 2-year-old Wilmer Josué Ramírez Vásquez. Some 130,000 family units have been detained in the 2019 fiscal year to date, and none have received flu shots while in custody.

Cheryl Clark contributed to this report.

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