The Washington PostDemocracy Dies in Darkness

Opinion Flu season is coming. The Trump administration isn’t ready to protect migrant children from disease.

Migrant families wait in the shade of the Anzalduas International Bridge before Border Patrol agents transport them in McAllen, Tex., on June 20. (Carolyn Van Houten/The Washington Post)

You might think, given the widespread condemnation of the abhorrent conditions at U.S. detention centers, that the Trump administration would do everything possible to minimize future scandals. And you might think, given the six migrant children who died in U.S. custody, that the government would be taking extraordinary steps to protect the most vulnerable detainees.

You would be wrong. As a group of doctors from Harvard and Johns Hopkins recently highlighted in a letter to Congress, government facilities are still putting migrant children at high health risk, placing them in facilities where influenza threatens to proliferate. And the government is making no concerted effort to protect the children in its custody against flu by making sure they have access to the appropriate vaccines.

Of the six children who died while they were in the custody of federal government, at least three of them suffered from the flu, autopsy reports show. The children who died were 2, 6 and 16, and they were the first children to die in custody in 10 years, officials said.

“We don’t hear about kids dying from the flu very often. There’s a reason for that,” said Alia Sunderji, a pediatric emergency physician doing her masters of public health at Johns Hopkins Bloomberg School of Public Health, who signed the letter to Congress.

Under normal circumstances, Sunderji explained, influenza doesn’t pose much of a threat to children. But conditions in detention centers are especially dangerous and could amplify the chances of the disease spreading among detainees. Children in these facilities are less likely to be immunized against the flu, and they are also more likely to contract other diseases during the stressful journey to the United States.

Detention centers are also the perfect setting for disease transmission. Some detainees come and go rapidly; others remain in the facilities for long periods of time. Combine those two factors, and you’ve created a “revolving door” effect, reducing the population’s ability to build immunity. Add in dangerous overcrowding and generally obscene conditions, and you have a potential disaster. For young children unable to get a vaccine because of health reasons or because they are not old enough, Sunderji calls it a “death trap.”

The doctors recommended in their letter that all children be screened for symptoms of influenza and tested for the virus upon arrival at a Customs and Border Protection (CBP) processing center. Those who have the flu should be isolated and treated. They also recommend that children be vaccinated according to Centers for Disease Control and Prevention guidelines, as should all migrants and staff during the flu season.

But the CBP doesn’t follow such a protocol. Vaccines, though “strongly encouraged,” are not mandated for staff. And an agency spokesperson clarified in a statement: “In general, 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.”

Of course, “short term” is open to interpretation. Many migrants have been detained for weeks — or even months. And while unaccompanied minors are supposed to be kept at a CBP facility no longer than 72 hours before being transferred to shelters administered by the Department of Health and Human Services, which does offer flu vaccines, many stay much longer.

The CBP clarified that migrants in its custody “may receive vaccinations by medical personnel at a local medical facility, if determined necessary by the medical professional during their assessment.” But that’s far from a concerted effort to reduce the risk of flu. A spokesperson for the agency confirmed that CBP doesn’t even track how many migrants are vaccinated.

It’s true that the surge in migrants over the past few months has strained U.S. immigration enforcement beyond its limits. Any attempt to offer vaccines to migrants, and to build the trust of parents in an effort to obtain parental consent where possible, would add yet another burden to an already overloaded system.

But how can the administration possibly justify not putting forth these efforts? At least three children with flu have needlessly died under the government’s watch during last year’s particularly bad influenza season. Shouldn’t the administration be doing everything in its power to avoid more deaths? Why did it take independent medical professionals to raise red flags about disease prevention? And why did reporters have to pry information out of the administration to see if they’re doing anything about it?

The next flu season is only months away, and it seems the administration is yet again entirely unprepared to face it. This is unconscionable. If the flu ends up taking another young migrant’s life, we’ll have only one way to explain it: neglect.

Read more:

The Post’s View: The Trump administration is harassing those helping migrants. The hypocrisy is unmistakable.

Scott Warren: I gave water to migrants crossing the Arizona desert. They charged me with a felony.

The Post’s View: Convicted for leaving water for migrants in the desert: This is Trump’s justice

Juliette Kayyem: Decriminalizing the border is not in anyone’s interest

David Von Drehle: I’ve been to the border. Here’s what I learned.