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EMBARGOED FOR WEDNESDAY, OCTOBER 14, 2020 AT 4:00 PM

Congress of the United States


Washington, D.C. 20515

October 14, 2020

The Honorable Chad F. Wolf


Acting Secretary
U.S. Department of Homeland Security
500 12th Street, S.W.
Washington, D.C., 20536

Dear Acting Secretary Wolf,


We write to inquire whether the U.S. Department of Homeland Security (DHS) will be
reversing its stance on providing flu vaccinations to migrants, including children and family units,
currently detained at U.S. Customs and Border Protection (CBP) facilities, ahead of this year’s flu
season.
During the 2018-2019 flu season, we saw numerous flu outbreaks in CBP holding facilities and
at least three children died of the flu in CBP custody.1 As you saw in the facilities, the flu can cause
severe illness and at times can lead to death. The best way to prevent the flu is by receiving a
vaccination. Last year, even the medical and public health experts at the Centers for Disease Control
and Prevention (CDC) recommended that migrants in CBP be vaccinated against the flu.2 Speaking on
behalf of CBP, government officials have consistently cited the “short-term” nature of detention in
CBP custody as a pretense for rejecting recommendations from the medical and public health experts
at the CDC.3 However, there have been many instances where detention has by no means been “short-
term,” including as recently as 2019. In addition, Immigration and Customs Enforcement (ICE) has
indicated that flu vaccines are offered at initial intake. We ask that you confirm the policies and
procedures that ICE follows. Given these circumstances, detention conditions pose a severe public
threat to migrants, employees and their families, and surrounding communities.
Amid a global pandemic, during which the United States has tragically lost over 210,000
Americans to COVID-19, the CDC continues to recommend that everyone six months of age and older
get a flu vaccination. Dr. Robert Redfield, Director of the CDC, underlined this point in testimony
before the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and
Related Agencies during its “Review of Coronavirus Response Efforts” hearing on September 16,
2020. According to Director Redfield’s written testimony:
It is also unclear what impact the ongoing COVID-19 pandemic will have on health care and
public health systems during the upcoming influenza season and beyond. Circulation of
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COVID-19 and influenza virus at the same time could place a tremendous burden on the health
care system. Therefore, getting a flu vaccine is especially important.4
It is clear DHS now recognizes the importance of the flu vaccine for keeping our communities
and country safe. A post published on the DHS website by Deputy Under Secretary for Management
Randolph Alles on September 8, 2020, entitled “It’s Time to Get Your Flu Vaccine,” includes the
following:5
As a result of the COVID-19 pandemic, it’s more important than ever to do everything possible
to reduce the spread of flu. Unlike with COVID-19, we have a proven, effective vaccine for the
flu. Getting a flu vaccine is one of the most important things you can do to safeguard your
health during the flu season. It also protects the health of your colleagues, your family, and the
wider community. I encourage all DHS employees to get a flu shot this September if possible,
but no later than the end of October. This will decrease the possibility that you will become
infected or severely ill from influenza.6
In order to protect DHS employees, their colleagues, families, and the wider community, it would
make sense to also offer vaccination to the individuals with whom they come into contact at work.
The explanatory statement accompanying division D of Public Law 116-93 directed CBP to
address the following in their medical directive and implementing guidance:
• “Clear definitions, metrics, automated reporting requirements, and formal mechanisms for
coordinating with the [Chief Medical Officer (CMO)] on making determinations that
conditions at the border constitute a public health crisis, which should take into consideration:
time in custody; holding facility capacity limits; emerging disease outbreaks, such as
influenza [emphasis added]; and the readiness of each U.S. Border Patrol and Office of Field
Operations facility. These metrics shall be reported on a common operating picture such as the
Unified Immigration Portal;
• Response plans for public health crisis conditions that include: a convalescence center concept,
executed in concert with the CMO and the U.S. Public Health Service; the provision of
vaccinations when deemed appropriate by the CMO [emphasis added]; and emergency
mechanisms to address overcrowding at Border Patrol and port of entry facilities through
custodial transfers to Immigration and Customs Enforcement, and the Office of Refugee
Resettlement, as appropriate.”
Although CBP’s medical implementation plan states that “USBP, with the CBP CMO, will work
with the DHS CMO and other stakeholders and working groups to identify crisis vaccination-related
requirements as part of the USG immigration care continuum,” it is unclear if CBP has attempted to
complete these requirements. In addition, DHS has failed to complete a medical response strategy for
emergent circumstances, which was also required by the explanatory statement accompanying public
law 116-93.

More can and should be done to mitigate the health risks of the COVID-19 pandemic and influenza
season. Please provide us with a schedule for when a medical response strategy, including vaccination-
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related requirements, will be developed and in place. This is not only critical for the upcoming
influenza season but also for future pandemic-related vaccinations.

In the meantime, should CBP continue to deny flu vaccines to migrants in “short-term” detention,
please provide all relevant documentation outlining a plan for ensuring that migrants will timely be
provided flu vaccines when held in CBP custody longer than 72 hours. We request a response no
later than October 23, 2020.

Sincerely,

Linda T. Sánchez Rosa DeLauro Lucille Roybal-Allard


Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


Nydia M. Velázquez Grace F. Napolitano Juan Vargas
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


Thomas R. Suozzi Raúl M. Grijalva Sylvia R. Garcia
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


James P. McGovern Earl Blumenauer Ruben Gallego
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


Bonnie Watson Coleman Donald S. Beyer Jr. Donna E. Shalala
EMBARGOED FOR WEDNESDAY, OCTOBER 14, 2020 AT 4:00 PM
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Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


Tony Cárdenas Ann Kirkpatrick Norma J. Torres
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


Alan Lowenthal Veronica Escobar Debbie Dingell
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


Sheila Jackson Lee Jimmy Gomez David Trone
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


Suzanne Bonamici Eleanor Holmes Norton Deb Haaland
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


Mark Pocan Adam Smith Judy Chu
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


Jamie Raskin Jason Crow Mary Gay Scanlon
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


EMBARGOED FOR WEDNESDAY, OCTOBER 14, 2020 AT 4:00 PM
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Pete Aguilar Danny K. Davis Chuy García


Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


Emanuel Cleaver, II Rashida Tlaib André Carson
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


Bill Foster Suzan DelBene Mark Takano
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


J. Luis Correa Filemon Vela Joaquin Castro
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


Jan Schakowsky Ami Bera, M.D. Doris Matsui
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


Grace Meng Henry Cuellar Dina Titus
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


Lauren Underwood Kim Schrier, M.D. Nanette Diaz Barragán
Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________ _________/s_________


EMBARGOED FOR WEDNESDAY, OCTOBER 14, 2020 AT 4:00 PM
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Vicente Gonzalez Jerrold Nadler Bradley S. Schneider


Member of Congress Member of Congress Member of Congress

_________/s_________ _________/s_________
Jackie Speier Peter Welch
Member of Congress Member of Congress

CC: Mark Morgan and Dr. Duane Caneva, Chief Medical Officer of DHS

1
Letter from Congresswomen DeLauro and Roybal-Allard to Acting Secretary of Department of Homeland Security Kevin McAleenan and Secretary of
Department of Health & Human Services Alex M. Azar II (August 5, 2019): https://delauro.house.gov/sites/delauro.house.gov/files/DeLauro_Roybal-
Allard_Letter_DHS_HHS.pdf
2
Letter from Director of the Centers for Disease Control and Prevention Dr. Robert Redfield to the Honorable Rosa DeLauro (November 7, 2019):
https://www.warren.senate.gov/imo/media/doc/CDC%20Response%20-%20migrant%20vaccination.pdf
3
Letter from Director of the Centers for Disease Control and Prevention Dr. Robert Redfield to the Honorable Rosa DeLauro (November 7, 2019):
https://www.warren.senate.gov/imo/media/doc/CDC%20Response%20-%20migrant%20vaccination.pdf
4
U.S. Department of Health and Human Services, Testimony from the witnesses appearing before the U.S. Senate Appropriations Subcommittee on
Labor, Health and Human Services, Education, and Related Agencies.” (Sept. 16, 2020):
https://www.appropriations.senate.gov/imo/media/doc/09.16.2020--HHS%20Covid%20Relief%20Efforts%20Testimony1.pdf
5
Department of Homeland Security, “It’s Time to Get Your Flu Vaccine.” (Sept. 8, 2020): https://www.dhs.gov/employee-resources/blog/2020/09/08/its-
time-get-your-flu-vaccine
6
Ibid.

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