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Study: Vaccine-Preventable Outbreaks Are Rising in ICE Detention Centers

Person being given a vaccine.

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Key Takeaways

  • From 2017-2020, outbreaks of vaccine-preventable diseases have increased across 17 United States Immigration and Customs Enforcement (ICE) detention facilities.
  • Influenza, varicella, and mumps are vaccine-preventable infectious diseases.
  • Overcrowding, lack of standard care, and underimmunization contribute to the escalation of outbreaks in detention centers.

Although influenza, varicella, and mumps are vaccine-preventable diseases, the mismanagement of such infectious diseases is impacting the health of people in immigration detention centers. A study conducted by researchers of the University of California-San Francisco (UCSF) found outbreaks of the illnesses in 17 United States Immigration and Customs Enforcement (ICE) detention facilities from 2017 to 2020.

If these diseases are left untreated, the conditions can be life-threatening.

While some may argue that these outbreaks have been caused by the current administration’s immigration and detention policies, the treatment and conditions of detainees have been an issue for decades.

“Medical neglect has been a long-standing issue that predates Trump," Sarah Gardiner, director of policy for Freedom for Immigrants, tells Verywell. "People have been working on this issue for decades."

In a September report by the United States House of Representatives Committee on Oversight and Reform, the committee investigated the conditions at ICE detention centers and found deficient medical care, prolonged detention, and filthy conditions. Population densities and overcrowding make detention centers harbors for outbreaks.

What Causes Outbreaks Inside Detention Centers?

Detainees are vulnerable to outbreaks due to factors like:

  • Overcrowding 
  • Lack of medical care and access to vaccinations 
  • Poor facility conditions and sanitation 
  • Medical neglect

The frequent influx of detainees coming from endemic areas allows for the outbreaks to transpire. In 2018 and 2019, there was an outbreak of mumps that infected nearly 900 detainees in 57 detention facilities. In 2019, there were 510,584 migrants detained in ICE custody.

Detainees congregate in common areas such as courtrooms, recreation yards, and visitation areas, making it difficult for them to physically space out and distance from others who might have the virus.

“ICE detention centers are high-risk environments for infectious disease outbreaks due to poor living conditions, limited access to preventative measures including immunizations and underimmunization in the migrant population,” Nathan C. Lo, MD, PhD, resident physician, co-author of the paper, and public health scientist at the UCSF, tells Verywell. 

In 2016, an Arizona detention facility experienced the largest measles outbreak since 1991. The measles cases accounted for one-third of the total cases that year. Although the average age for people who contracted influenza, varicella, and mumps were 18 to 28 years old, routine vaccines were only offered to detained children in limited circumstances.

“Crowding people together and giving them poor access to health care or vaccines makes these detention centers ripe for facilitating infectious outbreaks,” Lo said in a statement.

Medical neglect also contributes to the high rise in outbreaks. According to Gardiner, ICE has a reputation for failing to provide adequate medical care.

“In the summer of 2019, we saw a series of mumps outbreaks at different ICE detention facilities in California and Virginia, due to just completely negligent care,” Gardiner says. “Even before the COVID-19 pandemic started, ICE has proven itself to be incapable of providing even a basic standard of care.” 

The Centers for Disease Control and Prevention (CDC) recommends vaccines for varicella, mumps, and influenza due to their highly contagious nature. The mumps vaccine is 78% effective at protecting people against the viruses. The varicella vaccine is not too far behind in efficacy at 90% effectiveness in preventing chickenpox.

How to Keep People in Detention Centers Healthy

In people who have already been infected with mumps, the MMR vaccine has not been shown to be effective, increasing the urgent need for administrations to offer the MMR to detainees upon arrival at ICE facilities. “Based on the data, the key policy implication is that vaccinations should be offered upon early entry to detained migrants to prevent these infectious outbreaks,” Lo says.

Gardiner believes that releasing detainees is a better policy and public health option. “My policy solution is always going to be to release people as opposed to provide them better access to vaccines in detention,” Gardiner says. “It’s a public health issue. Jailing people in close confines has repercussions for all of us. This is about the safety of everyone. The best way to protect people is to release them.”

Outbreaks don’t just affect detainees, they also impact correctional staff’s health. Prior to the 2016 Arizona outbreak, two of the nine staff members were unvaccinated and three had unknown vaccination statuses. ICE officers interact with their families and community, increasing the rate of transmission for these viruses. 

At the beginning of the COVID-19 pandemic, ICE conducted a cursory review to identify people with underlying medical vulnerabilities, according to Gardiner. While ICE released people in the hundreds, thousands of detainees remain in the centers. “What we really needed was release in the tens of thousands. It’s clear that the best way to protect people from COVID-19 and detention is to release them,” Gardiner states. “We never needed the system. Every outbreak, every death is completely preventable.”  

What This Means For You

Outbreaks in detention centers affect the entire population. Community-based organizations provide fundamental services to detainees in ICE facilities. Reach out to local organizations to see how you can help or learn more.

Forward-Looking Solutions

Immigration might seem like a daunting issue to tackle, but Gardiner suggests people turn to community-based solutions. Community organizations like Freedom for Immigrants rely on volunteer-based infrastructure to provide support to detainees. Volunteers make regular visits to ICE detention and social visitation centers. Because of volunteers, organizations have been able to organize immigration proceeding support for families and accompany immigrants through various stages of the immigration process.

“There’s organizations around the country that are modeling what a world without detention looks like,” Gardiner says. “We should be investing in these community-based solutions to help people navigate the U.S. immigration system with dignity, and give them the tools they need to succeed and become successful members of our community.”

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  1. Lo NC, Nyathi S, Chapman LAC, et al. Influenza, Varicella, and Mumps outbreaks in US migrant detention centers. [published online ahead of print, 2020 Oct 29]. JAMA. 2020;e2020539. doi:10.1001/jama.2020.20539

  2. The House of Representatives Committee on Oversight and Reform. Committee Releases Staff Report on For-Profit Contractors Operating Immigrant Detention Centers. September 24, 2020.

  3. The United States House of Representatives. The Trump’s Administration’s Mistreatment of Detained Immigrants. Updated September 2020.

  4. Venkat H, Briggs G, Brady S, et al. Measles outbreak at a privately operated detention facility: Arizona, 2016. Clin Infect Dis. 2019;68(12):2018-2025. doi:10.1093/cid/ciy819

  5. University of California San Fransisco. ICE Detention Centers Saw Sustained Outbreaks of Vaccine-Preventable Diseases, Says Study. November 2, 2020.

  6. The Centers for Disease Control and Prevention. Measles, Mumps, and Rubella (MMR) Vaccination: What Everyone Should Know. Updated March 28, 2019.

  7. The Centers for Disease Control and Prevention. Chickenpox/Varicella Vaccination. Updated November 22, 2016.

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