Officials push swine-flu shots for migrants
By Erin Kelly
The Arizona Republic (Phoenix), September 26, 2009
Washington, DC — With swine-flu vaccinations set to begin next month, public-health officials are mobilizing to ensure that the nation's estimated 11 million-plus illegal immigrants are vaccinated.
And unlike the divisive debate over whether illegal immigrants should get federal health care, there is little dispute that they should receive the H1N1 shots.
'We believe it's important that all people be vaccinated regardless of immigration status if there's a pressing public-health concern,' said Jon Feere, legal policy analyst at the Center for Immigration Studies, which opposes taxpayer-funded health care for illegal immigrants and wants to reduce immigration.
Leaving up to 12 million immigrants unvaccinated – an estimated 500,000 in Arizona – would increase the health risk to everyone and make it much harder to control the epidemic, said Dr. Kevin Fiscella, associate professor of family medicine and community and preventive medicine at the University of Rochester School of Medicine and Dentistry in New York.
'We're all in this together,' he said.
About 800,000 to 1 million doses of the vaccine should arrive in Arizona next month, but not everyone will be able to get a shot right away. Priority will go to infants and young children, kids with chronic health infections and pregnant women, followed by school-age kids and adults who care for newborns or have chronic conditions such as asthma and diabetes.
Most of the general public will likely have to wait until at least December for their immunizations.
Experts say state and local governments will have to overcome major barriers to persuade illegal immigrants to trust pub- lic health departments enough to come forward then and get themselves and their children vaccinated.
'For an undocumented immigrant who lives in daily fear of being deported, contact with any quasi-governmental agen- cy, even a public-health department, induces anxiety,' Fiscella said. 'People worry, 'Are they going to ask me for my Social Security number?' '
Federal health officials are trying to quiet those fears with assurances that no one will be asked to prove their immigration status to get a vaccine at any public-health clinic or mass-vaccination site.
'Whether you're legal or illegal, the flu virus doesn't discriminate, and neither do we,' said Arleen Porcell, spokeswoman for the Centers for Disease Control and Prevention.
To get that message out, Porcell said, the CDC is holding briefings with Hispanic media, buying ads in Spanish-language magazines and newspapers, and working with non-profit community and religious groups that provide aid to immigrants on a regular basis.
In Maricopa County, public-health officials have been working with local Univision and Telemundo TV stations and the Radio Campesina Network to reach Spanish-speaking residents.
The county has created special public-service announcements and done frequent interviews to educate people about the H1N1 virus, said Jhoana Molina, coordinator of the hard-to-reach populations program at the Maricopa County Department of Public Health.
Working with Univision, the department has even set up phone banks that Spanish-speaking residents can call to talk to nurses and other health personnel to get information about virus prevention, Molina said. She said similar efforts will be made to get the word out about vaccination-clinic locations once the vaccine arrives in Arizona in October.
'We don't focus on who is and isn't undocumented,' Molina said. 'We try to get the word out to everyone.'
Although some children of illegal immigrants may get vaccinated at school, many will not, heath officials said. Vaccination plans vary from state to state and school to school.
In Arizona, state health officials are working with school nurses to prepare for mass-vaccination clinics at some public schools, according to a report posted on the Web site of the Arizona Department of Health Services.
Still, in many cases, children and their parents will have to go elsewhere. Most of those families will not be able to afford the $20 to $30 fee that drugstores typically charge at their mass-vaccination clinics, said Dr. Daniel Blumenthal, associate dean for community health at Morehouse School of Medicine in Atlanta.
Health and Human Services Secretary Kathleen Sebelius said the federal government is urging clinics not to charge patients, whether undocumented or not.
The vaccine itself is provided free by the federal government, but some clinics or retail stores are charging a fee to cover administrative costs.
'We've asked the providers to strongly consider not charging fees so there will be no financial barriers to vaccination,' Sebelius said in a conference call with regional reporters. 'We can't make that mandatory, but a lot of voluntary agreements have been made.'
While public-health officials are working to reach as many people as possible inside the United States, customs officials and Border Patrol agents are on the lookout for people entering the country who appear to be sick.
People with symptoms such as coughing, sneezing and red eyes are taken aside to be checked by health officials to see if they need medical treatment or can be sent on their way, said Kelly Ivahnenko, spokeswoman for U.S. Customs and Border Protection.
'We're obviously not going to deny entry to citizens or lawful travelers, but we're being vigilant for signs that they need medical help,' she said.
But spotting someone with swine flu is not always easy, Ivahnenko said.
'The challenge with H1N1 is that you can be infected and not show symptoms for a couple of days,' she said. 'And, by then, they're already moving around the country.'