August 10, 2009
Thomas R. Frieden, MD, MPH
Centers for Disease Control and Prevention (CDC)
1600 Clifton Road
Atlanta, GA 30333
RE: HPV Vaccination Mandate for Immigrant Women and Girls
Dear Dr. Frieden:
The undersigned, over 140 immigrants’ rights, women’s rights, public health, medical, and reproductive justice organizations write to urge the CDC to act quickly and finalize the proposed criteria for identifying Advisory Committee on Immunization Practices (ACIP) recommended vaccines as immunization requirements for immigrants.
As you know, ACIP recommended in 2007 that Gardasil, the only FDA-approved human papillomavirus (HPV) vaccine, be administered to females ages 11 to 26 in the U.S. This recommendation became an automatic requirement for prospective immigrants when the government updated its vaccination list in July 2008, mandating that female immigrants ages 11 to 26 seeking permanent residence or entry to the U.S. be immunized against HPV. In the enclosed January 26th letter to Dr. Besser, we outlined our concerns about the HPV vaccination mandate on immigrants and urged the CDC to retract its listing of HPV as a required vaccination for immigrants in the revised Technical Instructions to the Civil Surgeons for Vaccinations Requirements, and to direct ACIP to modify its recommendation to state that the HPV vaccination should not be mandated for immigrants.
At the February 25-26, 2009 ACIP meeting, the Division of Global Migration and Quarantine (DGMQ) proposed a set of criteria for identifying ACIP-recommended vaccines as immunization requirements for immigrants, which was published in the Federal Registrar on April 8, 2009 for comment. We are greatly encouraged that the CDC has responded to public concerns by proposing the criteria and we submitted comments in support of the proposed rule, however, it has been months since the public comment period closed and the rule has not yet been finalized. In the meantime, advocates continue to receive stories and concerns from those adversely affected by this mandate. In one of the many emails received, one woman wrote:
“… I have been raising my grand-daughter since she was 20 months old and was abandoned by her mother. To cut a long story short on how we came to be alone in the US etc. I will just say we were in very difficult circumstances and in the care of the Domestic Violence unit…
In July 2008 I sent all the paperwork and fees to apply for change of status/permanent residence for her. She was 16 years old. After the finger print [sic] appointment we were told to get the medical exam. The appointment came for August and that is when we found out about the HPV vaccination requirement.
I did some research and couldn’t understand why it had been made a requirement for immigrants … I sent all the paper work in to the USCIS and said that my grand-daughter doesn’t want to have that vaccination. Today, almost a year later, I have received notice that they have determined she is inadmissible to the United States without it… [but] we can file the I-601 waiver with the fee!
I am a single person, 62 years old working for $13,000 per year supporting myself and my adopted daughter and think it is ridiculous to have to pay another nearly $600 on top of the $1,700 I have already paid to do things the legal and correct way.”
We urge you to act immediately to finalize the rule and begin the process of correcting this egregious mandate.
Thank you for your consideration. We welcome the opportunity for further communication on this issue. Please contact Priscilla Huang at firstname.lastname@example.org, or (301) 270-4440, with questions or concerns.
 Email has been edited for brevity.