One of the differences between legal and illegal immigration is that immigrants who come here legally are screened to determine whether they fall into one of the classes of migrants who are ineligible for admission into the United States. The term “immigrant” means any alien who has not been classified as a nonimmigrant visitor.
This screening isn’t just to identify immigrants who are inadmissible because they are criminals or terrorists; it also identifies immigrants who “have a communicable disease of public health significance.” A medical examination is required of immigrants who are seeking admission to the United States.
It isn’t feasible to require nonimmigrant visitors to have medical examinations. Among other difficulties, there are too many of them — approximately 132 million nonimmigrants were admitted in fiscal 2023.
In addition, the Immigration and Nationality Act requires immigrants to establish that they have been vaccinated against certain vaccine-preventable diseases, such as “mumps, measles, rubella, polio, tetanus and diphtheria toxoids, pertussis, influenza type B and hepatitis B, and other vaccinations that have been recommended by CDC’s Advisory Committee for Immunization Practices.”
According to Tom Homan, President-elect Trump’s new border czar, “Despite immigration law to the contrary, no vaccinations are being required for entry, or administered after entry, to millions of migrants entering the country illegally now.”
“The completely predictable result is that not only are migrant centers themselves hotbeds for outbreaks of preventable infectious diseases, but that doctors’ offices, clinics, emergency rooms and hospitals across the United States are being overwhelmed by illegal aliens who are ill with diseases the U.S. had previously eradicated within its borders.”
Is Homan right? I think he is.
The medical exam for an alien who is applying for an immigrant visa “will include a medical history review, physical examination, chest X-ray and blood tests for syphilis. The physical examination will at least include examination of the eyes, ears, nose and throat, extremities, heart, lungs, abdomen, lymph nodes and skin.”
Immigrants with communicable diseases have been inadmissible for more than a century.
The Immigration Act of 1891 provided for the exclusion of “Persons suffering from a loathsome or a dangerous contagious disease,” and it required a medical examination of all migrants arriving at a port of entry.
Current law makes immigrants inadmissible if they have one of the diseases that the secretary of Health and Human Services has determined to be “a communicable disease of public health significance.” This includes the following diseases: gonorrhea; infectious leprosy; infectious syphilis; active tuberculosis; communicable “diseases that may make a person subject to quarantine;” and communicable “diseases that may pose a public health emergency of international concern.”
As I’ve written before, the Biden administration has released more than 5.4 million illegal crossers into the United States without medical examinations. In addition, there were 1.9 million “got aways,” a statutory term that refers to migrants who are directly or indirectly observed making an unlawful entry but were not apprehended or turned back.
The administration also has used the parole provision in the INA to mass parole 531,000 Cubans, Haitians, Nicaraguans and Venezuelans into the United States. They are not required to have in-person interviews or medical exams before entering the United States, and upon arrival, they receive the same scrutiny tourists receive.
Little is known about more than 852,000 otherwise inadmissible migrants who have had CBP One appointments from January-September 2023, 95.8 percent of whom were released into the United States on parole after a cursory interview.
The Centers for Disease Control and Prevention (CDC) says that “Measles is one of the most contagious human diseases known. … Before the measles vaccine was introduced, an estimated 48,000 people were hospitalized and 400–500 people died in the United States each year.”
It was declared eliminated in the United States in 2000, but cases continue to occur because it is being brought here from other countries with low vaccination rates.
This year, as of November 22, a total of 280 measles cases have been reported in 32 states. The fact that it is extremely infectious suggests that it may have spread to many more people, who in turn spread it to still more people.
The CDC says that whooping cough “spreads easily from person to person through the air. When a person with whooping cough sneezes or coughs, they release small particles with bacteria in them. Other people can then breathe in the bacteria.”
The seriousness of whooping cough varies according to age and underlying medical conditions. A two-month-old baby in Australia died from whooping cough last month.
The cramped, poorly ventilated migrant shelters in New York City facilitate the spread of whooping cough. And more than 210,0000 migrants have settled in NYC since the spring of 2022.
New York has had a 169 percent surge in this potentially fatal disease in 2024 compared to the same period in 2023. Cases have increased almost 500 percent over the number of occurrences at this point in 2019.
Tuberculosis is spread by air-borne germs when an infected person coughs or speaks. Without treatment, the death rate is close to 50 percent. In fact, it was the “leading cause of death from a single infectious agent in 2023.” More than 10 million people get it every year.
The CDC and others are working on preventing the spread of TB in 42 countries that are experiencing epidemics. These countries are located in Latin America and the Caribbean, Africa and Asia. From 2019 to 2022, there has been an increase in illegal immigration from those regions.
The United States reported 9,633 cases of TB in 2023, which was 16 percent higher than 2022, and the CDC traced 76 percent of these cases to people who were not born here.
The take-away is that we shouldn’t be letting millions of illegal border crossers into the country who haven’t been screened for communicable diseases. We shall see how the incoming administration handles this important issue.
Nolan Rappaport was detailed to the House Judiciary Committee as an executive branch immigration law expert for three years. He subsequently served as an immigration counsel for the Subcommittee on Immigration, Border Security and Claims for four years. Prior to working on the Judiciary Committee, he wrote decisions for the Board of Immigration Appeals for 20 years.
