Overseas Refugee Health Guidance | Immigrant and Refugee Health | CDC

Why is the CDC recommending Ivermectin for immigrants and refugees while decrying the efficacy or access to the drug for US citizens? Shouldn't we free citizens have a choice in our personal health?

"Ivermectin prophylaxis was taken by 76 controls and 41 cases. Two-dose ivermectin prophylaxis (AOR 0.27, 95% CI, 0.15-0.51) was associated with a 73% reduction of SARS-CoV-2 infection among healthcare workers for the following month."
https://pubmed.ncbi.nlm.nih.gov/33592050/

[CDC] Summary of Recommendations
This guidance is intended for the International Organization for Migration (IOM) physicians and other panel physicians who administer overseas predeparture presumptive treatment for intestinal parasites, but may also be referenced by U.S. medical providers caring for refugees who will be receiving presumptive treatment after they arrive in the United States.

While these recommendations have been implemented in many overseas sites, logistical and procurement issues still limit their full implementation in some. All Middle Eastern, Asian, North African, Latin American, and Caribbean refugees should receive presumptive therapy with:

All Middle Eastern, Asian, North African, Latin American, and Caribbean refugees should receive presumptive therapy with:
Albendazole, single dose of 400 mg (200 mg for children 12-23 months)
AND
Ivermectin, two doses 200 mcg/Kg orally once a day for 2 days before departure to the United States.
All African refugees who did not originate from or reside in countries where Loa loa infection is endemic (Box 1) should receive presumptive therapy with:
Albendazole, single dose of 400 mg (200 mg for children 12-23 months)
AND
Ivermectin, two doses 200 mcg/Kg orally once a day for 2 days
AND
Praziquantel, 40 mg/kg, which may be divided in two doses before refugees depart for the United States.