Amidst right-wing fury over a state official’s memo about vaccinating children, Tennessee public health officials have been ordered to cease all communications with young people about vaccines — a move that experts told TPM will exacerbate the impact of COVID-19 and other communicable diseases.
Without the Tennessee Department of Health providing much-needed education on vaccines, “these kids will die,” Dr. Georges Benjamin, the executive director of the American Public Health Association (APHA), told TPM in a phone interview. “Too many Tennessean kids will die.”
The news came Monday that Dr. Michelle Fiscus, Tennessee’s top vaccine official, had been fired by the state following weeks of outrage from Republicans in the state legislature at a memo she’d written — one restating a decades-old legal doctrine in the state that health professionals can vaccinate most minors over age 14 without parental consent.
“It was my job to provide evidence-based education and vaccine access so that Tennesseans could protect themselves against COVID-19,” Fiscus said after her firing. “I have now been terminated for doing exactly that.”
But it wasn’t just about COVID-19 vaccines: The Tennessean broke the news soon after that state public health officials had been ordered to stop all “proactive” vaccine outreach efforts to young people — and “no outreach whatsoever regarding the HPV vaccine.” State health officials were also told that the department would no longer set up COVID-19 vaccination sites at schools, and officials were barred from “pre-planning” school flu shot events. One county health director confirmed to TPM that they’d received guidance from the state in line with the documents reported by the Tennessean, including “no direct marketing to minors.”
Benjamin took special aim at how the Tennessee Department of Health’s chief medical officer had singled out the HPV shot in his email to staffers shutting down vaccine outreach efforts.
“Why would you want to stop something that prevents cancer?” Benjamin asked. “That’s the most idiotic thing I’ve ever heard.”
A Tennessee Department of Health spokesperson did not answer TPM’s specific questions about changes in policy within the department. They emphasized that the state hadn’t halted its immunization program, but added: “TDH wants to remain a trustworthy source of information to help individuals, including parents, make these decisions. And being that trustworthy messenger means we are mindful of hesitancy and the intense national conversation that is affecting how many families evaluate vaccinations in general.”
‘Into The Hands Of Anti-Vaccine Forces’
Still, young people are often more informed about vaccines than their parents, said L.J. Tan, chief strategy officer at the Immunization Action Coalition.
“The impact to the health of the public is dramatic when something like this happens,” he said.
“When you reduce education, you reduce awareness, you’re playing into the hands of the anti-vaccine forces,” Tan added. “Because they’re out there with their information. They’re not being reduced. They’re not being cut off.”
Benjamin, who served as the secretary of the Maryland Department of Health and Mental Hygiene before joining the APHA, expressed some sympathy for the challenges public health agencies have to navigate “in a political world.”
He told TPM he hoped that Tennessee health department’s decision was strategic — and, most importantly, temporary.
“What I hope this is a pause for them to develop a strategy to educate people and spend that time rallying support so the people that support [educating minors] outweigh the people that are against it,” he said. “What they’ve done is beyond the pale and unacceptable, but I’m trying to give the health officials some leeway to move forward.”
The Growing Vaccine Divide
Public health experts also expressed concern about the prohibition on using schools as COVID-19 vaccine sites, which could compound an existing urban-rural divide in vaccine use as the coronavirus continues to infect Tennesseans. Only 43% of people in the state have had at least one dose of the vaccine.
“It seems like we’re taking a big step backwards, we should be using all of our resources that are available to us to make sure that we get Americans vaccinated,” said Devin A. Jopp. CEO of the Association for Professionals in Infection Control and Epidemiology. “Schools are a logical collection site.”
“School-located immunizations are a very important source of providing access to vaccines. If we begin to eliminate the role of the school — not just in terms of educating but also being a location for giving access to the vaccine — we’re going to see disparities continue to increase in terms of immunization,” Tan told TPM.
The Tennessee Department of Health controls health departments in the state’s smaller counties and cities, but not large metropolises like Nashville and Memphis, which have their own departments, exacerbating the gap. Officials from both cities said their vaccination efforts would continue uninterrupted.
“Our mission is to promote, protect and improve the health of ALL in Shelby County,” Dr. La Sonya Hall, Interim Director of the Shelby County Health Department, which includes Memphis, told TPM. “In keeping with our mission, we will continue to provide a comprehensive vaccination program for Shelby County residents of all ages.”
After the news of Fiscus’ firing broke earlier this week, Nashville’s health department published a tweet advertising appointments for its back-to-school immunization clinics. A spokesperson for the department assured TPM the tweet was “planned and posted prior to learning about the State’s new change.”
Our team is taking appointments for back-to-school immunizations at our three clinics. Students entering kindergarten and 7th grade have specific requirements. We also offer HPV and meningococcal vaccinations to 7th graders, and COVID-19 vaccines are available for those 12 and up pic.twitter.com/SMYuSdNcZB
— NashvilleHealth (@NashvilleHealth) July 13, 2021
“To have this happen this abruptly is unprecedented and unacceptable,” Benjamin said of the Tennessee health department’s outreach shutdown. “And I doubt there are many health professionals who’ll disagree with me.”