Under GOP pressure, Tennessee health department ends all vaccine outreach to kids -- and not just for COVID

AP Photo/Marta Lavandier

It would be easier to accept this as a well-meaning overreaction to the small but real risk of heart inflammation from the COVID vaccines in kids if Republicans had been gung ho about vaccination all along. As it is, this reeks of another example of the party drifting towards what we’ll call an anti-anti-anti-vax position. No major righty politicians or media figures are flatly calling on people not to get vaccinated; even Marjorie Taylor Greene tapdances around it by claiming that thousands have died after getting their shots and leaving her audience to ruminate on that without overtly recommending what they’re supposed to do with the information. Virtually no Republican is overtly anti-vaccine.

But lots of people are anti-anti-anti-vaccine, by which I mean they’re eager to signal skepticism of the vaccine or to otherwise align themselves with vaccine opponents without outright denouncing vaccination. That’s what Greene does, that’s what Tucker Carlson does with his just-asking-questions shtick in which he never gets around to answering the questions he’s asking, that’s even what red-state governors have done in scrambling to stop businesses like cruise lines from requiring proof of vaccination as a condition of service. The same anti-anti-anti-vax sentiment is behind a new effort in Tennessee to undercut a longstanding state law under which anyone 14 or over can be treated by a physician without parental consent “unless the physician believes that the minor is not sufficiently mature to make his or her own health care decisions.”

Republican lawmakers in Tennessee were so incensed at the news that the state department of health was pitching COVID vaccination directly to kids that at least one said they might consider dismantling the department because of it. Yesterday, amid threats like those, the head of the department’s immunization outreach was suddenly handed her walking papers without being given a reason why. She knows why, though:

[Dr. Michelle] Fiscus said she was a scapegoat who was terminated to appease state lawmakers angry about the department’s efforts to vaccinate teenagers against coronavirus. The agency has been dialing back efforts to vaccinate teenagers since June.

“It was my job to provide evidence-based education and vaccine access so that Tennesseans could protect themselves against COVID-19,” Fiscus said in a written statement. “I have now been terminated for doing exactly that.”…

Since [a] June hearing, the health department has steadily backed down from its efforts to vaccinate minors. The agency halted all online vaccination outreach to teens and deleted Facebook and Twitter posts that gently recommended vaccines to anyone over the age of 12. Internal emails obtained by The Tennessean revealed agency leaders ordered county-level staff not to hold any vaccination events intended specifically for adolescents.

The June hearing mentioned above saw Republican legislators confront Fiscus about a letter she sent to doctors reminding them of the “Mature Minor Doctrine,” which authorizes treatment for kids 14 and older without parental consent. She claims the health department’s lawyer told her the language in the letter was approved by the office of the governor. Now she’s been fired. Rather than amend the Mature Minor Doctrine by statute, the legislature seemingly would rather vice-signal to the anti-vax part of its base by strong-arming the health department with threats of dissolution or defunding to get them to back off trying to vaccinate teenagers.

Which would be bad enough if the strong-arming applied only to COVID — although, again, the risk of heart inflammation to kids provides at least some justification for believing that parental input should be required before a teen gets their Pfizer or Moderna shot. The Tennessean is out with a new story this afternoon, though, that claims the anti-anti-anti vax influence of GOP lawmakers has now led the health department to give up on all vaccination outreach to adolescents. Not just the COVID vaccine. All vaccines.

The Tennessee Department of Health will halt all adolescent vaccine outreach – not just for coronavirus, but all diseases – amid pressure from Republican state lawmakers, according to an internal report and agency emails obtained by the Tennessean. If the health department must issue any information about vaccines, staff are instructed to strip the agency logo off the documents.

The health department will also stop all COVID-19 vaccine events on school property, despite holding at least one such event this month. The decisions to end vaccine outreach and school events come directly from Health Commissioner Dr. Lisa Piercey, the internal report states.

Additionally, the health department will take steps to ensure it no longer sends postcards or other notices reminding teenagers to get their second dose of the coronavirus vaccines. Postcards will still be sent to adults, but teens will be excluded from the mailing list so the postcards are not “potentially interpreted as solicitation to minors,” the report states.

School gyms had been a useful venue in rural areas, one of the few indoor spaces in the community large enough to accommodate many people getting their shots while still affording proper distancing. By some twist of logic, the health department wants to keep vaccines out of schools even when school property is being used to immunize adults. “Staff were also told not to do any ‘pre-planning’ for flu shots events at schools” either, the Tennessean went on to note; back-to-school vaccination efforts have now been dropped in the lap of the department of education so that the health department can be free of the political pressure it’s under. (Would any education bureaucrat want to aggressively push vaccine mandates for schools in light of what Fiscus and the health bureaucrats have been through lately?) As for declining to remind teens about their second dose, that seems not just ignorant but spiteful, a gesture towards making sure they don’t complete a course of vaccination they’ve already begun. Why? Why risk leaving them half-protected?

The anti-anti-anti vax party in Tennessee, which last year passed a resolution dismissing some of the coverage of the pandemic as sensationalist “fake news,” has belatedly awakened to the dire threat of 17-year-olds making vaccination decisions for themselves that they’ve been allowed to make legally for decades.

The Tennessean wonders how long it’ll be before the health department’s policy of not marketing vaccines to kids mutates into a policy not to market vaccines for kids. If the FDA approves the COVID vaccine for infants later this year, will the health department feel comfortable running ads encouraging parents to avail themselves, without fear of being threatened with defunding? What about traditional vaccines like measles? Can they advertise that or are public-health experts in Tennessee now informally discouraged from advocating for childhood vaccination as a rule? How far should they ride the trend towards populist crankery?

Republicans in Washington are doing what they can to counterprogram the Tuckers and Marjories but they don’t have much cultural influence over the party. “It’s grossly misfortunate and a huge human cost to have made vaccination political,” said Mitt Romney to HuffPost, calling it “moronic.” “After all, President Trump and his supporters take credit for developing the vaccine, why the heck won’t they take advantage of taking the vaccine they received plaudits for having developed?” Senate leaders like McConnell and Roy Blunt made the pitch today too, knowing which states are at the greatest risk from a new wave:

Tennessee is 46th out of 50 in vaccination rates, with just 38 percent fully immunized. They’re not sitting pretty like Vermont with most of the population protected and kids an afterthought. They need every new bit of immunity they can get in the population. Instead they’re going in the opposite direction with the new policy, and not just with respect to COVID anymore.

Here’s Fiscus discussing her not-so-mysterious termination with CNN.