Covid-19 cases rise in state with one of lowest vaccination rates


The top vaccines official in the state of Tennessee said on Monday that she had been fired after an argument over immunizing children against the coronavirus.

Now Dr Michelle Fiscus, a pediatrician who served as the state’s medical director for vaccine and vaccine-preventable diseases for two years, has said she is afraid for the people of her state – who are already at lagging behind in vaccination against the virus.

“It’s just amazing to me how absolutely political and egotistical our elected officials here are and how little they care about the people of Tennessee,” Fiscus told CNN in a telephone interview.

“The people of Tennessee are going to pay the price. “

Fiscus said she and other health officials had been pressured, but the last straw was what should have been a harmless memo citing Tennessee state law as to whether minors can get medical care without their parents’ permission.

In 41 states, minors must have the consent of a parent or guardian to be vaccinated, but Tennessee is one of five states that have a “mature minors doctrine” that allows health care providers decide whether a child has the capacity to consent to the vaccination themselves.

Four other states and Washington, DC have set an age limit for a minor to decide without a parent or guardian.

Fiscus said all she did was share the memo which laid out decades-old state policy.

“One recipient of this memo was upset that, according to Tennessee Supreme Court case law, minors between the ages of 14 and 17 could receive medical treatment in Tennessee without their parents’ consent and posted the memo on social media. “Fiscus said in a statement.

“Within days, lawmakers contacted TDH (Tennessee Department of Health) to ask questions about the note, with some interpreting it as an attempt to undermine parental authority. Let’s be clear: this was a briefing note containing language approved by the General Counsel’s Office of TDH that was sent to medical providers by the medical director of the state immunization program regarding the safeguards put in place 34 years ago by the Tennessee Supreme Court around the provision of care for minors, ”she added.

“What happened between the publication of this memo and today, when I was fired from my position as medical director of the immunization and vaccine-preventable diseases program at the Tennessee Department of Health, does not can only be described as weird. “

The Tennessee Department of Health has been called to testify before the state legislature, Fiscus said, and a frightened state health department has responded by halting vaccination awareness efforts.

The department told CNN via email that it couldn’t comment on the personnel issues.

National Association of County and City Health Officials (NACCHO) told CNN in May that more than 250 public health officials had quit their jobs since the start of the pandemic – many of them against their will, and others under pressure from people opposed to public health efforts to control the pandemic.

“The legislature has just completely blown up this mature minor doctrine completely disproportionately,” Fiscus said.

“Each of us should wake up each morning with a question in mind: ‘What can I do to protect the people of Tennessee from COVID-19? ” she wrote. “Instead, our leaders are putting up barriers to make sure Tennessee residents remain at risk, even with the Delta variant hitting us.”

Fiscus said she was concerned for the safety of people in her state. “I am angry that public health is political in this state,” she told CNN. “Public health should never, ever be political,” she added.

“People across the state government are afraid of losing their jobs because of this. We are not allowed to do what is fair and evidence-based and what is recommended by the CDC and other national experts on how to handle this pandemic. As a result, our number of cases is increasing. We only have 38% of Tennessee residents vaccinated, and Delta comes from our border states of Arkansas and Missouri. “

Tennessee implemented a quick and organized vaccine until the issue became politicized, Fiscus said. “We were one of the best and fastest in the country,” she said.

Now, she said, the state has stopped any vaccination campaign involving children. “It is a public health failure to protect the people of Tennessee and that is what is wrong,” she wrote.

“Specifically, it was my job to provide evidence-based education and access to vaccines so Tennesseans could protect themselves against COVID-19. I have now been fired for doing just that.

Earlier Monday, three health policy experts published a commentary in the Journal of the American Medical Association’s JAMA Pediatrics arguing that adolescents should be allowed to decide for themselves whether they should be vaccinated.

“Children and adolescents have the ability to understand and reason about low-risk, high-return health care interventions. State laws should therefore allow minors to consent to a COVID-19 vaccination without parental consent, ”Larissa Morgan of Carey Law School at the University of Pennsylvania, Jason Schwartz of Yale University and Dominic Sist of University of Pennsylvania Department of Medical Ethics and Health Policy wrote.

“In the context of vaccination, some older minors may have a more precise understanding of the risks and benefits of a vaccine than their hesitant guardians.”

Fiscus’ husband Brad Fiscus ran for a seat in the State House of Representatives as an Independent last fall and lost.

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