Tennessee fires top vaccine official as COVID-19 shows signs of new spread

Tennessee fires top vaccine official as COVID-19 shows signs of new spread

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The Tennessee state government on Monday fired its top vaccination official, becoming the latest of about two dozen states to lose years of institutional knowledge about vaccines in the midst of the coronavirus pandemic.

The termination comes as the virus shows new signs of spread in Tennessee, and the more-transmissible delta variant surfaces in greater numbers.

Dr. Michelle Fiscus, the medical director for vaccine-preventable diseases and immunization programs at the Tennessee Department of Health, said she was fired on Monday afternoon and provided a copy of her termination letter. It provides no explanation for her termination.

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."

Sarah Tanksley, a spokesperson for the health department, said the agency would not comment on the termination.

IN HER WORDS: Read Dr. Michelle Fiscus' scathing statement after termination: 'I am afraid for my state'

Fiscus took heat for teenage vaccinations

Republican lawmakers began to criticize Fiscus by name during a contentious hearing of the Joint Government Operations Committee on June 16.

Lawmakers were angry about a letter Fiscus sent to medical providers who administer vaccines explaining the state's “Mature Minor Doctrine,” a legal mechanism by which they are allowed to vaccinate minors above the age of 14 without consent from their parents.

The letter was sent in response to questions from vaccine providers but did not contain new information. The details of the Mature Minor Doctrine have been publicly available on the health department’s website since at least 2008. The doctrine was established in 1987, according to the health department.

Fiscus said the language in the letter was provided to her by the health department's attorney, who said at the time it had been "blessed by the governor's office."

At the June 16 hearing, Health Commissioner Dr. Lisa Piercey said to her knowledge the doctrine had only been invoked eight times this year. Three of those instances involved her own kids, who were vaccinated while she was at work, she said.

Lawmakers were still angry. Sen. Janice Bowling, R-Tullahoma, who repeatedly has spread vaccine misinformation during legislative hearings, insisted the state was misinterpreting its legal authority.

Bowling urged Piercey to "take action" to "remove the fear, the concerns and the anger that has gone across the state as a result of (Fiscus') letter."

“It is very disconcerting to see the letter, or memo, from Dr. Fiscus stating that Tennessee law allows the Department of Health to give vaccinations to children 14 years of age," Bowling said. "Tennessee law does not allow that."

Later in the same hearing, another lawmaker, Sen. Mark Pody, R-Lebanon, cited "extreme disappointment" the health department would allow children to be vaccinated through the Mature Minor Doctrine. Lawmakers later discussed dissolving the entire agency to stop it from promoting vaccines to teens.

Since this 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.

COVID-19 infections rise, delta variant spreads

These changes will likely hamper Tennessee’s vaccination efforts, which already lag behind much of the nation. As of Monday, federal and state data showed 38% of Tennesseans were fully vaccinated and the state’s rate of new vaccinations was idling.

At the current pace, Tennessee won’t reach 50% vaccinated until March, according to health department estimates in an internal report obtained by The Tennessean.

Tennessee has also begun to show some signs of a rebounding virus. After months of declining infections, the average number of new infections per day has more than doubled since a low point on June 23 – climbing from 169 to 351 as of Friday. The state’s average test positivity rate increased from about 2% to about 4.5% in the same time period. Daily hospitalizations and deaths remain in the single digits.

Tennessee is also detecting a growing number of infections from the delta variant, a more transmissible form of coronavirus that sparked new outbreaks among unvaccinated populations in Arkansas and Missouri.

The count of known delta variant cases rose from 27 on June 24 to 125 as of Thursday, according to state virus data. The count is likely higher because the variant can only be detected by subjecting virus samples to genomic sequencing, which is done sparingly.

Fiscus is at least the 25th official to leave a state’s top vaccination position since the beginning of the coronavirus pandemic, according to a USA TODAY investigation published earlier this month. Most of these officials quit or retired earlier than planned, sometimes because of frustration with the politicization of the virus, USA TODAY reported. While these officials are not well known to the general public, they are a backbone of the nation’s vaccination system, both within a pandemic and without.

Brett Kelman is the health care reporter for The Tennessean. He can be reached at 615-259-8287 or at [email protected]. Follow him on Twitter at @brettkelman.