Top Tennessee vaccine official says she was fired over shots for teens

Across the country, public health officials have left their jobs, strained by a pandemic unlike anything they had confronted before, then tested further as the coronavirus and vaccines became entangled in politics and disinformation.

In Tennessee, the state’s top immunization official, Michelle Fiscus, said this week that she was forced from her job after writing a memo describing a 34-year-old legal doctrine that suggested that some teenagers might get vaccines without their parents’ permission. Fiscus’ memo came as conservative lawmakers in the state were lashing out at efforts by her agency to raise awareness of vaccines among teenagers.

One Republican lawmaker, Scott Cepicky, accused the agency of employing “peer pressure” to prod young people into getting immunized.

In a lengthy and searing statement describing her departure, Fiscus said the actions of lawmakers have gravely endangered the public by undermining confidence in the vaccines even as virus cases are rising in Tennessee and as concerns about the delta variant are emerging in parts of the country.

“I am not a political operative, I am a physician who was, until today, charged with protecting the people of Tennessee, including its children, against preventable diseases like COVID-19,” Fiscus wrote. Her firing was reported by The Tennessean.

A spokesman for the Tennessee Department of Health declined Tuesday to comment on the dismissal of Fiscus, the agency’s medical director for vaccine-preventable diseases and immunization programs, saying the agency could not discuss personnel matters.

Tennessee is among the states where the virus has gained ground as vaccination efforts have sputtered, leaving public health officials to grapple with the political resistance and false information about the safety of the shots.

As in much of the country, Tennessee’s virus outlook has improved significantly since the winter, when cases soared. But in the past two weeks, the number of newly reported cases has climbed, with a statewide average of more than 460 cases daily, according to a New York Times database. Yet the vaccination rate has stalled; about 43% of the population has received at least one vaccine dose, lagging behind a national rate of 55%.

Twins Kira Barth and Nola Barth, 14, receive their first dose of the Pfizer-BioNTech COVID-19 vaccine at Vanderbilt Health in Nashville, May 13, 2021. (Brett Carlsen/The New York Times)

Anger from lawmakers intensified after the memo by Fiscus was circulated to medical providers explaining a so-called mature minor doctrine, which allows doctors to treat patients between the ages of 14 and 18 without parental consent under a state Supreme Court ruling from 1987. The memo repeated information that has been publicly available on the Department of Health’s website for years.

In recent weeks, lawmakers have pointed to the memo and to advertisements from the agency on social media, contending that the department was going too far in its efforts to reach teenagers. During hearings, lawmakers even raised the prospect of dissolving the department.

“When you have advertisements like this, with a young girl with a patch on her arm, all smiling,” Cepicky said as he held up a printout of a social media post during a recent hearing. “We all know how impressionable our young people are, and wanting to fit in in life.”

During that hearing last month, Lisa Piercey, state health commissioner, sought to calm lawmakers’ concerns, saying, “Under no circumstance is the department encouraging children to seek out vaccination without parental consent.”

She said that she was aware of only eight cases in which the doctrine has been invoked to vaccinate a minor. Three of them, she said, were her own children, vaccinated while she was at work.

Since then, the department has dialed back its campaign, removing posts informing the public that people 12 and older were eligible to be vaccinated.

In her statement, Fiscus, who had been a pediatrician with a practice in the Nashville suburbs before joining the health department, said her dismissal reflected the challenging climate for public health officials, who typically had low profiles before the pandemic but were suddenly thrust into the spotlight of a complicated and politically rancorous situation.

“Along the way we have been disparaged, demeaned, accused and sometimes vilified by a public who chooses not to believe in science,” Fiscus wrote, “and elected and appointed officials who have put their own self-interest above the people they were chosen to represent and protect.

“It was MY job to provide evidence-based education and vaccine access so that Tennesseans could protect themselves against COVID-19. I have now been terminated for doing exactly that.”

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