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Top Tennessee health official says she was fired after efforts to get teens vaccinated

"I am not a political operative, I am a physician who was, until today, charged with protecting the people of Tennessee ... against preventable diseases," Dr. Michelle Fiscus wrote.
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Tennessee officials have fired the state’s top vaccination official, who had been facing scrutiny from Republican state lawmakers over her department’s outreach efforts to vaccinate teenagers against Covid-19.

Dr. Michelle Fiscus, a pediatrician, was fired Monday as the medical director for vaccine-preventable diseases and immunization programs at the Tennessee Department of Health.

Dr. Michelle Fiscus speaks from Franklin, Tenn., on July 13, 2021.
Dr. Michelle Fiscus speaks from Franklin, Tenn., on July 13, 2021.AP

In an interview with MSNBC host Chris Hayes on Tuesday, Fiscus said her job was to roll out the Covid-19 vaccine “across the state and to make sure that that was done equitably and in a way that any Tennessean who wanted to access that vaccine would be able to get one.”

“I have now been terminated for doing exactly that,” she wrote in an early statement to the Tennessean.

Health Department spokesperson Sarah Tanksley said the agency would not comment on the termination.

Fiscus said tension with GOP lawmakers escalated when she publicized a public document on Tennessee's "Mature Minor Doctrine," a state Supreme Court case ruling from 1987 that states Tennesseans 14 to 18 years old may be treated "without parental consent unless the physician believes that the minor is not sufficiently mature to make his or her own health care decisions."

"Within days, legislators were contacting TDH asking questions about the memo with some interpreting it as an attempt to undermine parental authority," Fiscus said, adding that her conduct was called "reprehensible" by a Tennessee lawmaker.

"That member went on to call for the 'dissolving and reconstitution' of the Department of Health in the midst of a pandemic where one out of every 542 Tennesseans has died from Covid-19 on their watch and less than 38 percent of Tennesseans have been vaccinated," Fiscus wrote.

As of Monday, state and federal data showed 38 percent of Tennesseans were fully vaccinated against Covid-19, lagging behind much of the nation.

Fiscus told Hayes that the greatest challenges the state faces with raising its vaccination rate were the “politicization of public health and in people's choosing not to protect themselves.”

“We now have our most hesitant population being rural male conservative whites, who really do hang their hat on this political ideology that Covid-19 isn't real, isn't a threat, or that getting the vaccine somehow props up the left-wing part of our political system,” she said.

In her statement, Fiscus added: "I was told that I should have been more 'politically aware' and that I 'poked the bear' when I sent a memo to medical providers clarifying a 34-year-old Tennessee Supreme Court ruling. 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 alleged in her statement that the health department responded to the GOP outcry by "halting ALL vaccination outreach for children."

"Not just Covid-19 vaccine outreach for teens, but ALL communications around vaccines of any kind," Fiscus wrote.

The Tennessean reported Tuesday that all adolescent vaccine outreach, for all diseases, would be halted, according to emails and an internal report with state health department officials Friday and Monday.

The shift came two weeks after a June legislative hearing at which Republican lawmakers admonished the agency for how it was communicating about the vaccine, including through online posts. One digital graphic, which had a photo of a smiling child with a bandaid on his arm, said, “Tennesseans 12+ are eligible for vaccines. Give COVID-19 vaccines a shot.”

During the hearing, Republican Rep. Scott Cepicky held up a printout of a Facebook ad saying teens were eligible, and he called the agency’s advocacy “reprehensible” and likened it to peer pressure.

In an email to NBC News, Bill Christian, a spokesperson for the Department of Health, did not comment on reports that the state had halted all immunization outreach to minors but said that the department "wants to remain a trustworthy source of information to help individuals, including parents, make these decisions," Christian wrote.

He added that an "intense national conversation" is affecting how many families evaluate vaccinations in general.

"We are simply mindful of how certain tactics could hurt that progress," Christian wrote.

Fiscus says the health department’s attorney provided her the letter she shared with medical providers about the mature minor doctrine. The attorney had said the letter had been “blessed by the governor’s office.”

At a June hearing, Health Commissioner Dr. Lisa Piercey said she knew of only eight times this year when the doctrine was invoked, and three of them were for her own children, who received vaccines while she was at work.

Lee Savio Beers, president of the American Academy of Pediatrics, called Fiscus’s termination "the most recent example of a concerning trend of politicizing public health expertise."

The AAP is "concerned" about the report of the cancellation of vaccine outreach to minors.

"Actions like this only increase the likelihood that we’ll see other outbreaks of these diseases even as we continue to fight Covid-19," Beers said.

In a statement, Tennessee Democratic state senators condemned Fiscus' firing.

“Well folks, this is just insane," said state Senate minority leader Jeff Yarbro.

“The political firing of Dr. Fiscus isn’t just an embarrassment. It’s reckless when cases and hospitalizations are rising and 62 percent (of Tennesseans) remain unvaccinated."