Tennessee health official says she was fired for promoting teen vaccination

A Tennessee health official said she was terminated from her position as director of the state health department’s vaccine-preventable diseases and immunization program for promoting COVID-19 vaccination for teens.

Michelle Fiscus, MD, FAAP, released a statement to The Tennessean in which she gave a personal account of the situation.

“It is the mission of the Tennessee Department of Health to ‘protect, promote and improve the health and prosperity of the people of Tennessee’ and protecting them against the deadliest infectious disease event in more than 100 years IS our job,” Fiscus wrote. “It’s the most important job we’ve had in recent history. Specifically, 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.”

According to Fiscus, before the FDA authorized the use of the Pfizer-BioNTech COVID-19 vaccine for children as young as age 12 years in May, she reached out to the Tennessee Department of Health’s general counsel to request a statement on Tennessee’s Mature Minor Doctrine, which allows minors aged 14 to 17 years to receive medical care in Tennessee without parental consent.

In response, she said, she received a “new summary of the doctrine” that had been “blessed by the governor’s office.” On May 10, the day the Pfizer-BioNTech vaccine became the first vaccine available to children younger than age 16 years, Fiscus said she copied that language into a memo and distributed it to providers administering COVID-19 vaccines.

“Within days, legislators were contacting [the state health department] asking questions about the memo with some interpreting it as an attempt to undermine parental authority,” Fiscus wrote.

“Let me be clear: this was an informational memo containing language approved by the [state health department] Office of General Counsel which was sent to medical providers by the medical director of the state’s immunization program regarding the guardrails set 34 years ago by the Tennessee Supreme Court around providing care to minors,” Fiscus wrote.

Fiscus said the state health department, under pressure from legislators, also has halted all vaccination outreach programs for minors.

The Tennessee Department of Health said it could not comment on human resources or personal matters, but a spokesperson responded to one of Fiscus’ claims.

“To be clear, our vaccination efforts have not been halted or shuttered,” spokesperson Sarah Tanksley told Healio. “We are simply taking this time to focus on our messaging and ensure our outreach is focused on parents who are making these decisions for themselves and their families.”

AAP President Lee Savio Beers, MD, FAAP, called Fiscus’ termination “the most recent example of a concerning trend of politicizing public health expertise.” Fiscus is a member of the AAP’s Board of Directors.

“Pediatrician public health officials are medical experts who are trusted by the communities they serve,” Beers said in a statement.

“We are also concerned by reports that Tennessee has stopped all communications about any routine childhood vaccines, including those for measles and other vaccine-preventable illnesses at a time when children and adolescents overall still lag behind on these important vaccines due to the pandemic,” Beers said. “Actions like this only increase the likelihood that we’ll see other outbreaks of these diseases even as we continue to fight COVID-19. The AAP will continue to promote the vaccine and support pediatricians like Dr. Fiscus who are doing the vital work that’s needed to get us out of this pandemic.”

References:

Justia US Law. Cardwell v. Bechtol. https://law.justia.com/cases/tennessee/supreme-court/1987/724-s-w-2d-739-2.html. Accessed July 14, 2021.

Fiscus M. Tennessee’s former top vaccine official: ‘I am afraid for my state.’ Tennessean. https://www.tennessean.com/story/news/health/2021/07/12/covid-19-tennessee-fired-vaccine-official-michelle-fiscus-fears-state/7945291002/. Accessed July 14, 2021.