Michelle Fiscus

Michelle Fiscus

When Gov. Bill Lee announced earlier this month that the state would be promoting Tennessee tourism by offering 10,000 airline vouchers, the travelers he had in mind almost certainly weren’t national television news crews. And yet over the past two weeks, as the fallout from the ouster of the state’s vaccine chief spread, Nashville has provided the setting for segments on the Today show and the CBS Evening News focused on the scandal at the Tennessee Department of Health and a spike in COVID-19 cases in a state with a stubbornly low vaccination rate. 

Welcome to Tennessee. 

The state’s vaccination efforts were already yielding disappointing results. Seven months after the first COVID-19 vaccination in Tennessee — as of July 18 — only 42.9 percent of the state’s residents have received at least one dose. Only 38.4 percent are fully jabbed up. Those numbers could change by the time you read this, but they won’t change much. Uptake on the vaccine has been painfully slow, landing Tennessee among the bottom 10 states in the country. 

Then came two explosive developments, both first reported by The Tennessean, that put the state alone in the national spotlight. On Monday, July 12, Dr. Michelle Fiscus, who’d led the state’s immunization program since early 2019, was fired. The following day came the revelation, via internal memos, that the health department was pulling back on vaccine outreach to teens, not just for COVID-19, but also for other diseases including the flu and HPV. All this followed Republican attacks on Fiscus and the department of health — including threats to eliminate the department — based on promotion of the COVID-19 vaccine to the state’s youth. Fiscus had been singled out in particular for a letter she sent to health providers in the state giving them guidance on Tennessee’s Mature Minor Doctrine, which allows doctors to vaccinate minors older than 14 without parental consent. The doctrine stems not from Fiscus’ personal advice, but from a 1987 Tennessee Supreme Court decision, and Fiscus has said since that her letter was approved by the state’s attorneys and the governor’s office. 

After her firing, Fiscus immediately released a statement saying that she’d been fired for doing her job “because some of our politicians have bought into the anti-vaccine misinformation campaign rather than taking the time to speak with the medical experts.” Soon her face, her voice and her story were appearing via national news publications and cable news channels. Last week, her husband Brad Fiscus — who was handling the torrent of media requests suddenly coming the couple’s way — told a reporter with some frustration that a crew from CBS had shown up later than scheduled and taken over their home. 

Fiscus said she’d been told by people in the upper levels of state government that her firing was a way for the governor and department of health commissioner Lisa Piercey to appease angry Republican lawmakers. She also revealed that she’d received a dog muzzle in the mail shortly before she was fired. 

Although it was slow to respond with anything more than unconvincing dismissals of The Tennessean’s reporting, the health department eventually started churning out its own narrative. The department released records to the Scene’s sister publication, the Nashville Post, apparently meant to justify the firing. Among them was a memo from chief medical officer Tim Jones, a longtime Tennessee Department of Health epidemiologist, who said Fiscus had failed to maintain good working relationships, been an ineffective leader of the state’s Vaccine-Preventable Diseases and Immunization Program and sought to divert state funding to a nonprofit she founded. The memo also cited several complaints from Fiscus’ health department colleagues.

What the department didn’t release was Fiscus’ recent performance reviews, signed by Piercey, which described her as “outstanding” and noted that she “exceeded expectations” as the leader of the state’s vaccine program. Fiscus released those reviews to reporters and also rebutted the claims in the memo recommending her firing with an eight-page letter. She said that Jones and others among the health department’s leadership had actually shown support for her internally.

Meanwhile, health department spokespeople insisted to reporters that reports the department was ending all childhood vaccination outreach were false and emphasized high vaccination rates among public school students. The department also posted a lengthy statement on Twitter, explaining that of course the department would still be vaccinating children and referred to “disinformation” being circulated about the program’s status. 

“The Tennessee Department of Health assures families across Tennessee that information and access to vaccinations for children through state health departments continues and there has been no disruption to these services,” the statement reads. 

An accompanying statement from Piercey said the department had merely “evaluated annual marketing efforts intended for parents.”

That gave Tennessee Republicans something to retweet with criticism of the media but failed to directly address the actual controversy — the department’s apparent retreat from proactive outreach to teens about vaccines for COVID-19 and other illnesses. In any case, the state’s recent success in regard to getting children vaccinated came under Fiscus’ leadership. She’s gone now, but the task of getting more Tennesseans to show up for a COVID-19 vaccine remains — at least, if state officials actually see that as a goal. 

Days after her firing, Fiscus told the Scene that the state did not have a vaccine access problem — “We have vaccine positioned in every nook and cranny of the state where we can get it,” she told us — but primarily one of communications. While acknowledging that there were some Tennesseans who might not be persuadable, for various reasons, she said there were also many who needed to hear accurate information from sources they trust. Their doctors, possibly, or their governor. 

Fiscus noted Lee’s decision to receive the vaccine quietly himself rather than use it as an opportunity to promote vaccination to the rural, conservative residents who are most resistant. Communication from the health department was controlled by Lee’s office, she said, and the governor has opted to stay mum. 

“What we have not had is anything in the way of pro-vaccine messaging around vaccine confidence,” Fiscus said. “We asked the governor’s office since last fall, long before we had vaccines available, to start working on pro-vaccine messaging that was in advance of the vaccine rollout, to start building vaccine confidence, to start sharing the message that, ‘Hey, this is what we’re gonna have to do to get back to the lives that we loved.’ And the governor’s office refused to do that.”

The governor’s office has consistently declined to comment on the matter. 

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