Michelle Fiscus

The State of Tennessee has fired the health department’s top vaccine official, Michelle Fiscus, after a group of Republican legislators expressed qualms about encouraging teens to get vaccinated against COVID-19.

Fiscus, medical director for vaccine preventable diseases and immunization programs at the Tennessee Department of Health, says her termination — which was first reported by The Tennessean Monday afternoon — came among mounting pressure from state legislators who threatened to dissolve the health department over its efforts to encourage vaccinations among eligible minors.

Specifically, Fiscus said lawmakers were angry about a memo she sought to provide guidance to clinicians on how the Mature Minor Doctrine — a legal principle created by the Tennessee Supreme Court in 1987 that allows physicians to treat certain minors ages 14 to 18 without parental consent — applied to COVID vaccinations in Tennessee. The contents of that memo, she said, had been pre-approved by Gov. Bill Lee and the Department of Health's in-house attorney.

The department of health has since suspended messaging for all vaccinations for minors — including non-COVID, back-to-school vaccinations — Fiscus said.

In a comment to our sister publication the Nashville Post, the Tennessee Department of Health said it could not discuss personnel matters, but that the department "understands the importance of childhood immunizations, the impacts to overall health for Tennesseans, and we continue to support those outreach efforts. Providing information and access are routine public health functions, and that has not changed."

Representatives from Lee's office declined to comment.

In an interview with CNN Tuesday morning, Fiscus said the decision to terminate her was compelled by political interests, and that others in the health department who want to continue promoting vaccines fear they will lose their jobs.

“Our leadership has been toxic to work under," Fiscus said, "and morale within the department is poor. There are state workers all over the state that fear for their jobs because they just want to do the right thing and the administration is much more interested in politics."

Both Lee and department of health commissioner Lisa Piercey have said they hope to continue in public office after this term. Lee is up for re-election next year and is more frequently inserting himself in federal policy conversations (see his recent visit to the U.S.-Mexico border), which has raised eyebrows about his potential presidential ambitions. Piercey told The Tennessean earlier this year she hopes to become an elected official down the road, as governor, in congress or as a presidential cabinet member, she said at the time.

But greater problems still persist in state leadership’s current term: Tennessee’s COVID infection volumes and hospitalizations are rising again as the more contagious, more severe Delta variant spreads throughout the country. The state ranks among the worst in the U.S. for its vaccine uptake — at 38.1 percent, it is 10 percentage points below the national average — and public health officials fear regions with large numbers of unvaccinated residents will soon face alarming outbreaks.

Research so far shows the vast majority of people who are fully vaccinated against the coronavirus have protection against the Delta variant, although some can still contract the disease and develop symptoms.

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