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Tennessee has one of the lowest vax rates. Republicans are working to make sure that stays the case.

Tennessee Republicans demonstrate how vaccine skepticism has escalated to outright hostility.

Hands wearing surgical gloves hold a vaccine syringe above a tray with more syringes at a clinic set up by Healthcare Network on May 20, 2021, in Immokalee, Florida.
Only about 38 percent of Tennessee’s population has been fully vaccinated as of July 14.
Joe Raedle/Getty Images

With only about 38 percent of its population fully vaccinated, Tennessee is in desperate need of more people getting the Covid-19 jab. Instead, Republicans in the state are waging war on the inoculations for the most spurious of reasons.

Under pressure from increasingly vaccine-hostile Republicans, the public health department in Tennessee fired its top vaccine official earlier this week, then prohibited state officials from engaging in vaccine outreach of all forms to minors. These developments come as average new daily Covid-19 cases in the state have more than doubled since last month.

The official, Dr. Michelle Fiscus, wasn’t told in her termination letter why she was being fired (per a review of that letter by the Tennessean). But she was previously criticized by Republicans over a letter she sent to medical providers about the state’s “Mature Minor Doctrine,” a policy that has been in place since 1987 that allows health care providers to vaccinate minors 14 and older without consent from their parents. She alleges she was fired for that advocacy, or, in other words, doing “[her] job.”

While there has been an exodus of public health officials during the pandemic across many states, the developments in Tennessee show how vaccine skepticism is evolving in outright vaccine hostility — and how that hostility is translating into policy in states where vaccination rates are lagging. (Tennessee ranks 44th out of the 50 states in the percentage of residents who are fully vaccinated.)

What’s happening in Tennessee

Fiscus, the medical director for vaccine-preventable diseases and immunization programs at the department, became a flashpoint for that ire because of the aforementioned letter informing medical providers about the Mature Minor Doctrine.

During a hearing last month, Republicans called Fiscus’s letter “reprehensible” and accused her of “peer pressuring” teens.

“It looks like the Department of Health is marketing to children and it looks like you’re advocating,” said state Sen. Kerry Roberts (R), according to the Tennesseean. “Market to parents, don’t market to children. Period.”

Then, on Monday, Fiscus was let go. In response, she wrote a letter published by the Tennessean in which she said she’s “afraid for my state.”

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

In a sign of how state officials are trying to adapt to Republican vaccine hostility, Tennessee Chief Medical Officer Dr. Tim Jones wrote an email to staff following Fiscus’s firing directing them to conduct ”no proactive outreach regarding routine vaccines” and “no outreach whatsoever regarding the HPV vaccine.”

Per the Tennessean:

If the health department must issue any information about vaccines, staff are instructed to strip the agency logo off the documents.

The health department will also stop all COVID-19 vaccine events on school property, despite holding at least one such event this month. The decisions to end vaccine outreach and school events come directly from Health Commissioner Dr. Lisa Piercey, the internal report states.

Meanwhile, children enrolling in public schools in Tennessee are still required to follow the immunization schedule published by the Centers for Disease Control and Prevention (CDC).

Vaccine skepticism has become vaccine hostility

Policies like the Mature Minor Doctrine might be important for teens whose parents watch lots of Fox News, where vaccine skepticism has become a major topic in recent months.

Tucker Carlson’s top-rated show, for instance, highlights on a near-nightly basis stories of people having bad reactions to the Covid-19 vaccine, and portrays efforts by the government, institutions, and private sector companies to encourage more people to get inoculated as creeping authoritarianism.

Meanwhile, even though the vaccines have been shown to be safe and effective for kids as young as 12, former President Donald Trump used a Fox News interview last month to invoke the sort of anti-vax rhetoric he routinely trafficked in before his 2016 presidential campaign, saying ”the vaccine on very young people is something that you gotta really stop.”

Perhaps most egregiously, Rep. Marjorie Taylor Greene (R-GA) recently compared the Biden administration’s initiative to go door to door to encourage people to get vaccinated to Nazi-era “brown shirts.” Sen. Ron Johnson (R-WI), meanwhile, has used Fox News appearances and media events to highlight the stories of people who had bad reactions to a Covid-19 vaccine, even though the vast majority of people experience mild to no problems at all, according to the CDC.

“Just because the vaccine is generally safe doesn’t mean that it’s 100 percent safe,” Johnson said last month. While that statement is true, the Food and Drug Administration notes that it “continues to find the known and potential benefits clearly outweigh the known and potential risks,” and Johnson has repeatedly used misleading figures to sensationalize the risks of getting vaccinated. The vaccine, moreover, is far safer than actually contracting Covid-19, which has now killed more than 600,000 Americans.

To be clear, there are some responsible Republican voices urging people to get vaccinated. But the Trumpiest part of the GOP seems to be shifting from vaccine skepticism to outright hostility. At last week’s CPAC event in Dallas, for instance, attendees cheered when author Alex Berenson, a frequent Fox News guest who has built a reputation for spreading misinformation about Covid-19 vaccines, noted that the federal government is falling short of its vaccination goals.

Hours later, National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci described that scene at CPAC as “horrifying” and “almost terrifying.”

GOP vaccine hostility is based on politics, not public health

It wasn’t that long ago that Republicans like Ron Johnson were singing a very different tune about the Covid-19 vaccine. In December, for instance, Johnson said Trump “deserves a lot of credit” for his “brilliant operation” to “produce a vaccine while it was being tested and approved.”

The Washington Post put together a video highlighting how a number of Republicans praised the Covid-19 vaccines when Trump was in office, only to become skeptics once it became a useful tool to derail the Biden administration’s vaccination goals.

Ironically, the people most hurt by the sort of anti-vax rhetoric that has become commonplace among GOP politicians are their own constituents. As political scientist Seth Masket recently detailed for the Denver Post, there’s a “remarkably strong” correlation between states that Biden won in 2020 and states that have vaccination rates above 70 percent. Along the same lines, NPR reported last month that “Trump won 17 of the 18 states with the lowest adult vaccination rates,” and that “many of these states have high proportions of whites without college degrees.”

“To put it bluntly,” as my colleague German Lopez wrote, “polarization is killing people.”

This rhetoric and the effect it has had in plateauing vaccination rates in the US presents risks for everyone. Children under 12 are still unable to get vaccinated, preexisting conditions mean some groups of adults can’t be vaccinated or don’t get the full benefits of vaccines, and ongoing community spread in places like Tennessee presents more opportunities for the coronavirus to mutate into new and potentially more dangerous variants.

Instead of touting the successes of the Trump administration’s Operation Warp Speed and the role it played in helping Moderna and Johnson & Johnson rapidly develop Covid-19 vaccines, a loud and influential segment of the GOP has opted to try to persuade Trump supporters not to get vaccinated. And the developments in Tennessee indicate that this war against public health science won’t stop with the Covid-19 vaccine.