NASHVILLE, Tenn. (AP) - Tennessee's top health official said Friday that the state can still vaccinate some minors without parental consent, aiming to clear up contradictory claims from lawmakers who complained that the state's former vaccine chief circulated information about the longstanding childhood vaccination policy before she was fired.
On Friday, Health Commissioner Lisa Piercey, who fired Michelle Fiscus and temporarily paused outreach efforts for all childhood vaccines, dialed back claims by lawmakers that the state's clinicians won't follow the parental consent policy. That policy was established under a 1987 state Supreme Court case applicable across public and private health providers. Piercey said it remains in effect, but is used only in "very nuanced and fringe situations."
Piercey's redirect came two days after Republican Sen. Kerry Roberts and his co-chairman on the Government Operations Committee, GOP Rep. John Ragan, announced during a legislative meeting that "Dr. Piercey and the governor's office confirmed that it is not the policy of Tennessee Department of Health, Tennessee Department of Education, or our 89 county health departments to administer the COVID-19 vaccine to children without parental consent." They didn't say the six, larger independent county health departments or private providers would be held to the change.
The policy, named the Mature Minor Doctrine, has been a focal point in the ouster of Fiscus, who argued that she was let go to appease lawmakers opposed to vaccination outreach work on the COVID-19 shot for eligible minors.
In her first public comments since Fiscus was fired, Piercey wouldn't discuss the termination, other than to make a statement similar to what Gov. Bill Lee said the day before - that her job is to ensure that the department's people and policies conform to "his vision and in our belief about the appropriate role of government."
However, Piercey did say the "pause" in outreach for childhood vaccinations is over. She said they had to ensure that childhood vaccine marketing didn't seem to target children and not their parents, as some lawmakers claimed.
Piercey said she met with the senator on Thursday about his statement and said they are now "completely aligned" that there are "very nuanced and fringe situations where that might occur, and none of us want to get in the way of that."
"Including Chairman Roberts as of yesterday when I talked to him, and the governor as well, we do recognize that there are some very unique situations where there are older teenagers that might be in social situations that don't allow them to have parents come in with them for one reason or the other," Piercey said. "So, we will be able to continue servicing them under the Mature Minor Doctrine."
A Department of Health official's recommendation to fire Fiscus claims she sent around "her own interpretation" of the doctrine, which allows providers to vaccinate children 14 and up without a parent's consent if they deem the child mature enough. The recommendation also alleged deficiencies in her leadership, citing issues with staff.
Fiscus has said the letter she sent in response to providers was verbatim from documents provided by the department's chief legal counsel. She provided email records to back up the assertion. She also issued a point-by-point rebuttal to the alleged fire-able offenses and distributed years of positive performance reviews from her supervisor, including as early as last month when she was praised for her "strong leadership."
Piercey has said she knew of only eight times this year when Tennessee's doctrine was invoked, and three were for her own children, who received vaccines while she was at work.
Tennessee is among five states where providers can decide if a minor is mature enough to consent to vaccination without a parent, according to the Kaiser Family Foundation, which said 41 other states require parental consent and five have a self-consent age under 18.
Regarding the halt to childhood vaccination outreach, Piercey said the department looked at all "public-facing materials," including marketing, fliers, postcard reminders and consent forms. She said that "while we never intended to target children, I understand that there was a gap in the perception of how it was being received."
She said the only permanent change is the removal of 11 social media posts that only featured children. Future ads will feature children with their parents, she said.
And while some back-to-school vaccination events may have been paused, some are scheduled as soon as next week. The department's logo was left off some fliers, including school-based ones, while they were reassessed, but now the logo is going back on documents, she said.
"The reason that we paused is that we wanted to leave no room for interpretation about where we are shooting, and we are shooting to get the message to parents," Piercey said.