A bunch of high-level managers on the Louisiana Division of Well being walked right into a Nov. 14 assembly in Baton Rouge anticipating to speak about outreach and neighborhood occasions.
As a substitute, they had been instructed by an assistant secretary within the division and one other official that division management had a brand new coverage: Promoting or in any other case selling the COVID, influenza or mpox vaccines, a longtime observe there — and at most different public well being entities within the U.S. — should cease.
NPR has confirmed the coverage was mentioned at this assembly, and at two different conferences held throughout the division’s Workplace of Public Well being, on Oct. 3 and Nov. 21, by way of interviews with 4 workers on the Division of Well being, which employs greater than 6,500 individuals and is the state’s largest company.
Based on the staff, who spoke on the situation of anonymity as a result of they concern dropping their jobs or different types of retaliation, the coverage can be applied quietly and wouldn’t be put in writing.
Staffers had been additionally instructed that it applies to each side of the well being division’s work: Staff couldn’t ship out press releases, give interviews, maintain vaccine occasions, give shows or create social media posts encouraging the general public to get the vaccines. In addition they couldn’t put up indicators on the division’s clinics that COVID, flu or mpox vaccines had been accessible on website.
The brand new coverage in Louisiana was applied as some politicians have promoted false details about vaccines and as President-elect Donald Trump seeks to have anti-vaccine activist Robert F. Kennedy Jr lead the U.S. Division of Well being and Human Companies. And a few public well being consultants are involved that if different states observe Louisiana, the U.S. may face rising ranges of illness and additional erosion of belief within the nation’s public well being infrastructure.
At a Dec. 16 information convention, Trump addressed ongoing considerations about Kennedy’s nomination, and whether or not it may result in vital modifications in nationwide vaccine coverage.
Trump stated that Kennedy can be “a lot much less radical than you’d assume” and that he has “a really open thoughts.” Trump additionally referred to as himself a “huge believer” within the polio vaccine and stated “you are not going to lose the polio vaccine.”
A blow to public well being observe
Workers at Louisiana’s well being division concern the brand new coverage undermines their efforts to guard the general public, and violates the basic mission of public well being: to stop sickness and illness by following the science.
“I imply, do they need to dismantle public well being?” one worker on the well being division stated.
“We’re actually speaking about deaths,” stated one other. “Even a discount in flu and COVID vaccines can result in elevated deaths.”
Gov. Jeff Landry’s workplace referred inquiries to the Louisiana Division of Well being, and didn’t reply when requested if Landry helps the modifications.
In a press release, the Louisiana Division of Well being instructed NPR it has been “reevaluating each the state’s public well being priorities in addition to our messaging round vaccine promotion, particularly for COVID-19 and influenza.”
The assertion described the transfer as a shift “away from one-size-fits-all paternalistic steering” to a stance through which “immunization for any vaccine, together with practices like masks sporting and social distancing, are a person’s private selection.”
The assertion didn’t deal with mpox vaccinations.
The assertion stated that the flu vaccine can scale back sickness severity and due to this fact might assist high-risk sufferers — however falsely claimed “the flu vaccine doesn’t stop one from getting the influenza virus.” Based on the Facilities for Illness Management and Prevention, the vaccine reduces the chance of getting the flu.
Consultants concern penalties of undermining belief in vaccine
Final yr, 652 individuals in Louisiana died of COVID, together with 5 kids. Louisiana at present is tied with DC for the highest charge of flu within the U.S. In 2022 alone, flu killed 586 individuals in Louisiana.
Each well being division employees member, former employees member, public well being official and vaccine skilled contacted by NPR repeated the scientific consensus that vaccines are protected, efficient, and important for stopping sickness, hospitalizations, and deaths.
“It is a step backwards,” stated Kimberly Hood, who led the Workplace of Public Well being, a subunit of the well being division, from 2021 to 2022. “It is a medical marvel that we’re lucky sufficient to dwell in a time the place these vaccines can be found to us, and to not make use of that device is unconscionable.”
The coverage rises to the extent of “absurdity,” stated Dr. Paul Offit, director of the Vaccine Schooling Heart on the Youngsters’s Hospital of Philadelphia. “It is gotten to the purpose of parody, the place a public well being company would not promote the general public’s well being.”
“It is a harmful, harmful factor,” Offit stated. “It is essentially the most susceptible amongst us that suffer this, and it will likely be our kids that suffer this. And my query can be, will they be held accountable?”
The coverage is akin to “malpractice,” particularly given Louisiana’s poor well being outcomes, stated Dr. Georges Benjamin, the manager director of the American Public Well being Affiliation (APHA).
The U.S. vaccination program represents “probably the most necessary public well being interventions that we have now,” Benjamin added.
“It is reckless,” stated Lawrence Gostin, a professor of world well being regulation at Georgetown College. “I feel it is a signal of what’s about to occur underneath the second Trump administration.”
If U.S. senators verify Kennedy to run HHS, he stated, “we’ll see the fomenting of public mistrust of vaccines so we lose valuable herd immunity, and we’ll see main outbreaks of illness which are totally preventable over the following 4 years.”
NPR reached out to Kennedy for remark however didn’t hear again.
Coverage change follows new governor’s election
Till turning into Louisiana governor in early 2024, Republican Jeff Landry served because the state’s legal professional common for eight years. Throughout the pandemic, he criticized the state’s COVID response and filed lawsuits over federal and state vaccine mandates.
On Dec. 6, 2021, Legal professional Basic Landry spoke at a state committee listening to towards including COVID to the childhood immunization schedule. At his aspect was Robert F. Kennedy, Jr., who offered false claims about COVID vaccines.
This yr the Republican-controlled legislature handed 5 payments — all signed by Gov. Landry — and two resolutions aimed toward loosening vaccine necessities, limiting the facility of public well being authorities and sowing doubt about vaccine security.
Gov. Landry additionally appointed Dr. Ralph Abraham, a household medication physician, to be the state’s surgeon common. That place co-leads the Division of Well being, and is tasked with crafting well being coverage that’s then carried out by the departmental co-leader, the secretary.
Dr. Wyche Coleman, an ophthalmologist, was named deputy surgeon common.
At a Sept. 26, 2024 legislative assembly on the state’s dealing with of the COVID pandemic, Abraham and Coleman repeated misinformation about COVID vaccine security and the debunked hyperlink between vaccines and autism.
“I see, now, vaccine damage every single day of my observe” from COVID vaccines, Abraham stated.
Abraham stated masking, lockdowns and vaccination necessities “had been virtually ineffective,” that COVID vaccine antagonistic results have been “suppressed,” that “we do not know” whether or not blood from individuals who’ve been vaccinated is protected for donation and that “we hope and pray” COVID vaccines do not enhance the chance miscarriages.
Surgeon Basic Abraham additionally stated “there’s nothing fallacious” with Louisiana conducting its personal analysis into whether or not childhood vaccines trigger autism.
“You might most likely fill Tiger Stadium with mothers who’ve youngsters that had been regular sooner or later, received a vaccine and had been then autistic after,” stated Deputy Surgeon Basic Coleman at that assembly.
These public feedback by Abraham and Coleman are inaccurate and alarming, based on public well being consultants.
“Anybody who’s articulating that these vaccines will not be effectively examined, they don’t seem to be protected, they don’t seem to be efficient, shouldn’t be providing you with the science as we all know it as we speak,” stated APHA’s Benjamin.
“To have prime public well being officers peddling such scientific falsehoods and threatening the well being of their populations, whom they’ve sworn an oath to serve, nearly makes me cry,” stated Georgetown’s Gostin.
In three conferences, shock and confusion at new coverage
The brand new ban on vaccine promotion represents a brand new degree of political interference, based on two present well being division workers.
“We have by no means felt so uncertain of our future,” considered one of them stated. “Like, why am I right here? Why am I doing this anymore? Since you’re simply so stifled and you aren’t serving to individuals.”
Within the Oct. 3 assembly, Deputy Secretary Dr. Pete Croughan, an inner medication doctor, instructed the state’s regional medical administrators that they weren’t allowed to carry routine fall flu vaccination occasions, based on a employees member with information of what was mentioned on the assembly.
These flu shot occasions had develop into a key a part of the well being division’s flu marketing campaign in recent times, which included spending over $170,000 yearly on exterior public consciousness campaigns that included paid billboards, bus advertisements, radio, digital, and social media advertisements urging the general public to get vaccinated for the flu.
This yr, as a substitute of flu vaccine occasions, the medical administrators had been instructed to pivot to Narcan giveaways.
The division’s influenza web page would not seem to have been up to date this yr; it nonetheless promotes occasions from 2023.
The division additionally seems to have pulled again from vaccination messaging on social media channels.
Final fall, it printed six Instagram posts selling flu and COVID vaccinations, and particular vaccine occasions. Within the final three months, the well being division’s Instagram has had no posts about vaccination, and only a single put up about flu.
That latest put up lists preventative measures like hand washing, however not vaccination.
That stands in stark distinction to a flu put up from the autumn of 2020 which said “it is extra necessary than ever to get your flu vaccination to guard your self and people round you.”
Regional medical administrators are answerable for finishing up the well being division’s coverage and applications throughout the state.
Within the assembly, Croughan instructed them in the event that they need to convey doses of flu vaccine to an area occasion, they can not use signage and even tablecloths that includes the well being division’s brand.
“You can not ask individuals, ‘Hey, we have now flu pictures. Would you want one?'” at a neighborhood occasion, based on the employees member with information of the assembly. “But when they arrive as much as us, understanding we’re the well being division and say, ‘Hey, we hear y’all may need flu pictures,’ we are able to say, ‘Sure, would you want one?'”
The medical administrators had been instructed that as a result of the well being division is a authorities company, employees will not be allowed to “coerce individuals” by selling vaccinations, particularly for COVID, flu and mpox. “They’ve positively made it clear that we’re not speculated to be pushing vaccines in any respect,” the employees member added.
There was no rationalization for why these specific vaccines had been grouped collectively.
“Why on earth they selected COVID, influenza and mpox vaccines, that are solely totally different vaccines for solely totally different functions, simply exhibits a scarcity of sophistication and understanding of science,” Gostin stated.
“I am unable to consider any cause aside from political causes,” stated Hood, the previous head of the Workplace of Public Well being.
Opposition to COVID vaccines has gained momentum throughout the Republican Social gathering, as a part of the backlash to pandemic-related public well being measures. In terms of the flu vaccine, Kennedy’s anti-vaccination nonprofit, the Youngsters’s Well being Protection, has made a number of false claims about its risks.
Coverage might stem from surgeon common’s letter
On the Nov. 14 assembly, the brand new prohibitions had been relayed to program employees by Tonya Joiner, an assistant secretary within the division and the pinnacle of the Workplace of Public Well being, and Katye Magee, a coverage director.
Staff had been instructed that Joiner and Magee had been relaying the coverage as a result of Surgeon Basic Ralph Abraham couldn’t attend.
Staffers requested them what precisely they’ll say about COVID, flu and mpox vaccines, going ahead.
They had been instructed acceptable public vaccine messaging ought to be one thing alongside the traces of: Speak to your medical supplier.
“That appeared to be the catchphrase for all of this,” stated one employees member with information of the assembly.
The secretive rollout of the brand new coverage raised considerations about authorities transparency and accountability, and a former state worker with information of the state’s well being insurance policies stated it was “extremely irregular” to intentionally hold the coverage out of writing.
“I am very shocked that anybody would name a state assembly, not present an agenda for that assembly, not present a written set of notes from that assembly,” stated Hood. “I feel that, to me, it appears like persons are making an attempt to keep away from public data legal guidelines.”
When workers within the assembly requested for the rationale for the coverage change, management referenced a letter signed by Abraham and Coleman stating that there is no such thing as a “conclusive proof” that masking prevents the unfold of respiratory viruses and that “proof proving efficacy in prevention of an infection, transmissions, hospitalization or deaths is much from conclusive” for the flu vaccine.
That letter supplies a template for a Louisiana doctor to make use of to get an exemption from a hospital’s flu vaccination and masking insurance policies. The letter, on Louisiana Division of Well being letterhead, shouldn’t be accessible on the division’s web site however was posted to X on Nov. 13, the day earlier than it was talked about within the assembly.
Within the letter, Abraham and Coleman additionally stated requiring hospital employees who don’t get the flu vaccine to put on a masks was “punitive coercion.”
One Louisiana well being skilled not employed by the division stated the letter was “loopy. I am simply going to say it. Full falsehoods.”
On the third assembly, on Nov. 21, the STD/HIV/Hepatitis program on the division held a employees assembly the place greater than 80 workers realized of the ban on selling COVID, mpox and flu vaccines, based on two employees members. Staff had been additionally instructed the coverage wouldn’t be put in writing.
When employees requested whether or not the coverage utilized to hepatitis B vaccinations, they had been instructed “there was no official response to that but,” stated a employees member who attended the assembly.
“There have been so many questions and considerations,” the employees member stated. “Loads of of us had been disillusioned and simply annoyed.”
A slippery slope to future illness outbreaks
Consultants instructed NPR they feared a coverage that undermines COVID, flu and mpox vaccinations may have a spillover impact, decreasing public belief in vaccinations total, together with these given to kids to stop a bunch of harmful and lethal sicknesses.
“I consider that we’ll see measles instances. I consider we’ll see whooping cough instances. I consider we’ll possible see meningitis outbreaks,” stated Hood.
Within the Nov. 14 assembly, a employees member requested whether or not the ban on selling vaccines utilized to kids’s immunizations, however the reply was noncommittal, based on an worker with information of the assembly’s particulars.
“My understanding was it is not clear to what extent we would be capable to promote childhood vaccinations,” the employees member stated.
(The Louisiana Division of Well being’s assertion to NPR stated the modifications in coverage and messaging don’t apply to childhood immunizations.)
Nationally, vaccination charges for critical childhood ailments have been falling in recent times, together with in Louisiana.
Given these traits, the brand new vaccine coverage in Louisiana may be very worrying, stated Dr. Joseph Bocchini, a pediatric infectious illness specialist in Shreveport, Louisiana, and the president of the Louisiana chapter of the American Academy of Pediatrics.
Earlier in his profession, he noticed kids hospitalized with measles — a harmful illness that may trigger listening to loss, mind harm and dying.
“I have been a doctor for 50 years, so I’ve seen numerous these ailments disappear, and so they’ve disappeared due to protected and efficient vaccines,” he stated.
The rise of public well being officers selling misinformation
Louisiana is not the one state the place public well being officers have not too long ago introduced controversial selections and repeated false or discredited well being theories.
Florida’s surgeon common has made false claims about COVID vaccines, undermined college vaccine mandates for the measles and stated native officers ought to cease including fluoride to water provides.
Hood traced Louisiana’s new coverage, partially, to Kennedy’s ties to Louisiana’s Republican Social gathering.
“Robert F. Kennedy Jr. got here to the legislature whereas I used to be nonetheless in my function on the Workplace of Public Well being, to talk out towards the COVID vaccine,” she stated, referencing his Dec. 6, 2021, look with Gov. Landry. “So I used to be not 100% surprised to listen to his affect was going to be felt on this administration.”
Louisiana’s ban represents an escalation in utilizing vaccine misinformation to direct state well being coverage, based on James Hodge, a public well being regulation skilled at Arizona State College’s Sandra Day O’Connor Faculty of Legislation.
“What’s very distinct is a few kind of official coverage superior by the state division of well being saying it’s possible you’ll not push and or promote these vaccines in any respect,” Hodge stated. “That is derelict. It is extremely controversial.”
But it surely’s the form of coverage the nation may see if Kennedy is confirmed as secretary for Well being and Human Companies, Hodge added. In a checklist he product of potential actions the Trump administration may take, Hodges positioned “revising CDC vaccine suggestions” on the prime.
This story comes from NPR’s well being reporting partnership with WWNO and KFF Well being Information.