Doctor assistant Danis Walker vaccinates a development employee exterior a Lowes Residence Enchancment retailer in New Orleans on June 11, 2021.
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Rosemary Westwood/WWNO
A gaggle 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 have been advised 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 follow 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, via interviews with 4 staff on the Division of Well being, which employs greater than 6,500 folks and is the state’s largest company.
In keeping with the workers, who spoke on the situation of anonymity as a result of they worry dropping their jobs or different types of retaliation, the coverage could be carried out quietly and wouldn’t be put in writing.
Staffers have been additionally advised that it applies to each facet of the well being division’s work: Staff couldn’t ship out press releases, give interviews, maintain vaccine occasions, give displays or create social media posts encouraging the general public to get the vaccines. Additionally they couldn’t put up indicators on the division’s clinics that COVID, flu or mpox vaccines have been out there on website.
The brand new coverage in Louisiana was carried out 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.
Anti-vaccine activist Robert F. Kennedy Jr. spoke at a rally in Georgia on Oct 23. He’s President-elect Donald Trump’s option to change into Secretary of the Division of Well being and Human Companies. On Dec. 6, 2021, Kennedy spoke at a Louisiana committee listening to and offered false claims in regards to the security of COVID vaccines. He sat beside then-Legal professional Common Jeff Landry.
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At a Dec. 16 information convention, Trump addressed ongoing issues about Kennedy’s nomination, and whether or not it may result in vital adjustments in nationwide vaccine coverage.
Trump mentioned that Kennedy will likely be “a lot much less radical than you’d suppose” and that he has “a really open thoughts.” Trump additionally known as himself a “large believer” within the polio vaccine and mentioned “you are not going to lose the polio vaccine.”
A blow to public well being follow
Employees at Louisiana’s well being division worry the brand new coverage undermines their efforts to guard the general public, and violates the elemental mission of public well being: to forestall sickness and illness by following the science.
“I imply, do they need to dismantle public well being?” one worker on the well being division mentioned.
“We’re actually speaking about deaths,” mentioned one other. “Even a discount in flu and COVID vaccines can result in elevated deaths.”
On this file picture, Anthony Reed (left) and Christopher Bowles (proper) present the Band-Aids they acquired after receiving the mpox vaccine on the Southern Decadence Well being Hub in New Orleans on Sept. 4, 2022. The well being hub, on the annual LGBTQ celebration, was organized by the Louisiana Division of Well being.
Shalina Chatlani/Gulf States Newsroom
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Shalina Chatlani/Gulf States Newsroom
Gov. Jeff Landry’s workplace referred inquiries to the Louisiana Division of Well being, and didn’t reply when requested if Landry helps the adjustments.
In an announcement, the Louisiana Division of Well being advised 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 during which “immunization for any vaccine, together with practices like masks sporting and social distancing, are a person’s private alternative.”
The assertion didn’t deal with mpox vaccinations.
The assertion mentioned that the flu vaccine can scale back sickness severity and subsequently could assist high-risk sufferers — however falsely claimed “the flu vaccine doesn’t forestall one from getting the influenza virus.” In keeping with the Facilities for Illness Management and Prevention, the vaccine reduces the danger of getting the flu.
Specialists worry penalties of undermining belief in vaccine
Final yr, 652 folks in Louisiana died of COVID, together with 5 kids. Louisiana presently is tied with DC for the highest price of flu within the U.S. In 2022 alone, flu killed 586 folks in Louisiana.
Each well being division employees member, former employees member, public well being official and vaccine knowledgeable contacted by NPR repeated the scientific consensus that vaccines are secure, efficient, and important for stopping sickness, hospitalizations, and deaths.
“It is a step backwards,” mentioned 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 stay 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,” mentioned Dr. Paul Offit, director of the Vaccine Training Middle on the Kids’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 mentioned. “It is probably the most susceptible amongst us that suffer this, and it will likely be our kids that suffer this. And my query will likely be, will they be held accountable?”
The coverage is akin to “malpractice,” particularly given Louisiana’s poor well being outcomes, mentioned Dr. Georges Benjamin, the manager director of the American Public Well being Affiliation (APHA).
The U.S. vaccination program represents “one of the crucial vital public well being interventions that now we have,” Benjamin added.
“It is reckless,” mentioned Lawrence Gostin, a professor of worldwide well being legislation at Georgetown College. “I feel it is a signal of what’s about to occur below the second Trump administration.”
If U.S. senators verify Kennedy to run HHS, he mentioned, “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 might be absolutely 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 lawyer normal for eight years. Through the pandemic, he criticized the state’s COVID response and filed lawsuits over federal and state vaccine mandates.
On Dec. 6, 2021, Legal professional Common 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.
Legal professional Common Jeff Landry speaks about medicines being donated by drug firms in the course of the coronavirus pandemic in Baton Rouge on April 6, 2020. in Baton Rouge, La. After Landry grew to become governor in 2024, his appointees on the Louisiana Division of Well being oversaw a coverage shift that forbid employees from selling vaccines for COVID, flu and mpox.
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Gov. Landry additionally appointed Dr. Ralph Abraham, a household medication physician, to be the state’s surgeon normal. 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 normal.
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 harm every single day of my follow” from COVID vaccines, Abraham mentioned.
Abraham mentioned masking, lockdowns and vaccination necessities “have been virtually ineffective,” that COVID vaccine adversarial results have been “suppressed,” that “we do not know” whether or not blood from individuals who’ve been vaccinated is secure for donation and that “we hope and pray” COVID vaccines do not enhance the danger miscarriages.
Surgeon Common Abraham additionally mentioned “there’s nothing incorrect” with Louisiana conducting its personal analysis into whether or not childhood vaccines trigger autism.
“You might in all probability fill Tiger Stadium with mothers who’ve youngsters that have been regular sooner or later, acquired a vaccine and have been then autistic after,” mentioned Deputy Surgeon Common 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 usually are not effectively examined, they don’t seem to be secure, they don’t seem to be efficient, isn’t providing you with the science as we all know it right now,” mentioned 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, virtually makes me cry,” mentioned Georgetown’s Gostin.
In three conferences, shock and confusion at new coverage
The brand new ban on vaccine promotion represents a brand new stage of political interference, based on two present well being division staff.
“We have by no means felt so uncertain of our future,” considered one of them mentioned. “Like, why am I right here? Why am I doing this anymore? Since you’re simply so stifled and you aren’t serving to folks.”
Dr. Ralph Abraham, then a member of Congress for Louisiana, speaks at a enterprise occasion on March 18, 2019 in Baton Rouge. In 2024, Louisiana Gov. Jeff Landry appointed Abraham as Surgeon Common, who units coverage for the Louisiana Division of Well being.
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Melinda Deslatte/AP
Within the Oct. 3 assembly, Deputy Secretary Dr. Pete Croughan, an inner medication doctor, advised 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 change 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 have been advised 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 publish about flu.
That latest publish lists preventative measures like hand washing, however not vaccination.
That stands in stark distinction to a flu publish from the autumn of 2020 which acknowledged “it is extra vital than ever to get your flu vaccination to guard your self and people round you.”
Regional medical administrators are chargeable for finishing up the well being division’s coverage and packages throughout the state.
Within the assembly, Croughan advised them in the event that they need to deliver doses of flu vaccine to a neighborhood occasion, they cannot use signage and even tablecloths that includes the well being division’s emblem.
“You can’t ask folks, ‘Hey, now we have 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, realizing we’re the well being division and say, ‘Hey, we hear y’all might need flu pictures,’ we will say, ‘Sure, would you want one?'”
The medical administrators have been advised that as a result of the well being division is a authorities company, employees usually are not allowed to “coerce folks” by selling vaccinations, particularly for COVID, flu and mpox. “They’ve undoubtedly made it clear that we aren’t presupposed to be pushing vaccines in any respect,” the employees member added.
There was no rationalization for why these explicit vaccines have 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 an absence of sophistication and understanding of science,” Gostin mentioned.
“I can not consider any purpose apart from political causes,” mentioned Hood, the previous head of the Workplace of Public Well being.
Opposition to COVID vaccines has gained momentum throughout the Republican Occasion, as a part of the backlash to pandemic-related public well being measures. Relating to the flu vaccine, Kennedy’s anti-vaccination nonprofit, the Kids’s Well being Protection, has made a number of false claims about its risks.
Coverage could stem from surgeon normal’s letter Â
On the Nov. 14 assembly, the brand new prohibitions have been relayed to program employees by Tonya Joiner, an assistant secretary within the division and the top of the Workplace of Public Well being, and Katye Magee, a coverage director.
Staff have been advised that Joiner and Magee have been relaying the coverage as a result of Surgeon Common Ralph Abraham couldn’t attend.
Staffers requested them what precisely they’ll say about COVID, flu and mpox vaccines, going ahead.
They have been advised acceptable public vaccine messaging ought to be one thing alongside the strains of: Speak to your medical supplier.
“That appeared to be the catchphrase for all of this,” mentioned one employees member with information of the assembly.
The secretive rollout of the brand new coverage raised issues about authorities transparency and accountability, and a former state worker with information of the state’s well being insurance policies mentioned it was “extremely irregular” to intentionally maintain 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,” mentioned Hood. “I feel that, to me, it seems like persons are attempting to keep away from public data legal guidelines.”
When staff within the assembly requested for the rationale for the coverage change, management referenced a letter signed by Abraham and Coleman stating that there isn’t any “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 gives 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, isn’t out there 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 mentioned 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 mentioned 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 staff discovered of the ban on selling COVID, mpox and flu vaccines, based on two employees members. Staff have been additionally advised the coverage wouldn’t be put in writing.
When employees requested whether or not the coverage utilized to hepatitis B vaccinations, they have been advised “there was no official response to that but,” mentioned a employees member who attended the assembly.
“There have been so many questions and issues,” the employees member mentioned. “Numerous of us have been dissatisfied and simply annoyed.”
A slippery slope to future illness outbreaks
Specialists advised NPR they feared a coverage that undermines COVID, flu and mpox vaccinations may have a spillover impact, decreasing public belief in vaccinations general, together with these given to kids to forestall a bunch of harmful and lethal diseases.
“I consider that we’ll see measles instances. I consider we’ll see whooping cough instances. I consider we’ll possible see meningitis outbreaks,” mentioned 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 of promote childhood vaccinations,” the employees member mentioned.
(The Louisiana Division of Well being’s assertion to NPR mentioned the adjustments in coverage and messaging don’t apply to childhood immunizations.)
Nationally, vaccination charges for critical childhood illnesses have been falling in recent times, together with in Louisiana.
Given these tendencies, the brand new vaccine coverage in Louisiana may be very worrying, mentioned 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 demise.
“I have been a doctor for 50 years, so I’ve seen loads of these illnesses disappear, they usually’ve disappeared due to secure and efficient vaccines,” he mentioned.
The rise of public well being officers selling misinformation
Louisiana is not the one state the place public well being officers have just lately introduced controversial selections and repeated false or discredited well being theories.
Florida’s surgeon normal has made false claims about COVID vaccines, undermined faculty vaccine mandates for the measles and mentioned 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 Occasion.
“Robert F. Kennedy Jr. got here to the legislature whereas I used to be nonetheless in my position on the Workplace of Public Well being, to talk out towards the COVID vaccine,” she mentioned, 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 legislation knowledgeable at Arizona State College’s Sandra Day O’Connor School of Legislation.
“What’s very distinct is a few kind of official coverage superior by the state division of well being saying you could not push and or promote these vaccines in any respect,” Hodge mentioned. “That is derelict. It is extremely controversial.”
Nevertheless it’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 record he manufactured from attainable 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.
