Doctor assistant Danis Walker vaccinates a building employee outdoors a Lowes House Enchancment retailer in New Orleans on June 11, 2021.
Rosemary Westwood/WWNO
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Rosemary Westwood/WWNO
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 informed 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 inside the division’s Workplace of Public Well being, on Oct. 3 and Nov. 21, via interviews with 4 workers on the Division of Well being, which employs greater than 6,500 folks and is the state’s largest company.
Based on the staff, 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 applied quietly and wouldn’t be put in writing.
Staffers had been additionally informed 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 shows 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 had been obtainable on web site.
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 comply with Louisiana, the U.S. might 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 turn 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 concerning the security of COVID vaccines. He sat beside then-Lawyer Normal Jeff Landry.
Jabin Botsford/The Washington Publish through Getty Pictures
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Jabin Botsford/The Washington Publish through Getty Pictures
At a Dec. 16 information convention, Trump addressed ongoing issues about Kennedy’s nomination, and whether or not it might result in important modifications in nationwide vaccine coverage.
Trump mentioned that Kennedy will likely be “a lot much less radical than you’ll suppose” and that he has “a really open thoughts.” Trump additionally known as himself a “huge 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 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 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 photograph, 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 modifications.
In an announcement, the Louisiana Division of Well being informed 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 steerage” to a stance through 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 cut back sickness severity and due to this fact could assist high-risk sufferers — however falsely claimed “the flu vaccine doesn’t forestall 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 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 charge 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 dwell in a time the place these vaccines can be found to us, and to not make use of that instrument is unconscionable.”
The coverage rises to the extent of “absurdity,” mentioned Dr. Paul Offit, director of the Vaccine Schooling Middle 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 mentioned. “It is probably the most weak amongst us who are suffering this, and will probably be our youngsters who are suffering 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 vital vital public well being interventions that we’ve,” Benjamin added.
“It is reckless,” mentioned Lawrence Gostin, a professor of worldwide well being regulation at Georgetown College. “I feel it is a signal of what’s about to occur beneath the second Trump administration.”
If U.S. senators affirm Kennedy to run HHS, he mentioned, “we will see the fomenting of public mistrust of vaccines so we lose valuable herd immunity, and we will see main outbreaks of illness which are totally preventable over the subsequent 4 years.”
NPR reached out to Kennedy for remark however didn’t hear again.
Coverage change follows new governor’s election
Till changing into Louisiana governor in early 2024, Republican Jeff Landry served because the state’s lawyer basic 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, Lawyer Normal 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.
Lawyer Normal 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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BILL FEIG/AP
Gov. Landry additionally appointed Dr. Ralph Abraham, a household medication physician, to be the state’s surgeon basic. 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 basic.
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 follow” from COVID vaccines, Abraham mentioned.
Abraham mentioned 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 secure for donation and that “we hope and pray” COVID vaccines do not enhance the chance miscarriages.
Surgeon Normal 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 children that had been regular someday, acquired a vaccine and had been then autistic after,” mentioned Deputy Surgeon Normal Coleman at that assembly.
These public feedback by Abraham and Coleman are inaccurate and alarming, in keeping with public well being consultants.
“Anybody who’s articulating that these vaccines should not properly examined, they don’t seem to be secure, they don’t seem to be efficient, shouldn’t be supplying you with the science as we all know it at this time,” 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 degree of political interference, in keeping with two present well being division workers.
“We have by no means felt so not sure 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 Normal, who units coverage for the Louisiana Division of Well being.
Melinda Deslatte/AP
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Melinda Deslatte/AP
Within the Oct. 3 assembly, Deputy Secretary Dr. Pete Croughan, an inner medication doctor, informed the state’s regional medical administrators that they weren’t allowed to carry routine fall flu vaccination occasions, in keeping with a employees member with information of what was mentioned on the assembly.
These flu shot occasions had turn 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 outdoors 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 an alternative of flu vaccine occasions, the medical administrators had been informed 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 revealed 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 current 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 acknowledged “it is extra vital 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 informed them in the event that they need to convey doses of flu vaccine to a neighborhood occasion, they cannot use signage and even tablecloths that includes the well being division’s brand.
“You can’t ask folks, ‘Hey, we’ve flu pictures. Would you want one?'” at a neighborhood occasion, in keeping with the employees member with information of the assembly. “But when they arrive as much as us, figuring out 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 had been informed that as a result of the well being division is a authorities company, employees should not allowed to “coerce folks” by selling vaccinations, particularly for COVID, flu and mpox. “They’ve undoubtedly made it clear that we aren’t purported to be pushing vaccines in any respect,” the employees member added.
There was no clarification for why these specific vaccines had been grouped collectively.
“Why on earth they selected COVID, influenza and mpox vaccines, that are solely completely different vaccines for solely completely different functions, simply exhibits a scarcity of sophistication and understanding of science,” Gostin mentioned.
“I am unable to consider any motive aside from political causes,” mentioned Hood, the previous head of the Workplace of Public Well being.
Opposition to COVID vaccines has gained momentum inside the Republican Occasion, as a part of the backlash to pandemic-related public well being measures. With regards to 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 could stem from surgeon basic’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 top of the Workplace of Public Well being, and Katye Magee, a coverage director.
Staff had been informed that Joiner and Magee had been relaying the coverage as a result of Surgeon Normal Ralph Abraham couldn’t attend.
Staffers requested them what precisely they’ll say about COVID, flu and mpox vaccines, going ahead.
They had been informed 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,” 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 hold the coverage out of writing.
“I am very stunned 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 feels like persons are attempting 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 isn’t 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 way 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 obtainable 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 workers discovered of the ban on selling COVID, mpox and flu vaccines, in keeping with two employees members. Staff had been additionally informed the coverage wouldn’t be put in writing.
When employees requested whether or not the coverage utilized to hepatitis B vaccinations, they had been informed “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. “A number of people had been disenchanted and simply pissed off.”
A slippery slope to future illness outbreaks
Consultants informed NPR they feared a coverage that undermines COVID, flu and mpox vaccinations might have a spillover impact, lowering public belief in vaccinations general, 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 are going to see whooping cough instances. I consider we are going to seemingly 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, in keeping with an worker with information of the assembly’s particulars.
“My understanding was it isn’t 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 modifications 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 could 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 injury and dying.
“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 choices and repeated false or discredited well being theories.
Florida’s surgeon basic has made false claims about COVID vaccines, undermined college vaccine mandates for the measles and mentioned native officers ought to cease including fluoride to water provides.
Hood traced Louisiana’s new coverage, partly, 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 function 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% shocked 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, in keeping with James Hodge, a public well being regulation knowledgeable at Arizona State College’s Sandra Day O’Connor Faculty of Legislation.
“What’s very distinct is a few form 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 type of coverage the nation might see if Kennedy is confirmed as secretary for Well being and Human Companies, Hodge added. In a checklist he made from doable actions the Trump administration might 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.
