Doctor assistant Danis Walker vaccinates a building employee outdoors a Lowes House 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 had 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 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 inside the division’s Workplace of Public Well being, on Oct. 3 and Nov. 21, by way of 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 concern shedding their jobs or different types of retaliation, the coverage could be carried out quietly and wouldn’t be put in writing.
Staffers had been additionally advised 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. Additionally they couldn’t put up indicators on the division’s clinics that COVID, flu or mpox vaccines had been accessible on web site.
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 Providers. And a few public well being consultants are involved that if different states observe 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 out to be Secretary of the Division of Well being and Human Providers. 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 Basic Jeff Landry.
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Jabin Botsford/The Washington Put up through Getty Photos
At a Dec. 16 information convention, Trump addressed ongoing issues about Kennedy’s nomination, and whether or not it might result in vital adjustments in nationwide vaccine coverage.
Trump stated that Kennedy can be “a lot much less radical than you’d suppose” and that he has “a really open thoughts.” Trump additionally known as himself a “massive believer” within the polio vaccine and stated “you are not going to lose the polio vaccine.”
A blow to public well being observe
Employees 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 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 stated.
“We’re actually speaking about deaths,” stated 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 a press release, 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 through which “immunization for any vaccine, together with practices like masks carrying and social distancing, are a person’s private selection.”
The assertion didn’t tackle mpox vaccinations.
The assertion stated that the flu vaccine can cut back sickness severity and subsequently might assist high-risk sufferers — however falsely claimed “the flu vaccine doesn’t stop one from getting the influenza virus.” In keeping with the Facilities for Illness Management and Prevention, the vaccine reduces the chance of getting the flu.
Specialists concern penalties of undermining belief in vaccine
Final 12 months, 652 folks in Louisiana died of COVID, together with 5 youngsters. Louisiana at present 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 workers member, former workers 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,” 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 stay in a time the place these vaccines can be found to us, and to not make use of that software is unconscionable.”
The coverage rises to the extent of “absurdity,” stated Dr. Paul Offit, director of the Vaccine Training Heart on the Kids’s Hospital of Philadelphia. “It is gotten to the purpose of parody, the place a public well being company does not promote the general public’s well being.”
“It is a harmful, harmful factor,” Offit stated. “It is probably the most susceptible amongst us who are suffering this, and it will likely be our youngsters who are suffering 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 “one of the vital essential public well being interventions that we’ve,” Benjamin added.
“It is reckless,” stated Lawrence Gostin, a professor of worldwide well being regulation at Georgetown College. “I believe 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 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 changing 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, Lawyer Basic Landry spoke at a state committee listening to in opposition to including COVID to the childhood immunization schedule. At his aspect was Robert F. Kennedy, Jr., who offered false claims about COVID vaccines.
This 12 months 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 Basic Jeff Landry speaks about medicines being donated by drug corporations through 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 workers 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 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 daily of my observe” from COVID vaccines, Abraham stated.
Abraham stated masking, lockdowns and vaccination necessities “had been virtually ineffective,” that COVID vaccine hostile 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 improve the chance miscarriages.
Surgeon Basic Abraham additionally stated “there’s nothing unsuitable” with Louisiana conducting its personal analysis into whether or not childhood vaccines trigger autism.
“You could possibly most likely fill Tiger Stadium with mothers who’ve youngsters that had been regular sooner or later, acquired 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 secure, they don’t seem to be efficient, is just not supplying you with the science as we all know it in the present day,” 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, virtually 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 staff.
“We have by no means felt so not sure of our future,” certainly 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 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 Basic, 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 inside medication doctor, advised the state’s regional medical administrators that they weren’t allowed to carry routine fall flu vaccination occasions, based on a workers member with data of what was mentioned on the assembly.
These flu shot occasions had turn out to be 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 adverts, radio, digital, and social media adverts urging the general public to get vaccinated for the flu.
This 12 months, as an alternative of flu vaccine occasions, the medical administrators had been advised to pivot to Narcan giveaways.
The division’s influenza web page does not seem to have been up to date this 12 months; 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 submit about flu.
That current submit lists preventative measures like hand washing, however not vaccination.
That stands in stark distinction to a flu submit from the autumn of 2020 which said “it is extra essential than ever to get your flu vaccination to guard your self and people round you.”
Regional medical administrators are liable 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 an area occasion, they can not use signage and even tablecloths that includes the well being division’s emblem.
“You can not ask folks, ‘Hey, we’ve flu photographs. Would you want one?'” at a neighborhood occasion, based on the workers member with data 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 photographs,’ we will say, ‘Sure, would you want one?'”
The medical administrators had been advised that as a result of the well being division is a authorities company, workers will not be allowed to “coerce folks” by selling vaccinations, particularly for COVID, flu and mpox. “They’ve positively made it clear that we aren’t speculated to be pushing vaccines in any respect,” the workers member added.
There was no clarification for why these explicit vaccines had been grouped collectively.
“Why on earth they selected COVID, influenza and mpox vaccines, that are totally completely different vaccines for totally completely different functions, simply reveals an absence of sophistication and understanding of science,” Gostin stated.
“I am unable to consider any motive aside from political causes,” stated Hood, the previous head of the Workplace of Public Well being.
Opposition to COVID vaccines has gained momentum inside the Republican Get together, as a part of the backlash to pandemic-related public well being measures. In the case of 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 might stem from surgeon normal’s letter Â
On the Nov. 14 assembly, the brand new prohibitions had been relayed to program workers 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 advised 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 will say about COVID, flu and mpox vaccines, going ahead.
They had been advised 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 workers member with data of the assembly.
The secretive rollout of the brand new coverage raised issues about authorities transparency and accountability, and a former state worker with data of the state’s well being insurance policies stated 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,” stated Hood. “I believe that, to me, it seems like persons are making an attempt 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 way from conclusive” for the flu vaccine.
That letter offers 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, is just not 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 workers 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 workers assembly the place greater than 80 staff realized of the ban on selling COVID, mpox and flu vaccines, based on two workers members. Staff had been additionally advised the coverage wouldn’t be put in writing.
When workers requested whether or not the coverage utilized to hepatitis B vaccinations, they had been advised “there was no official response to that but,” stated a workers member who attended the assembly.
“There have been so many questions and issues,” the workers member stated. “Quite a lot of people had 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 might have a spillover impact, lowering public belief in vaccinations general, together with these given to youngsters to forestall a bunch of harmful and lethal diseases.
“I imagine that we’ll see measles circumstances. I imagine we’ll see whooping cough circumstances. I imagine we’ll doubtless see meningitis outbreaks,” stated Hood.
Within the Nov. 14 assembly, a workers member requested whether or not the ban on selling vaccines utilized to youngsters’s immunizations, however the reply was noncommittal, based on an worker with data of the assembly’s particulars.
“My understanding was it isn’t clear to what extent we would be capable of promote childhood vaccinations,” the workers member stated.
(The Louisiana Division of Well being’s assertion to NPR stated the adjustments in coverage and messaging don’t apply to childhood immunizations.)
Nationally, vaccination charges for severe 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 youngsters 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 a variety of these ailments disappear, and so they’ve disappeared due to secure 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 normal 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, partly, to Kennedy’s ties to Louisiana’s Republican Get together.
“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 in opposition to the COVID vaccine,” she stated, 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, based on James Hodge, a public well being regulation knowledgeable at Arizona State College’s Sandra Day O’Connor School of Regulation.
“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 type of coverage the nation might see if Kennedy is confirmed as secretary for Well being and Human Providers, Hodge added. In a listing he manufactured from attainable 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.
