Doctor assistant Danis Walker vaccinates a building employee exterior 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 have 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 inside the division’s Workplace of Public Well being, on Oct. 3 and Nov. 21, by means of 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 workers, who spoke on the situation of anonymity as a result of they concern shedding their jobs or different types of retaliation, the coverage can be carried out quietly and wouldn’t be put in writing.
Staffers have been additionally instructed 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. In addition they couldn’t put up indicators on the division’s clinics that COVID, flu or mpox vaccines have been accessible 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 Providers. And a few public well being specialists are involved that if different states comply with 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 turn into Secretary of the Division of Well being and Human Providers. On Dec. 6, 2021, Kennedy spoke at a Louisiana committee listening to and introduced false claims in regards to the security of COVID vaccines. He sat beside then-Legal professional Basic Jeff Landry.
Jabin Botsford/The Washington Submit by way of Getty Pictures
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Jabin Botsford/The Washington Submit by way of Getty Pictures
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 shall be “a lot much less radical than you’d assume” and that he has “a really open thoughts.” Trump additionally known as himself a “massive believer” within the polio vaccine and mentioned “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 stop sickness and illness by following the science.
“I imply, do they wish 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 received 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 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 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 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.
Specialists concern penalties of undermining belief in vaccine
Final yr, 652 folks in Louisiana died of COVID, together with 5 kids. Louisiana at the moment 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 workers member, former workers member, public well being official and vaccine professional 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,” 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 device is unconscionable.”
The coverage rises to the extent of “absurdity,” mentioned Dr. Paul Offit, director of the Vaccine Training 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 susceptible amongst us who are suffering this, and it is going to be our youngsters who are suffering this. And my query shall 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 necessary public well being interventions that we’ve,” Benjamin added.
“It is reckless,” mentioned Lawrence Gostin, a professor of worldwide well being legislation at Georgetown College. “I believe it is a signal of what’s about to occur underneath 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 might be 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 turning into Louisiana governor in early 2024, Republican Jeff Landry served because the state’s lawyer 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 in opposition to including COVID to the childhood immunization schedule. At his aspect was Robert F. Kennedy, Jr., who introduced 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 ability of public well being authorities and sowing doubt about vaccine security.
Legal professional Basic 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 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 drugs 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 mentioned.
Abraham mentioned masking, lockdowns and vaccination necessities “have 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 improve the chance miscarriages.
Surgeon Basic Abraham additionally mentioned “there’s nothing flawed” with Louisiana conducting its personal analysis into whether or not childhood vaccines trigger autism.
“You possibly can most likely fill Tiger Stadium with mothers who’ve children that have been regular someday, received a vaccine and have been then autistic after,” mentioned Deputy Surgeon Basic Coleman at that assembly.
These public feedback by Abraham and Coleman are inaccurate and alarming, in keeping with public well being specialists.
“Anybody who’s articulating that these vaccines aren’t properly 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 right now,” mentioned APHA’s Benjamin.
“To have high 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,” one among 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 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 drugs doctor, instructed the state’s regional medical administrators that they weren’t allowed to carry routine fall flu vaccination occasions, in keeping with a workers member with data 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 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 an alternative of flu vaccine occasions, the medical administrators have 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 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 necessary 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 instructed them in the event that they wish to deliver 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 not ask folks, ‘Hey, we’ve flu photographs. Would you want one?'” at a neighborhood occasion, in keeping with the workers member with data 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 may need flu photographs,’ we will say, ‘Sure, would you want one?'”
The medical administrators have been instructed that as a result of the well being division is a authorities company, workers aren’t allowed to “coerce folks” 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 workers member added.
There was no clarification for why these specific vaccines have been grouped collectively.
“Why on earth they selected COVID, influenza and mpox vaccines, that are completely completely different vaccines for completely completely different functions, simply reveals an absence of sophistication and understanding of science,” Gostin mentioned.
“I am unable to consider any purpose 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 Celebration, as a part of the backlash to pandemic-related public well being measures. In relation 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 might stem from surgeon common’s letter Â
On the Nov. 14 assembly, the brand new prohibitions have 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 have been instructed that Joiner and Magee have 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 have been instructed acceptable public vaccine messaging needs to be one thing alongside the traces of: Discuss to your medical supplier.
“That gave the impression to be the catchphrase for all of this,” mentioned 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 mentioned it was “extremely irregular” to intentionally maintain 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 believe that, to me, it feels like individuals 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 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 way 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, 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 mentioned 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 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 workers assembly the place greater than 80 workers realized of the ban on selling COVID, mpox and flu vaccines, in keeping with two workers members. Staff have been additionally instructed the coverage wouldn’t be put in writing.
When workers requested whether or not the coverage utilized to hepatitis B vaccinations, they have been instructed “there was no official response to that but,” mentioned a workers member who attended the assembly.
“There have been so many questions and issues,” the workers member mentioned. “Loads of people have been disenchanted and simply annoyed.”
A slippery slope to future illness outbreaks
Specialists instructed 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 stop a bunch of harmful and lethal sicknesses.
“I consider that we are going to see measles circumstances. I consider we’ll see whooping cough circumstances. I consider we’ll doubtless see meningitis outbreaks,” mentioned Hood.
Within the Nov. 14 assembly, a workers 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 data of the assembly’s particulars.
“My understanding was it isn’t clear to what extent we would be capable to promote childhood vaccinations,” the workers 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 ailments have been falling in recent times, together with in Louisiana.
Given these developments, 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 dying.
“I have been a doctor for 50 years, so I’ve seen a variety of these ailments disappear, they usually’ve disappeared due to protected 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 lately introduced controversial choices and repeated false or discredited well being theories.
Florida’s surgeon common 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, partly, to Kennedy’s ties to Louisiana’s Republican Celebration.
“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 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 legislation professional 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 might not push and or promote these vaccines in any respect,” Hodge mentioned. “That is derelict. It is extremely controversial.”
Nevertheless it’s the sort of coverage the nation may see if Kennedy is confirmed as secretary for Well being and Human Providers, Hodge added. In a record he manufactured from doable actions the Trump administration may take, Hodges positioned “revising CDC vaccine suggestions” on the high.
This story comes from NPR’s well being reporting partnership with WWNO and KFF Well being Information.
