Commentary: State leaders own responsibility for low vaccination rates

Working in the hospital on the front lines of the pandemic caused by the SARS-Cov-2 (COVID-19) virus last winter was the hardest thing I’d ever had to do as a physician. We were experiencing a massive surge of sick COVID-19 positive patients in the emergency department, many of whom were so ill they required high amounts of oxygen to help them breathe. I went to work every day terrified that I would catch the virus and give it to my husband.

I’ll never forget the day I was on shift with a full hospital, full ICUs, completely full ER, with patients in the hallways, a full waiting room and several ambulances with more critically ill patients on the way. Every hospital in the Nashville area was full as well so there was no way to transfer patients elsewhere. My charge nurse cried that day. It was completely overwhelming. The sense that the situation had spun out of control permeated the air. I have no doubt that many of us healthcare workers likely have undiagnosed post traumatic stress disorder from what happened in our hospitals at the height of the pandemic.

The worst thing about working during that time was knowing it didn’t have to be that bad. Our healthcare system in Tennessee nearly broke due to lack of strong leadership from our governor and others in the state. Had we instituted a statewide mask mandate and stay at home orders, the situation would not have been as dire. Many other doctors and public health officials joined me, begging and pleading with our leaders to do more. They did not listen then and are not listening now.

When the vaccine became available to healthcare workers in December and I got my shot, I nearly cried tears of relief. I received the two-dose Pfizer regimine. After my shots, I knew I had a layer of armor at work every day to protect me and my loved ones from the deadly virus. When my husband was able to get his shot, I held back more tears. I had seen t0o many patients struggling to breath while the virus viciously attacked their lungs. It was just a matter of time before the rest of the country would line up to get vaccinated and then the pandemic would be over. Or so I thought.

The vaccine rollout was frustrating to watch. We now had a mighty tool in our arsenal to stamp out the disease that ravaged our country, but its distribution occurred at an infuriatingly slow pace. Tennessee was one of the worst states with regard to the speed of its vaccine rollout. Teachers who were desperate for the vaccine prior to in person classes resuming were driving several counties away to get their shots. I know many people who, frustrated by the time it was taking for vaccine availability, drove to other states to get their first shot.

Now despite the availability of vaccines, the vast majority of Tennesseans remain unvaccinated. We lag behind the rest of the country. While I write this, only 38.5% of Tennesseans have been fully vaccinated. Why is this? Well, for starters, our governor refused to get his shots publicly. Instead, he had it done in private, only letting the public know about it sometime later. Also, we have state leaders passing laws barring state institutions from requiring covid vaccinations and allowing for religious exemptions. Moves like these erode the public trust in vaccinations.

Most recently, one of our top vaccination officials, Dr. Michelle Fiscus, was fired from the Tennessee Department of Health for simply relaying a state doctrine to the workers doing the vaccinations. She reiterated the Tennessee Mature Minor Doctrine which allows minors 14-18 to receive some medical care, including vaccinations, without parental consent. This would likely be a rare event, an unaccompanied teen showing up to a vaccination center wanting a covid shot, but something that needed to be addressed should it occur. There was backlash as the policy got misconstrued as if the public health department actively campaigned to vaccinate minors while their parents were unaware.

Regardless of how one feels about vaccinating minors without parental consent, firing our top vaccination official while the pandemic still rages around us and vaccination rates are dismal, is the worst decision the state has made during the pandemic. And boy have they made a lot of mistakes. From lack of leadership at the very top, to refusing to pass a statewide mask mandate, the politicizing of the public health department, to spreading misinformation leading to the anti-vaccination attitudes permeating all corners of our state. I firmly believe our government here in Tennessee has failed in its duty to protect the health of its citizens during this pandemic. This has made my job harder in every possible way.

Despite the frustration I feel on a daily basis watching the missteps our state leaders continue to make, I will continue to speak up for vaccinations and public health. I take my Hippocratic Oath seriously. I wish our state leaders took their oaths of office the same way. My duty is to protect the health of my patients. My patients expect me to take the best care of them during their emergencies. Right now our state is in an emergency as the delta variant bears down on us from all sides. Vaccination is the only way out of this pandemic. We need all of our state leaders, including our governor, to get behind the message that vaccines are safe, effective and available. Until they do, we will continue to see people fall ill and die from a virus that is now preventable.