Tennessee lawmakers want to know if kids in state custody are getting vaccines; DCS isn’t saying

As COVID infections rise among Tennessee children, two Democratic lawmakers say they have tried — and thus far failed — to learn how the state’s Department of Children’s Services is providing kids in their custody vaccinations.

DCS bears the singular responsibility for the care and well-being of about 9,000 Tennessee kids at any given time, most removed from their homes after allegations of abuse or neglect. More than 3,700 of these children are 12 or older and therefore eligible for a COVID-19 vaccination.

For two weeks, Rep. Gloria Johnson, D-Knoxville, and Sen. Heidi Campbell, D-Nashville, have sought “up-to-date data on COVID-19 vaccinations amongst the children who are wards of DCS, whether incarcerated, in state foster care or in the care of a third-party home” and the “department’s plan to ensure all eligible children receive a vaccine moving forward.”

The department has yet to provide any answers to the lawmakers’ emailed questions from July 27. Instead they offered a meeting, emails show. DCS has similarly failed to respond to a series of emailed questions and a phone messages from the Lookout over the past week about vaccinations efforts.

“I’m happy to meet with them, but we want this information and we haven’t gotten it,” Johnson said. No meeting has taken place either, she said.

Johnson said she was seeking the information to “know that these kiddos are getting good care, that they aren’t falling through the cracks. That the homes or places they are in aren’t influencing whether or not they get vaccinated. These kids have been through a lot. We need to do everything possible to make sure that getting COVID isn’t added to their burden and, of course, to ensure the health of everyone in the community.”

The request comes as Tennessee is seeing more children testing positive for the virus, as the Delta variant drives a new wave in COVID infections across the state.

While more Tennesseans are opting to get vaccinated, the state’ overall vaccination rate remains among the lowest in the nation, and among children it is even lower. Eligible children in Tennessee are the least likely age group to have been vaccinated.

Just 16.8% of 12-16 year olds in Tennessee have been fully vaccinated (8.4% are partially vaccinated), while 26.2% of young people between the ages of 17 and 20 have been fully vaccinated (with 7% partially vaccinated), according to Department of Health data, which does not include an 18-and-under breakdown.

Tennessee’s leaders, including Gov. Bill Lee and Department of Health chief Dr. Lisa Piercey, have stressed it is up to parents to make the decision whether children receive the vaccine.

Kids in DCS custody are under the legal care and control of the state, which serves as their de facto parents.

In response to Lookout questions in July, DCS Chief of Staff Jennifer Donnals said the decision to vaccinate eligible children in DCS custody is up to foster parents and agencies who contract with the department to operate residential facilities with multiple children.

Vaccination information is kept in each child’s medical records, she said. Donnals did not respond to a question about whether the department is able to generate reports from its central database of children’s records to show how many eligible children have been vaccinated, a data point that could bring scrutiny to how the state chooses to respond to the needs of children in its care during a pandemic.

DCS guidance given to agencies and foster parents about vaccinations was re-written after the high-profile firing of Dr. Michelle Fiscus, the state’s former vaccine chief at the Department of Health, whose own guidance to healthcare providers across the state highlighting the “mature minor doctrine” case law giving children autonomy to decide whether they get a vaccine became a flashpoint of controversy.

A previous version of the DCS guidance, dated March 18, says: “vaccinations against this infection have been determined to be critically important in controlling the pandemic and getting ‘back to normal.’ Vaccines are deemed to be highly effective in prevention severe infections and death.”

The updated guidance for foster parents eliminates nearly all information about the vaccine. Instead, the document, updated July 20, includes one sentence about the COVID vaccine that says:

“Foster parents and other care providers are entrusted with the authority and responsibility for the daily upbringing and care of children in their care consistent with the child’s individualized circumstances and in consultation with the child’s medical provider, including routine authority for matters such as well-care treatment, vaccination, vision and hearing.”

The change in the department’s outreach language came eight days after Dr. Fiscus’ departure.

In an interview with the Lookout, Dr. Fiscus said she was particularly concerned about kids in DCS custody who are living in residential facilities, which include juvenile detention facilities, treatment centers for children with emotional or physical care needs that are operated by agencies that contract with DCS, and in the Wilder Youth Developmental Facility, a secure facility for youth who have committed serious offenses.

More than 1,500 of the children in DCS custody live in these group settings, which have been the source of mass outbreaks infecting hundreds of children.

“The kids who are in DCS custody who are in group living, we saw cases sweep through,” Dr. Fiscus said said in an interview with the Lookout. “Now we can prevent that from happening and it’s tragic that we’re not providing ready access to the vaccine.”

By late July, at least 1,247 kids in DCS custody have contracted COVID, including 729 kids in group facilities that saw outbreaks, 443 living in foster homes and 75 boys living at Wilder.

At least 51 other kids in DCS custody have contracted COVID in juvenile detention centers, a number that was last updated in March. DCS has since stopped posting the data on COVID outbreaks in these county facilities.