Physician assistant Danis Walker vaccinates a building employee outdoors a Lowes Home Improvement 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 Department of Health walked right into a Nov. 14 assembly in Baton Rouge anticipating to speak about outreach and group occasions.
Instead, they had been informed by an assistant secretary within the division and one other official that division management had a brand new coverage: Advertising 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 Office of Public Health, on Oct. 3 and Nov. 21, via interviews with 4 staff on the Department of Health, which employs greater than 6,500 individuals and is the state’s largest agency.
According to the workers, who spoke on the situation of anonymity as a result of they concern 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: Employees 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. They additionally couldn’t put up indicators on the division’s clinics that COVID, flu or mpox vaccines had been accessible on website.
The 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. Department of Health and Human Services. And some public well being consultants 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 is President-elect Donald Trump’s option to grow to be Secretary of the Department of Health and Human Services. 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-Attorney General Jeff Landry.
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Jabin Botsford/The Washington Post by way of Getty Images
At a Dec. 16 news conference, Trump addressed ongoing considerations about Kennedy’s nomination, and whether or not it may result in vital adjustments in nationwide vaccine coverage.
Trump mentioned that Kennedy might be “a lot much less radical than you’d suppose” and that he has “a really open thoughts.” Trump additionally referred to 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 observe
Staff at Louisiana’s well being division concern the brand new coverage undermines their efforts to guard the general public, and violates the elemental mission of public well being: to forestall 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.”
In this file picture, Anthony Reed (left) and Christopher Bowles (proper) present the Band-Aids they received after receiving the mpox vaccine on the Southern Decadence Health Hub in New Orleans on Sept. 4, 2022. The well being hub, on the annual LGBTQ celebration, was organized by the Louisiana Department of Health.
Shalina Chatlani/Gulf States Newsroom
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Shalina Chatlani/Gulf States Newsroom
Gov. Jeff Landry’s workplace referred inquiries to the Louisiana Department of Health, and didn’t reply when requested if Landry helps the adjustments.
In an announcement, the Louisiana Department of Health 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 steering” to a stance wherein “immunization for any vaccine, together with practices like masks carrying and social distancing, are a person’s private alternative.”
The assertion didn’t handle mpox vaccinations.
The assertion mentioned that the flu vaccine can scale back sickness severity and subsequently could assist high-risk sufferers — however falsely claimed “the flu vaccine doesn’t stop one from getting the influenza virus.” According to the Centers for Disease Control and Prevention, the vaccine reduces the risk of getting the flu.
Experts concern penalties of undermining belief in vaccine
Last yr, 652 individuals in Louisiana died of COVID, together with 5 kids. Louisiana presently is tied with DC for the highest rate of flu within the U.S. In 2022 alone, flu killed 586 people in Louisiana.
Every 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 protected, efficient, and important for stopping sickness, hospitalizations, and deaths.
“It’s a step backwards,” mentioned Kimberly Hood, who led the Office of Public Health, a subunit of the well being division, from 2021 to 2022. “It’s 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 Education Center on the Children’s Hospital of Philadelphia. “It’s gotten to the purpose of parody, the place a public well being company does not promote the general public’s well being.”
“It’s a harmful, harmful factor,” Offit mentioned. “It’s probably the most susceptible amongst us who are suffering this, and it will likely be our youngsters who are suffering this. And my query might be, will they be held accountable?”
The coverage is akin to “malpractice,” particularly given Louisiana’s poor health outcomes, mentioned Dr. Georges Benjamin, the chief director of the American Public Health Association (APHA).
The U.S. vaccination program represents “one of the vital necessary public well being interventions that we have now,” Benjamin added.
“It’s reckless,” mentioned Lawrence Gostin, a professor of worldwide well being legislation at Georgetown University. “I believe it is a signal of what’s about to occur below the second Trump administration.”
If U.S. senators affirm Kennedy to run HHS, he mentioned, “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 totally preventable over the subsequent 4 years.”
NPR reached out to Kennedy for remark however didn’t hear again.
Policy change follows new governor’s election
Until turning into Louisiana governor in early 2024, Republican Jeff Landry served because the state’s legal professional common for eight years. During the pandemic, he criticized the state’s COVID response and filed lawsuits over federal and state vaccine mandates.
On Dec. 6, 2021, Attorney General Landry spoke at a state committee hearing 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 ability of public well being authorities and sowing doubt about vaccine security.
Attorney General 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 Department of Health 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 general. That place co-leads the Department of Health, 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 meeting 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 day by day of my observe” from COVID vaccines, Abraham mentioned.
Abraham said masking, lockdowns and vaccination necessities “had been virtually ineffective,” that COVID vaccine adversarial 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 enhance the chance miscarriages.
Surgeon General Abraham additionally mentioned “there’s nothing incorrect” with Louisiana conducting its personal analysis into whether or not childhood vaccines trigger autism.
“You may most likely fill Tiger Stadium with mothers who’ve children that had been regular sooner or later, received a vaccine and had been then autistic after,” mentioned Deputy Surgeon General Coleman at that assembly.
Those public feedback by Abraham and Coleman are inaccurate and alarming, based on public well being consultants.
“Anyone who’s articulating that these vaccines should not nicely examined, they are not protected, they are not efficient, just isn’t supplying you with the science as we all know it at this time,” 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, nearly makes me cry,” mentioned Georgetown’s Gostin.
In three conferences, shock and confusion at new coverage
The new ban on vaccine promotion represents a brand new stage of political interference, based on two present well being division staff.
“We’ve by no means felt so uncertain of our future,” one in every of them mentioned. “Like, why am I right here? Why am I doing this anymore? Because you are simply so stifled and you aren’t serving to individuals.”
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 General, who units coverage for the Louisiana Department of Health.
Melinda Deslatte/AP
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Melinda Deslatte/AP
In the Oct. 3 assembly, Deputy Secretary Dr. Pete Croughan, an inside medication doctor, informed 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 grow to be a key a part of the well being division’s flu marketing campaign lately, 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 yr, as an alternative of flu vaccine occasions, the medical administrators had been informed to pivot to Narcan giveaways.
The department’s influenza page does 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.
Last fall, it printed six Instagram posts selling flu and COVID vaccinations, and particular vaccine occasions. In 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 post lists preventative measures like hand washing, however not vaccination.
That stands in stark distinction to a flu post from the fall of 2020 which said “it is extra necessary 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 applications throughout the state.
In the assembly, Croughan informed them in the event that they wish to carry 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 individuals, ‘Hey, we have now flu pictures. Would you want one?'” at a group occasion, based on the workers member with data of the assembly. “But if they arrive as much as us, realizing we’re the well being division and say, ‘Hey, we hear y’all may need flu pictures,’ we are able to say, ‘Yes, would you want one?'”
The medical administrators had been informed that as a result of the well being division is a authorities company, workers should not allowed to “coerce individuals” by selling vaccinations, particularly for COVID, flu and mpox. “They have undoubtedly made it clear that we aren’t imagined to be pushing vaccines in any respect,” the workers member added.
There has been no clarification for why these explicit vaccines had 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 a scarcity of sophistication and understanding of science,” Gostin mentioned.
“I am unable to consider any cause aside from political causes,” mentioned Hood, the previous head of the Office of Public Health.
Opposition to COVID vaccines has gained momentum inside the Republican Party, as a part of the backlash to pandemic-related public well being measures. When it involves the flu vaccine, Kennedy’s anti-vaccination nonprofit, the Children’s Health Defense, has made a number of false claims about its risks.
Policy could stem from surgeon common’s letter
At 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 Office of Public Health, and Katye Magee, a coverage director.
Employees had been informed that Joiner and Magee had been relaying the coverage as a result of Surgeon General Ralph Abraham couldn’t attend.
Staffers requested them what precisely they will say about COVID, flu and mpox vaccines, going ahead.
They had been informed acceptable public vaccine messaging must be one thing alongside the traces of: Talk 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 considerations 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 preserve the coverage out of writing.
“I’m 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,” mentioned Hood. “I believe that, to me, it feels like persons are attempting 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 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 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 Department of Health letterhead, just isn’t 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.
In 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’m simply going to say it. Complete falsehoods.”
At the third assembly, on Nov. 21, the STD/HIV/Hepatitis program on the division held a workers assembly the place greater than 80 staff discovered of the ban on selling COVID, mpox and flu vaccines, based on two workers members. Employees had been additionally informed the coverage wouldn’t be put in writing.
When workers 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 workers member who attended the assembly.
“There had been so many questions and considerations,” the workers member mentioned. “Plenty of people had been disillusioned and simply annoyed.”
A slippery slope to future illness outbreaks
Experts informed NPR they feared a coverage that undermines COVID, flu and mpox vaccinations may have a spillover impact, lowering public belief in vaccinations general, together with these given to kids to forestall a bunch of harmful and lethal diseases.
“I imagine that we are going to see measles instances. I imagine we are going to see whooping cough instances. I imagine we are going to doubtless see meningitis outbreaks,” mentioned Hood.
In 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, based on an worker with data of the assembly’s particulars.
“My understanding was it is not clear to what extent we’d be capable to promote childhood vaccinations,” the workers member mentioned.
(The Louisiana Department of Health’s assertion to NPR mentioned the adjustments in coverage and messaging don’t apply to childhood immunizations.)
Nationally, vaccination rates for critical childhood ailments have been falling lately, including 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’ve been a doctor for 50 years, so I’ve seen a number of these ailments disappear, and so they’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 selections and repeated false or discredited well being theories.
Florida’s surgeon common has made false claims about COVID vaccines, undermined school vaccine mandates for the measles and mentioned native officers ought to stop adding fluoride to water supplies.
Hood traced Louisiana’s new coverage, partly, to Kennedy’s ties to Louisiana’s Republican Party.
“Robert F. Kennedy Jr. got here to the legislature whereas I used to be nonetheless in my function on the Office of Public Health, 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, based on James Hodge, a public well being legislation knowledgeable at Arizona State University’s Sandra Day O’Connor College of Law.
“What’s very distinct is a few type 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 mentioned. “That’s derelict. It’s extremely controversial.”
But it is the form of coverage the nation may see if Kennedy is confirmed as secretary for Health and Human Services, Hodge added. In a list he fabricated from possible 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 Health News.
