Fired Tennessee vaccine official got glowing reviews before being terminated

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Dr. Michelle Fiscus, the former top vaccination official at the Tennessee Department of Health, believes her recent firing was politically motivated. She is seen here at her home in Franklin, Tenn., Wednesday, July 14, 2021.
Dr. Michelle Fiscus, the former top vaccination official at the Tennessee Department of Health, believes her recent firing was politically motivated. She is seen here at her home in Franklin, Tenn., Wednesday, July 14, 2021.

The same top Tennessee health official who called last week for the firing of the state's then-vaccination chief Dr. Michelle Fiscus previously approved years of glowing performance reviews for Fiscus, new records show.

Tennessee Department of Health Chief Medical Officer Dr. Tim Jones sent a memo to Commissioner Dr. Lisa M. Piercey dated Friday, recommending Fiscus' termination, according to a document released Thursday by the state health department.

In it, Jones wrote Fiscus should be fired because of a "failure to maintain good working relationships with members of her team, her lack of effective leadership, her lack of appropriate management and unwillingness to consult with superiors and other internal stakeholders."

Fiscus denies the claims of inappropriate behavior. Her husband said Thursday she did not know of it before the department made the document public.

"We're not gonna sit back and allow these falsehoods to be presented when she didn't have any chance to respond," Fiscus' husband Brad Fiscus said Thursday.

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In performance evaluations from the 2019-2020 review period her bosses said she had "been attentive to her team," "exceeded expectations in managing" programs and did an "outstanding job."

"Dr. Fiscus is a trusted and reliable advocate to promote vaccination in Tennessee," her manager John Dunn wrote. "Dr. Fiscus has been a strong leader for the VPD team and has been an integral piece of the COVID pandemic response. Her leadership and efforts in multiple areas have been critical."

Jones signed off on the review process on Feb. 18, 2020, July 7, 2020, and Oct. 12, 2020, according to the records.

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Firing came after flare-up with lawmakers

Fiscus was fired from her role Monday in a move she believes was politically-motivated. She'd worked with the vaccination team since 2016.

She said she believes she was made a scapegoat and was terminated to appease state lawmakers angry about the department's efforts to vaccinate teenagers against coronavirus.

The state agency has been dialing back vaccination outreach efforts targeting teenagers since June. Adolescent vaccine outreach for all diseases was halted amid pressure from Republican state lawmakers, reports showed this week.

The health department released three documents responsive to news media records requests, including Jones' memo, but did not include any performance reviews. Michelle Fiscus released the documents to the Tennessean after she was fired.

Reports on Fiscus' performance from the 2016-2017 and 2017-2018 review periods are equally positive on her leadership and outreach work.

Then-manager Dr. Morgan McDonald praised Fiscus' work on building opportunities for her team and "consistent leadership," as well as calling her an "excellent manager."

Fiscus could not find a copy of her 2018-2019 review and has requested a copy from the department, Brad Fiscus said Thursday.

Focus on Michelle Fiscus, who had until then largely operated in the background of the state health department, grew in mid-June when lawmakers became angry about a letter Fiscus sent to medical providers who administer vaccines.

The May letter was in response to questions from vaccine providers related to the state's “Mature Minor Doctrine," a legal mechanism by which they are allowed to vaccinate certain minors above the age of 14 without consent from their parents.

Fiscus said the language in the letter was provided to her by the health department's attorney, who said at the time it had been "blessed by the governor's office."

Later, lawmakers expressed concern the letter was unduly encouraging adolescents to get vaccinations without parental consent.

The department has couched the steps taken to stop targeting minors with vaccination outreach as the result of a temporary evaluation to ensure it is aimed squarely at parents.

"There has been no disruption to the childhood immunization program or access to the COVID-19 vaccine while the department has evaluated annual marketing efforts intended for parents,” Piercey said in an email release on Thursday. “The Tennessee Department of Health not only supports immunizations but continues to provide valuable information and access to parents who are seeking vaccinations for their children.

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Outreach listed in job description

When Fiscus was given a 10% raise in 2019, a document on file with the state indicates her role is to be the "department's representative to the legislature" on the state's immunization program and to work with outside agencies like the Centers for Disease Control and Prevention.

Fiscus' performance reviews list specific goals for her to work toward, which last year included a mandate to "promote the importance of immunizations to public health" and to "represent the Tennessee Immunization Program to outside partners and stakeholders."

She received an overall rating of "outstanding" across the combined review with no assessment lower than "advanced."

Jones' letter cited a report Dunn had heard complaints "of disrespectful treatment and ineffective management" that both attempted to mediate with Fiscus.

He disputed Fiscus' explanation of the source of the information in the May letter, claiming it was not properly run past leadership and departmental legal counsel.

"These examples clearly demonstrate that Dr. Fiscus’s performance in this role has led to strained relationships with internal and external stakeholders at multiple levels, and to an ineffective and noncohesive workplace. Her leadership and management of her team does not foster the culture or environment expected at the Tennessee Department of Health," Jones wrote.

The memo also claims Michelle Fiscus improperly set up a nonprofit for which she requested funding to support immunization programming. Brad Fiscus indicated his wife has received no money herself from the program and set it up under CDC guidelines "as part of her job."

"Part of the grant from the CDC that they receive is to engage vaccine coalitions in their states or to create a vaccine coalition if there isn't one for the sole purpose of making creating vaccine awareness, dispelling misinformation about the effectiveness or the harm of vaccines, and so on," he said.

Colleagues rally in support

Fiscus' firing and the state's about-face on youth immunization outreach have captured national attention at the same time Tennessee's COVID-19 infection rates tripled in a matter of weeks.

Colleagues at the American Academy of Pediatrics spoke out this week in support of Fiscus, a member of the organization's board of directors, in a statement noting she does "vital work."

“Pediatrician public health officials are medical experts who are trusted by the communities they serve. Dr. Fiscus’s termination is the most recent example of a concerning trend of politicizing public health expertise," the organization's president, Dr. Lee Savio Beers, wrote. “Actions like this only increase the likelihood that we’ll see other outbreaks of these diseases even as we continue to fight COVID-19."

Brett Kelman contributed.

Reach reporter Mariah Timms at mtimms@tennessean.com or 615-259-8344 and on Twitter @MariahTimms.

This article originally appeared on Nashville Tennessean: Tennessee top vaccine official got glowing reviews before being fired

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