Tennessee's top health official said Friday that the state is resuming its vaccination advocacy efforts after a "pause" to review marketing materials geared toward teenagers promoting inoculations against Covid-19, an initiative that provoked outrage among conservative politicians.
The scaling back of its vaccination outreach drew national attention when Tennessee's top vaccination official, Dr. Michelle Fiscus, a pediatrician, was fired last week after she said Republican lawmakers disapproved of her actions promoting Covid vaccines to eligible children.
On Friday, state Health Commissioner Dr. Lisa Piercey declined to discuss Fiscus' departure, but addressed the larger issue with reporters, saying "there was a perception that we were marketing to children, and that totally was against our view of parental authority."
More from NBC News
"The reason we paused is because we wanted to leave no room for interpretation about where we are shooting: We are shooting to get the message to parents," she said, adding "we strongly believe that parents are the best decision-makers when it comes to medical decisions for their children."
In June, Republican lawmakers rebuked the health department for how it targeted online posts toward children, including a digital graphic that had a photo of a child with a Band-Aid and the words, "Tennesseans 12+ are eligible for vaccines. Give COVID-19 vaccines a shot."
The Tennessean newspaper, citing emails and an internal report, first reported last week that the state would halt all adolescent vaccine outreach, for all diseases. The paper also found that the health department had deleted some pro-vaccine posts on Facebook and Twitter and instructed employees to stop all vaccine-related posts aimed at teens before halting vaccine outreach posts altogether — and not only those related to the Covid vaccines.
The series of moves drew condemnation from state Democrats, who also blamed "anti-vaccine lawmakers from the controlling party" for removing Fiscus.
"A well respected member of the public health community was sacrificed in favor of anti-vaccine ideology," state Sen. Raumesh Akbari, who represents Memphis, said in a statement. "This disgraceful hatchet job is going to endanger the lives of unvaccinated Tennesseans at a time when we have a safe and reliable way to protect our families from this virus."
In an email to NBC News last week, Department of Health spokesman Bill Christian did not comment specifically on the reports that the state had halted all immunization outreach to minors, but said that the department "wants to remain a trustworthy source of information to help individuals, including parents, make these decisions."
Fiscus said in an interview on MSNBC last week that her job was to roll out the Covid vaccine "across the state and to make sure that that was done equitably and in a way that any Tennessean who wanted to access that vaccine would be able to get one." Her husband came forward to say she had received a dog muzzle at work only days before she was ousted.
She also said tension with GOP lawmakers escalated when she publicized a document on Tennessee's "Mature Minor Doctrine," a state Supreme Court ruling from 1987 that states Tennesseans ages 14 to 18 may be treated "without parental consent unless the physician believes that the minor is not sufficiently mature to make his or her own health care decisions."
As the controversy mounted, Piercey had left the state on a vacation to Greece.
She said Friday that there may be "fringe and nuanced" situations in which a Covid vaccine may need to be given to a minor without parental permission, which The Tennessean reported contradicts a claim from Republican lawmakers who said the health commissioner had previously agreed to stop such a practice.
The fight over the vaccination of children in Tennessee comes as Piercey and public health officials have painted a grim picture with the surge in Covid cases and positivity rates — coinciding with much of the rest of the country — and said there's been a 200 percent increase in Covid cases since July 1. About 97 percent of all hospitalizations are among the unvaccinated, and the state has struggled with a lagging vaccination rate, she added.
"We're certainly going in the wrong direction for hospitalizations," Piercey warned.