In TDH memo, chief medical officer cites 'lack of leadership' in recommendation to fire Fiscus

dr. michelle fiscus
Posted at 11:43 AM, Jul 15, 2021
and last updated 2021-07-15 23:09:03-04

NASHVILLE, Tenn. (WTVF) — Tennessee’s chief medical officer cited a “lack of effective leadership” in his recommendation to fire the state’s top vaccinations official earlier this week.

NewsChannel 5 obtained the personnel file for Dr. Michelle Fiscus via a formal records request through the Tennessee Department of Health.


Fiscus was fired from the department of health on Monday after facing scrutiny from Republican state lawmakers over TDH's outreach efforts to vaccinate teenagers against COVID-19.

However, Dr. Tim Jones, the state’s chief medical officer, recommended in a memo to TDH Commissioner Dr. Lisa Piercey that Fiscus be fired due to her “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 on [Vaccine Preventable Diseases and Immunization Program] projects.”

Jones states in the memo that he and another doctor met with Fiscus and another physician to discuss complaints against her, alleging “disrespectful treatment and ineffective management” on her part. He said that meeting ended with a “refusal of both parties to communicate constructively.”

Jones also alleged that in May, Fiscus shared a letter of “her own interpretation of state and federal law with external partners with respect to vaccinations and other medical treatment of minors.” Jones said that should have been reviewed by both leadership and departmental legal counsel.

Jones concluded the memo by saying:

"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."


NewsChannel 5 requested Dr. Fiscus' performance reviews from the state. They have not responded.

However, we received copies of her annual reviews from 2016 to 2020 from her husband. All performance ratings on those were listed as either outstanding, advanced, or that goals were met.

SEE FULL REVIEWS HERE: 2016-2017 Review; 2017-2018 Review; 2019-2020 Reveiw


Fiscus had recently come under fire from Republican state lawmakers over the Tennessee Department of Health's outreach efforts to vaccinate teenagers against COVID-19. She sent a memo with information on the Mature Minor Doctrine, case law that allows doctors to treat teenage patients without parental consent.

"I had medical providers asking what to do if someone under age presented themselves for COVID-19 vaccine if they could provide it or not," she said in an interview with NewsChannel 5's Kyle Horan.

Watch the full interview with Dr. Fiscus below:

Full Interview with Dr. Michelle Fiscus

Read more: Tennessee's top vaccination official fired after she came under scrutiny for mature minor doctrine

State lawmakers took issue with the memo, with State Sen. Janice Bowling (R-Tullahoma) saying the doctrine wasn't in the code and had no power.

"It's very disconcerting to see the memo, the letter from Dr. Fiscus stating that Tennessee law allows the department of health to give vaccinations to children 14-years of age," Bowling said during a committee meeting on June 16.

Fiscus believes she was fired to appease lawmakers.

The week prior to her termination, emails obtained by NewsChannel 5 Investigates, show TDH officials were ordered to not even acknowledge that August is National Immunization Awareness Month.

Click here to read the emails

During the month, Fiscus says TDH typically sends out a news release, a Governor's proclamation and communicates with local health departments and partners. But this year, TDH officials were told there will be no outreach at all.

TDH released a statement denying that the department plans to pause vaccination efforts.

"As shared previously our vaccination efforts have not been halted or shuttered. We are simply taking this time to focus on our messaging and ensure our outreach is focused on parents who are making these decisions for themselves and their families," the statement read.

Some lawmakers threatened to abolish TDH after it acknowledged the Mature Minor Doctrine. Communications within TDH show the department bowing to lawmakers' concerns, stating TDH will not hold any immunizations events on school property or hold COVID-19 vaccine events at organizations that solely work with children and adolescents.


NewsChannel 5 reached out to Governor Bill Lee's office, asking if he had plans to address Fuscus' dismissal or the TDH's stoppage of vaccine promotion for National Immunization Awareness Month. The office responded with the following statement.

Unfortunately, there have been a number of items mis-reported about vaccine programs being halted. That's not the case. Please see below. I've copied Casey Black, our press sec, too.

1) While we don't offer comments on personnel matters, I would be remiss if I didn't note Tennessee is not a civil service state. It is an at-will employment model which is commonly referred to as "serving at the pleasure."

2) On the topic of vaccines, there have been a number of misleading reports about halting immunizations for children - the Department of Health has not halted the Vaccines for Children Program that provides information and vaccine access to Tennessee parents. This program covers immunizations including DTap, MMR, Polio, Chicken Pox and Hepatitis B and will continue to be successfully administered:

  • Tennessee ranked among the top 10 states for MMR vaccination coverage among kindergartners during the 2019-2020 school year
  • 95.3 percent of 2020-2021 kindergarten students in TN were fully immunized
  • For more than a decade Tennessee has above 90 percent coverage of kindergarten students receiving childhood immunizations including DTap, MMR, Polio, Chicken Pox, Hepatitis B.

The department is mindful of ensuring parents, not kids, are the intended audience for any outreach efforts regarding medical decisions for children and has simply re-evaluated some tactics like reminder postcards and follow-up communications. While childhood immunization rates temporarily dropped during the COVID-19 pandemic, we are already seeing vaccination rates rebound to pre-pandemic levels and will continue supporting parents who are working to get their families back on track. Separately, the department continues efforts for parents around the COVID-19 vaccine for kids 12+.

It's worth noting that while the state does have above 90% coverage in those five immunizations mentioned for kindergartners, the state struggles in immunizations for younger children, according to TDOH's own annual "2020 immunization status survey of 24-month old children in Tennessee."

"When observing the 3-year average...Tennessee ranks in the bottom 20% of the state for completion of seven vaccine series and ranks in the bottom 40% of states for the remaining five antigens." the report found.

Additionally, the report noted that after doctors' offices reopened after the pandemic, "catch-up vaccinations have not occurred, leaving thousands of Tennessee's children vulnerable to vaccine preventable diseases."

The Tennessee Department of Health released a press release Thursday afternoon, with much of the same information as the statement from the Governor's Office. "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,” TDOH commissioner Lisa Piercey saud in the release. “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. We are proud of the efforts of our staff across the state and will continue to promote vaccination and the vaccination work of our partners.”

Neither the Governor's Office, nor the TDOH, directly refuted our previous reporting that Tennessee officials were ordered in an email not to promote Immunization Awareness Month.

Dr. Fiscus issued a statement, responding to the state's justification of her termination. She says in part, "...The information I have shared is not 'misleading,' it is the response from the Governor’s office that both dodges the questions posed and twists the narrative away from the subject at hand. "



Tennessee has one of the lowest COVID-19 vaccination rates in the country.

According to the Centers for Disease Control and Prevention, nationwide, 55.7% of Americans have received at least one dose of a COVID-19 vaccine and 48.2% have received two. In Tennessee, only 42.6% of residents have received at least one dose and 38.2% are fully vaccinated.

dwnload-img-vacc-maps (1).png
This map shows the number of COVID-19 vaccine doses that have been administered in each state.

TDH Commissioner Dr. Lisa Piercey said in June that demand for the vaccine in Tennessee was so low, the state is not accepting its full allotment of vaccine doses.

According to the CDC, new cases in the state have been on the rise in recent weeks, with the rate of new cases per 100,000 residents up 191% from the week prior.

As of July 14, there have been a total of 872,362 cases reported in the state and 12,625 residents have died from COVID-19.