Public Health Experts Decry Louisiana’s Ban on Vaccine Promotion

In the wake of state public health officials barring promotion of certain vaccines — as is occurring in Louisiana — physicians and medical societies must speak out about the value of vaccination in children as well as adults, public health experts said Friday.

“Medical societies can speak out,” Georges Benjamin, MD, executive director of the American Public Health Association, said in a phone interview. “They can certainly send a letter of protest to the governor and [say] that they’re not practicing the standard of care. The nursing societies can speak up. The hospital association can speak up. This is going to create business — tragic business — for the hospitals.” Businesses can also speak up, since a rise in vaccine-preventable diseases also hurts their customers and employees, he said.

Benjamin was responding to recent actions by the Louisiana Department of Health. As first reported by NPR, the state health department informed its employees that they were not allowed to promote COVID, influenza, or mpox vaccines. The directive, which department officials said they would not put into writing, related to all aspects of public health employees’ jobs: employees could not send out press releases, give interviews, hold vaccine events, give presentations or create social media posts encouraging the public to get the vaccines, according to the story. They also could not put up signs at the department’s clinics that COVID, flu, or mpox vaccines were available on site.

One staff member told NPR that medical directors were told that because the health department is a government agency, staff are not allowed to “coerce people” by promoting vaccinations, especially for COVID, flu, and mpox. “They have definitely made it clear that we are not supposed to be pushing vaccines at all,” the staff member added.

Benjamin said what the health department was doing was akin to malpractice. “It’s just like a physician having a patient with appendicitis in front of them, having the skill and technique be able to take out their appendix and refusing to do it, knowing that it will cripple or even kill the patient,” he said. “Here’s something that we know we can prevent from happening — we can prevent people from getting sick and dying from vaccine-preventable diseases. And they’re going to simply ignore it. We know that we have hundreds and thousands of people who get influenza every year and end up in the hospital, and many of them die. I just can’t even contemplate a health department doing that. It makes no sense whatsoever.”

“If this was a practicing clinician in the community doing this, they would be going in front of the board about their license,” he continued. “Now, [the board] may not take it away, but they would at least be reviewed … And then the board would decide what they want to do about it. And if they were a physician practicing in my state, when I was the health officer, I would have referred them to the board for review.”

In response to an email from MedPage Today, a Louisiana Health Department spokesperson did not respond to specific questions but instead sent a statement saying that “the department is shifting away from one-size-fits-all paternalistic guidance to a more informative approach aimed at enabling individuals, in consultation with their doctor, to make better decisions for themselves.”

“The department’s stance is that immunization for any vaccine [sic], along with practices like mask-wearing and social distancing, are an individual’s personal choice,” the statement continued. “If an individual has questions on whether or not they should get a certain vaccine, that discussion and decision should occur between a patient and their healthcare provider, who best understands their individual situation and medical history.”

The statement acknowledged that “While the flu vaccine does not prevent one from getting the influenza virus, it can lessen the severity of the illness and thus has a role in combating the effects of viral respiratory illnesses such as the flu … By decreasing the severity of the illness in people, particularly people who are medically vulnerable, this results in decreased hospitalization and mortality.” The statement also referred to COVID but contained no mention of mpox.

Paul Offit, MD, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, said in a phone interview that all physicians — including pediatricians, who administer a large share of vaccines — need to be speaking out on this issue. “Doctors need to be strong and clear and stand up for the health of the child,” he said. “They need to say, these vaccines are important, and here’s why. And if we let immunization rates drop, some of these diseases are going to come back and children are going to suffer needlessly.” Internists and family physicians need to do the same, he added.

“I think this is a troubled time,” Offit added. “I think you are about to see a massive assault on public health, including vaccines.” He noted that the seeds of distrust in public health officials “have been there for a while, but now you’re seeing it reach the logical end — a public health department won’t act on behalf of the public health. I think that is reflected in the people who currently are being considered for these different [federal] positions, like RFK [Robert F. Kennedy] Jr.” for HHS secretary; Kennedy is known for being a vaccine skeptic. “They’re all people who don’t trust the agencies they’re about to head.”

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