Draft:Michelle Fiscus

Dr. Michelle Fiscus is an American pediatrician and an expert in vaccination and immunization. She served as medical director for vaccine-preventable diseases and immunization programs at the Tennessee Department of Health until 2021, when she was terminated after sending a letter to medical providers who administer vaccines outlining the legal right of certain minors to receive vaccines without parental consent. She subsequently sued and received a favorable settlement.

Biography
Fiscus received her undergraduate degree from Indiana University, followed by a medical degree from the Indiana University School of Medicine. She completed her residency in pediatrics at the James Whitcomb Riley Hospital for Children in Indianapolis.

A board-certified pediatrician, in the 1990s, Fiscus was affiliated with PediaNet RealTime Pediatrics in Cool Springs, Tennessee. By the 2010s, she served on the board of directors for the Tennessee Chapter of the American Academy of Pediatrics, serving for a time as its president.

In May 2021, after the FDA approved the Pfizer vaccine for use among adolescents, Tennessee Department of Health (TDH) medical director of vaccines and immunization Michelle Fiscus issued an informational memo with language from the TDH general counsel explaining the mature minor doctrine present under state case law, which ruled that minors over the age of 14 are mature enough to consent to medical procedures such as vaccination on their own. The memo was met with criticism from other state officials, who saw the memo as an attempt to "undermine parental authority" by implicating plans to vaccinate children without parental consent.

On July 12, 2021, the state fired Fiscus from the TDH; she cited disputes over the aforementioned memo as the likely reasoning, and stated that Tennessee had also ceased all vaccine outreach specifically directed towards minors (including outreach unrelated to COVID-19). Fiscus told CNN that "It is just astounding to me how absolutely political and self-centered our elected people are here and how very little they care for the people of Tennessee". and that "public health should never, ever, ever be political." The state argued that Fiscus was 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."

On July 23, TDH commissioner Lisa Pierce stated that the state would (as per Lee's earlier statements) promote vaccination for minors via communications aimed towards parents and guardians.

In an interview with WTVF aired July 28, Fiscus accused Governor Lee of refusing to authorize use of the single-dose Janssen vaccine in state health departments due to his religious views, citing claims that the vaccine was made using fetal tissue. The TDH states on its website that "Fetal tissue was not used to make [the Janssen vaccine], nor any other, COVID-19 vaccine. In developing its vaccine, [Janssen] used a fetal cell line, which no longer contains the original donor cells". The Governor's communications director issued a statement that Tennessee "has never limited or delayed the public's access to any of the approved COVID-19 vaccines, either in public health departments or the pharmacy partnerships that have been a part of vaccine distribution."

In July 2021, Dr. Michelle Fiscus, the medical director for vaccine-preventable diseases and immunization programs at the Tennessee Department of Health, was terminated after she sent a letter to medical providers who administer vaccines regarding vaccinating minors. In her letter, Fiscus explained the state's “Mature Minor Doctrine,” a legal mechanism based on the 1987 case of Cardwell v. Bechtol, which stated physicians may treat minors between the ages of 14 and 18 without parental consent, unless the physician believes the minor is too immature to make his or her own health-care decisions.

During a Senate hearing on Fiscus' firing, Tennessee state senator Janice Bowling argued that the state was misinterpreting its legal authority. She proposed legislation barring government mandates of COVID-19 vaccines and allowing religious exemptions. The legislation was signed into law by Republican Governor Bill Lee, effective May 25, 2021, despite the vocal and aggressive opposition of several organizations for physicians, first responders and other health-care providers.

Fiscus went on to become chief medical officer of the Association of Immunization Managers. In October 2023, Tennessee settled the lawsuit arising from the termination of Dr. Fiscus, agreeing to pay her $150,000.