The Donald Trump-fueled descent of the GOP into a party of reality-rejecting, science-denying conspiracy theorists is well-documented, and a growing phenomenon, as the extreme factions of the party overtake or push out the relatively few moderate Republicans remaining. And almost nowhere is the enduring harm of the Trump years more apparent than in the American right’s response to the Covid-19 vaccine. Vaccinations, long rightly heralded as miracles of modern medicine that have saved millions of lives, are suddenly ideologically divisive along party lines.
The danger inherent in this conflict came to a head this week in Tennessee, where pediatrician Dr. Michelle Fiscus, one of the state’s top vaccine officials, was fired after circulating information about a decades-old state policy regarding vaccinations for teens.
Republicans in the US are the most likely to say that they will simply refuse to be vaccinated against Covid-19, according to a Monmouth University poll. And some of these Republicans aren’t just refusing vaccination for themselves. Many of them, including elected GOP officials, are also trying to make it harder for children to get vaccinated by penalizing public health officials who point out that they can.
It’s ironic: The party of “pro-life” doesn’t believe that children — including teens — have basic rights to preserve their well-being, separate from their parents’ wishes or consent.
The dovetailing of vaccine rejection and the rejection of children’s rights is currently playing out in Tennessee. Fiscus, the medical director for vaccine-preventable diseases and immunization programs at the Tennessee Department of Health, said Monday that she was fired after writing a memo about Covid-19 vaccinations for young people, and including the legal standard for parental consent to health care in Tennessee. As Fiscus put it in a statement, “according to Tennessee Supreme Court case law, minors ages 14-17 years are able to receive medical care in Tennessee without parental consent.”
That is a simple statement of fact, one that is repeated on the Tennessee Department of Health’s own website. This “mature minor doctrine” (Tennessee is one of five states in the US to have one) essentially says that minors 14 and over are presumed competent to make basic health care decisions. That would include vaccination. But, according to Fiscus’ statement, “Within days, legislators were contacting TDH (Tennessee Department of Health) asking questions about the memo with some interpreting it as an attempt to undermine parental authority.” It wasn’t — but even if the Department of Health did encourage young adults to get vaccinated, that would be squarely within the purview of a state health department.
Fiscus wrote that “it was my job to provide evidence-based education and vaccine access so that Tennesseans could protect themselves against Covid-19. I have now been terminated for doing exactly that…” The department told CNN in an email it could not comment on personnel matters.
In a phone interview with CNN, Fiscus said she is worried about the safety of Tennesseans, adding “I am angry that public health is political in this state. Public health should never, ever, ever be political. People all through state government are scared to death that they are going to lose their jobs over this.” According to the National Association of County and City Health Officials (NACCHO), more than 250 public health officials left their jobs between when the pandemic started and May 2021 — many against their will, some facing pressure from those opposed to public health efforts curb the pandemic.
Fiscus said the Tennessee health department has been called to testify before the state legislature, and has responded by stopping vaccination outreach efforts. More than 12,000 Tennesseans have died of Covid-19 and apparently conservatives in this GOP-controlled state government are more upset about teenagers having the right to get vaccinated than they are about the anti-vaccine movement’s mounting body count: more than 99% of American Covid deaths are now among those who are not fully vaccinated.
Meanwhile, health policy experts published a commentary Monday in the Journal of the American Medical Association’s JAMA Pediatrics arguing that teens should have the right to decide whether to get vaccinated. “Children and adolescents have the capacity to understand and reason about low-risk and high-benefit health care interventions. State laws should therefore authorize minors to consent to Covid-19 vaccination without parental permission,” Larissa Morgan of the University of Pennsylvania Carey Law School, Jason Schwartz of Yale University and Dominic Sisti of the Department of Medical Ethics and Health Policy at the University of Pennsylvania wrote. “In the context of vaccination, some older minors may possess a more accurate understanding of the risks and benefits of a vaccine than their hesitant guardians.”
When it comes to teenagers and vaccines, though, two right-wing authoritarian buttons get pushed: Science denial and parental control. The entire concept of children having rights has long been rejected by many conservatives — just ask Hillary Clinton. Back in 1992, her work at the Children’s Defense Fund drew controversy, as did a law journal article she wrote arguing that it was absurd for courts to treat all minors under the age of 18 was equally and universally incompetent to make some of their own decisions. (In his speech at the Republican National Convention in 1992, conservative commentator Pat Buchanan falsely characterized her position as believing that “12-year-olds should have a right to sue their parents”).
Or look to the many religious conservatives who have protested efforts by the United Nations to advocate for children’s rights (thanks to these same religious conservatives, the US is one of just three nations on earth, along with Somalia and South Sudan, that has not ratified the UN Convention on the Rights of the Child).
Many of the same folks who believe that a fetus has more rights than a pregnant woman immediately invert that relationship as soon as a child is born, arguing that parents have near-total authority over their kids — including the authority to hit their children, to refuse them a basic education and to put their kids’ health at risk.
Obviously, not all children are capable of making their own medical decisions, which is why Tennessee law — and the law of many other states — differentiates between young children and more mature teenagers and asks doctors to assess the decision-making capabilities of their teenage patients.
What’s particularly striking about the current controversy in Tennessee is that the fired health official wasn’t doing anything outside of the bounds of existing law — but the right-wing reaction to the very concept that teenagers might have some limited rights to bodily autonomy, coupled with the paranoid dogmatic rejection of vaccines, created a perfect storm of conservative outrage.
This is all immensely dangerous. Authoritarianism, including the belief that young people are the property of their parents, is a recipe for abuse. Rejection of science, reason, and the reality in front of one’s face, even as the outcome of that rejection is mass illness and death, is more akin to cult membership than political alignment.
This is where the growing extremist wing of the Republican Party wants to take the country. It’s not “pro-life.” When it comes to Covid, its actions boil down to being pro-death.
Jill Filipovic is a journalist based in New York and author of the book “OK Boomer, Let’s Talk: How My Generation Got Left Behind.” Follow her on Twitter. The opinions expressed in this commentary are solely her own.