Tennessee’s recently-ousted immunization director is warning that amid a dangerous surge in Covid-19 cases, the state’s Republican leadership is furthering a “misinformation campaign” that will likely result in fewer residents getting vaccinated against the disease and more people dying preventable deaths.

Until Monday, Dr. Michelle Fiscus served as the medical director for vaccine-preventable diseases and immunization programs at the Tennessee Department of Health (TDH). Fiscus was fired from the department reportedly as a result of pressure from Republican lawmakers who recently called into question the state’s policy of vaccinating adolescents between the ages of 12 and 15, as the Centers for Disease Control and Prevention (CDC) has recommended.

In a statement published by The Tennessean on Monday after her firing, Fiscus noted GOP objections to her work at the health department as well as how the state had suspended all outreach for teenagers regarding vaccines—both for Covid-19 as well as other diseases.

Chief Medical Officer Dr. Tim Jones told TDH staffers on Monday that they should complete “no proactive outreach regarding routine vaccines” and “no outreach whatsoever regarding the HPV vaccine,” according to The Tennessean. 

Jones also called for any information about back-to-school vaccinations to be associated only with the state Department of Education—not TDH.

“Any kinds of informational sheets or other materials that we make available for dissemination should have the TDH logo removed,” Jones told staff members.

The department has reacted to “sabre-rattling” by the GOP by “halting ALL vaccination outreach for children,” Fiscus wrote. “No back-to-school messaging to the more than 30,000 parents who did not get their children measles vaccines last year due to the pandemic… No reminders to the parents of teens who are late in receiving their second Covid-19 vaccine. THIS is a failure of public health to protect the people of Tennessee.”

Observers on social media expressed shock at the state’s decision to halt all vaccine outreach.

“If you want a clear and dangerous sign of how far down the anti-vaxx rabbit hole Republicans are going, look no further than what’s going on in Tennessee,” tweeted New York magazine.

Republican Party members took issue last month with a memo authored by Fiscus after the CDC released recommendations for vaccinating 12-to-15-year-olds against Covid-19. Fiscus explained that under Tennessee’s Mature Minor Doctrine, a 34-year-old law that resulted from a state Supreme Court ruling, healthcare providers can legally vaccinate minors who are at least 14 years old.

“What has occurred in the time between the release of this memo and today, when I was terminated from my position as medical director of the vaccine-preventable diseases and immunization program at the Tennessee Department of Health, can only be described as bizarre,” wrote Fiscus on Monday.

After a single recipient interpreted the memo as undermining parental consent and posted about Fiscus’s guidance on social media, Republican legislators on the Government Operations Committee called on TDH officials to appear at a hearing, where health officials were accused of “targeting” minors. 

One committee member called “for the ‘dissolving and reconstitution’ of the Department of Health in the midst of a pandemic where one out of every 542 Tennesseans has died from Covid-19 on their watch and less than 38% of Tennesseans have been vaccinated,” Fiscus wrote.

According to the National Association of County and City Health Officials, Fiscus is one of more than 250 public health officials who have either been fired or resigned since the pandemic began, as Republican leaders across the country have dismissed mask-wearing and social distancing guidelines, attacked health experts, and pushed misinformation about vaccines.

“We have been disparaged, demeaned, accused, and sometimes vilified by a public who chooses not to believe in science, and elected and appointed officials who have put their own self-interest above the people they were chosen to represent and protect,” Fiscus wrote.

State and territory vaccination officials have had a turnover rate of nearly 40% during the pandemic, she added.

Fiscus’s departure and TDH’s elimination of vaccine outreach comes as the highly transmissible Delta variant is behind 59% of new cases in Tennessee, and is spreading quickly. According to the New York Times, the seven-day average number of daily new cases was up 429% on Tuesday. 

“I am afraid for my state,” wrote Fiscus. “And I am deeply saddened for the people of Tennessee, who will continue to become sick and die from this vaccine-preventable disease because they choose to listen to the nonsense spread by ignorant people.”