TDH youth vaccination directive leaves metro department in limbo

Local Coronavirus Coverage

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BLOUNTVILLE, Tenn. (WJHL) – State-level changes surrounding COVID-19 vaccinations for youth have the metro Sullivan County Regional Health Department (SCRHD) in limbo about more than just COVID vaccinations.

SCHRD Emergency Response Coordinator Mark Moody said the department’s current interpretation of a Tennessee Department of Health (TDH) directive has leaders unsure about whether they can do traditional in-school flu vaccine clinics this fall, among other things.

“We’ve sent a team into the schools and offered flu shots for those kids that qualified and had the appropriate consents to do, so we’re unsure of where that stands at this point in time,” Moody told News Channel 11 Wednesday.

WEB SPECIAL: Interview with Mark Moody on TDH changes

The uncertainty stems from the TDH’s pullback from any marketing of COVID vaccine to minors following a legislative outcry about such marketing. An obscure rule known as the “Mature Minor Doctrine” also comes into play.

SCRHD isn’t required to follow TDH directives like the regional health offices that oversee 89 of Tennessee’s 95 counties. Like its five sister “metro” health departments, SCRHD is answerable to its county mayor (Richard Venable) — but it tends to align its practices with TDH guidance.

“We make every attempt to adhere to Department of Health policies and directives as much as possible but our first boss is the mayor of Sullivan County,” Moody said.

That effort means SCRHD won’t host a school vaccine clinic for things like measles, MMR and the like, even though Moody said the pandemic caused more kids than usual to miss those shots last year.

“It would have been nice to have a campaign to encourage folks to come get their kids’ school shots so to speak brought up to date,” Moody said.

He said traditionally, “we did host a back to school event that specifically targeted or was for the K through 12 age group to get shots, boosters, whatever was needed.

“But right now my understanding of our direction is we will not do any type of campaigning. Now if somebody comes in we’ll still do the vaccination but we’re not going to do media postings or social media postings advocating that.”

Nor will the department conduct additional vaccination events at K-12 schools. It did that at Ross N. Robinson Middle in Kingsport, Sullivan Central High in Blountville and Tennessee High in Bristol late last month and early this month prior to the controversy.

“Some parents brought their kids there to be vaccinated, but we also vaccinated a fair number of just community members that were driving by, saw the vaccination POD (point of distribution) was there and stopped and got vaccinated,” Moody said.

“That was prior to any directives or any changes.”

He said all SCRHD PODS to date have been open to people in any eligible age group.

“We have not ever conducted an event targeting just solely youth.”

SCRHD will have vaccine PODS at all ages back-to-school events at the Kingsport YMCA July 23 and at a city park July 31.

“I feel like we’re in compliance with that because we’ve been invited by the event organizer to participate along with other programs, the teen pregnancy, smoking and some of those other programs the health department sponsors and conducts,” Moody said.

But the recent school-based events won’t be repeated unless the department’s interpretation of the recent directive changes.

“I believe it talks about not holding events that specifically target youth only … 12 to 18 … (and) no vaccination events on school properties.”

‘Mature Minor’ doctrine takes center stage

Another legislative complaint centered around instances of minors 14 and older getting vaccinated without parental consent when health departments allowed use of the “mature minor” doctrine.

Listed on the TDH website, the doctrine cites a “presumption of capacity” to make decisions for 14 through 17-year-olds — without parental consent — unless a doctor believes the minor’s not sufficiently mature to make independent health care decisions.

“That mature minor doctrine has been in place since 1987 and is utilized by every health department across the state,” Moody said. “That is applied on a daily basis with pregnancy issues, tests, etc.”

He said SCRHD had not provided any COVID vaccinations to unaccompanied minors and wasn’t planning to do so even before the recent uproar.

“We stuck with requiring parental consent on any vaccination we gave.”

North of the state line, Virginia requires people be 18 and older to consent to the vaccine, Mount Rogers Health District Director Dr. Karen Shelton said in response to an email query.

But Southwest Virginia public health authorities are working with the K-12 schools, and in them.

“We do vaccinate in the schools with signed parent consent, as we do every year for flu vaccine,” Shelton said. “We have worked with the schools in (Southwest Virginia), as other Districts across the state have worked with their local schools, to provide COVID vaccine,” Shelton wrote.

Moody acknowledged the theoretical possibility of a “mature minor” wanting the COVID vaccine but being unable to get parental consent.

“That’s an unknown and one of the challenges with this new direction that has been mandated from state government and therefore the Tennessee Department of Health,” he said.

That just makes it very challenging to give the vaccine to those that understand and seek to be vaccinated.”

Generally the current situation leaves the department in flux when it comes to promoting vaccinations of any kind for children and for administering any of them on school properties.

But Moody said the doors are open five days a week at the Blountville and Kingsport health department facilities.

“Parents can bring their kids in and get them vaccinated.”

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