Health departments are telling staff they can no longer promote flu and COVID vaccines

This is a problem.

NPR reported yesterday that the Louisiana Department of Health has told staff "advertising or otherwise promoting" influenza, mpox, and COVID vaccines is no longer allowed. Promoting and increasing access to vaccinations is one of the central functions of health departments across the country.

According to the article, the Louisiana Department of Health released a statement to NPR saying they have been "reevaluating both the state's public health priorities as well as our messaging around vaccine promotion, especially for COVID-19 and influenza."

But according to NPR interviews with employees, health department leadership told them they are no longer allowed to promote these vaccines at the health department, which includes posting on social media, holding flu vaccine events, giving presentations or interviews, and even posting signs that these vaccines are available at health department clinics.

According to one anonymous staff member interviewed by NPR, "You cannot ask people, 'Hey, we have flu shots. Would you like one?'... But if they come up to us, knowing we are the health department and say, 'Hey, we hear y'all might have flu shots,' we can say, 'Yes, would you like one?'"

This is not the first time a health department in the US as limited promotion or even access to vaccines.

For the last several years, the Florida Health Department has recommended against COVID mRNA vaccines, initially based on a flawed analysis that claimed COVID mRNA vaccines were associated with an increased risk of cardiac-related death in young men. The analysis did not look at myocarditis specifically, which is a rare, established safety signal after COVID mRNA vaccination, but cardiac-death from a wide variety of causes including 'cardiac arrest,' a catch-all term for "the heart stopped."

Later, previous internal drafts of that analysis were discovered which showed the opposite result – no increased risk of cardiac-related death after vaccination – as well as a separate analysis showing higher risk of cardiac-related deaths after COVID infection. Those results, which support the safety of COVID vaccines and the risk of COVID infection, were not included in the version released by the Florida Health Department. The Florida Health Department went on to call for halt in the use of COVID mRNA vaccines, and recommend against booster shots.

In 2023, Texas passed a provision that prohibited any entity receiving state health department funding from promoting COVID vaccines, meaning local health departments could no longer host COVID vaccine clinics or distribute information promoting vaccination.

Earlier this year, a health department in Idaho went a step further and banned the department from giving COVID vaccines at all. According to the Associated Press, this ban was supported by numerous public comments calling for an end to vaccine mandates, which were not happening in the district.

The move by the Louisiana Health Department is another indicator that distrust in COVID vaccines is being redirected to other vaccines as well, in this case influenza and mpox shots. Trust in childhood vaccines has declined since the pandemic as well, even before RFK Jr. was nominated for HHS secretary.

What do we do?

For those who understand and value the profound benefit vaccines have brought society, this is heartbreaking news. Public health departments are supposed to promote public health, and being told you're not allowed to talk about or promote the tools we have to do that is extremely frustrating, to put it mildly. Even worse, it adds to the confusion for the public – they are now getting conflicting information about the safety and efficacy of vaccines from different health departments, understandably feeling unsure who to trust.

As individuals, what can we do?

1. Answer questions. It's easy to react to these changes out of anger, but shame and anger do not work, and often backfire. Unfortunately, many of the vaccine rumors of old (like vaccines and autism) are going to be new for many people. Remember that the vast majority people with questions about vaccines are not malicious or foolish, but are genuinely confused because of conflicting messages and simply don't know who to trust. It helps to patiently answer their questions, not get angry at them for having questions in the first place.
2. Resist polarization. It's easy to paint these issues as black and white, but the COVID vaccine rollout was complex and messy, and there were valid criticisms of public health policies during the pandemic that ultimately contributed to this mistrust (remember when everyone was told COVID vaccines were 100% effective?) Unfortunately these valid frustrations, fueled by false rumors, misleading analyses, and anger, are now driving policies that don't make sense. It's important to recognize and acknowledge valid frustrations about COVID vaccines policies (like the blurring of science and values), and distinguish that from blatantly inaccurate information.
3. Share accurate information. These health departments are being told they can't, but you can.
4. If you haven't already, remember to get your flu and COVID shots.

Kristen Panthagani, MD, PhD, is a resident physician and Yale Emergency Scholar, completing a combined Emergency Medicine residency and research fellowship focusing on health literacy and communication. In her free time, she is the creator of the medical blog You Can Know Things and author of Your Local Epidemiologist’s section on Health (Mis)communication. You can find her on  Instagram, Bluesky, Substack, or subscribe to her website below. Views expressed belong to KP, not her employer.