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This rural, red Southern county was a vaccine success story. Not anymore

Brett Kelman, Kaiser Health News on

Published in News & Features

Dr. Michelle Fiscus, who was fired from her position as Tennessee’s top vaccine official in July amid anti-vaccine political pressure from state lawmakers, told KHN that the health department knew as of last year that county-level data became skewed as it was pulled from the state’s immunization information system, known as TennIIS, to be reported to the CDC and the public.

TennIIS was designed long before the pandemic to track routine vaccinations across the state and was not intended to be used to calculate county rates, Fiscus said.

“(TennIIS) has never been used for, pre-COVID, to produce county-level reports on vaccination rates because the data has always been incomplete,” Fiscus said. “When the data was pulled out, each ZIP code had to be ascribed a county because there wasn’t another good way to do it.”

Allison Adler, a spokesperson for the West Virginia health department, said the state records vaccinations from ZIP codes that cross county lines the same way as Tennessee “a majority of the time.” But, Adler added, the state takes steps to make the data more accurate after it is received from STChealth.

Megan Grotzke, a spokesperson for the Montana health department, confirmed the state faced similar issues in “isolated instances” where ZIP codes straddle county lines and said the agency “has made an effort to correct these.”


Other states appear to have avoided the ZIP code issue before it skewed their public vaccination data. Health department officials in Arizona, Louisiana, and Ohio — all of which employ STChealth’s services similarly to Tennessee — said the COVID-19 vaccination data is geocoded by the agency to ensure vaccinations are attributed to the proper county or parish.


(KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.)

©2022 Kaiser Health News. Visit Distributed by Tribune Content Agency, LLC.


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