A regional public health department in Idaho has ceased to administer COVID-19 vaccines across six counties, following a closely contested decision by its governing board. This marks what appears to be the first instance in the United States of a health department being barred from distributing these vaccines, which are typically a core responsibility of public health agencies.
The Southwest District Health board’s ruling is particularly noteworthy, especially in the context of national discussions around the COVID-19 vaccine. While states like Texas and Florida have implemented measures limiting health departments’ promotion of the vaccine, none have outright prohibited its administration. Adriane Casalotti, chief of government and public affairs at the National Association of County and City Health Officials, expressed astonishment at this development, stating that while some health departments have paused vaccinations due to factors like budget constraints or low demand, it’s rare for a segment of public health to reject the vaccine itself based on judgment.
Located along the border between Idaho and Oregon, the district encompasses three counties within the Boise metropolitan area. Vaccination rates within this region have significantly decreased; the health department administered 1,601 doses in 2021 compared to just 64 doses so far in 2024. The trend extends to other vaccinations as well, making Idaho the state with the highest exemption rates for childhood vaccinations in the country. Last year, the Southwest District Health Department faced challenges during a measles outbreak that resulted in 10 infections.
During a meeting held on October 22, the board voted 4-3 to impose the vaccine ban, despite testimony from the medical director advocating for its importance. Dr. Perry Jansen conveyed concerns about people not receiving the necessary vaccines, advocating for a measured approach that weighs the risks and benefits rather than adopting a blanket policy against vaccination.
Contrasting with Jansen’s viewpoint, over 290 public comments were submitted, many advocating for the cessation of vaccine mandates or public funding for vaccines, issues that were not at play in this district. Some speakers were prominent figures known for opposing vaccinations, including Dr. Peter McCullough, a cardiologist from Texas who endorses alternative treatments alongside traditional ones.
Board Chairman Kelly Aberasturi indicated familiarity with some of those who called for the ban, recalling previous local protests against public health measures. While he expressed support for the board’s decision, he also conveyed disappointment, highlighting concerns that it could set a precedent for restricting other vaccines or treatment options. Supporters of the ban argued that residents could still access vaccines elsewhere, suggesting that providing them through the health department implied a safety endorsement.
Many individuals relying on the health department for vaccinations, particularly vulnerable populations such as the homeless or those in long-term care facilities, found themselves with limited options, as noted by both Jansen and Aberasturi. Aberasturi, drawing from his own experiences, emphasized the importance of assisting individuals in challenging circumstances, while pointing out that some board members may lack such understanding.
State health authorities continue to recommend that residents consider receiving the COVID-19 vaccine. An Idaho health department spokesperson declined to make comments on district-specific affairs but highlighted that community health centers are still offering the vaccines to those without insurance. Aberasturi expressed intentions to advocate for allowing the health department to vaccinate older individuals and residents in long-term care, underlining the board’s duty to prioritize the health and well-being of the community. He concluded that the procedures followed in reaching this decision did not adequately reflect the comprehensive care expected from the health board.
