As COVID infections spread in Tennessee, the state’s Department of Health says more people are getting vaccinated. After months of declines, the number of vaccinations jumped more than 20% last week.

The uptick is widespread, with increases reported in 94 of Tennessee’s 95 counties, says Dr. Lisa Piercey, the state’s health commissioner.

“That means some Tennesseans, a lot of Tennesseans who have been hesitant are now saying, ‘You know what? I’m ready.’ ”

Still, the jump from 62,000 per week to 76,000 per week hasn’t been big enough to move the state’s vaccination rate very far. Below 45% have taken the first dose, leaving Tennessee as one of the least protected states.

Piercey says the one-week surge could be a reaction to the rapidly spreading Delta variant, which led to cases shooting up more than 200% in the past week. And the flood of cases is beginning to stress hospitals. They’re now treating more than 1,000 patients with COVID — roughly the same number as in February. Hospitalizations bottomed out in early July with fewer than 200 statewide.

More than 90% of hospitalizations and positive cases in Tennessee are among the unvaccinated. And of the small percentage who become sick enough to be hospitalized, 80% are over age 65, Piercey says, making them more likely to have weakened immune systems.

“The vast majority of all of the infections happening right now are among the unvaccinated,” Piercey says. “Vaccination is the single best tool we have to prevent COVID-19 in ourselves and in our communities.”

WPLN’s Paige Pfleger contributed to this report.

Tennessee’s science museums have jointly decided to promote vaccines during August, which is the CDC’s National Immunization Awareness Month.

The Science Alliance of Tennessee is a consortium of six nonprofit science museums. Most of their effort entails filling their social media feeds with fact-based information. They also plan to hand out cards explaining mRNA technology and antibodies. The cards have “myth-buster” material about COVID shots:

Myth: Vaccines will make me sick.

Plausible: We might experience some of the same symptoms … the big difference is we recover quickly because there’s no harmful virus in us.

Jennifer Uhll of the Discovery Center in Murfreesboro says the initiative is intentionally broader than COVID to sidestep the politics of the pandemic.

“There’s been a lot of discussion among our peers about: what is our place? What falls in line with our mission?” she says. “Especially Discovery Center, our mission is to engage curious minds to fuel the future. So, we want to make sure we’re educating and not pushing an agenda.”

The Adventure Science Center in Nashville is also participating. The museums have not previously marked National Immunization Awareness Month.

Conservative radio talk show host Phil Valentine has been placed on a ventilator, according to his radio station, SuperTalk 99.7 WTN. He’s been hospitalized now for more than two weeks.

From the Valentine Family: continue to pray! #prayforphil pic.twitter.com/69ssmR6kbR

— SuperTalk 99.7 WTN (@997wtn) July 28, 2021

Valentine had shown improvement over the weekend, according to his family. But they say a ventilator will let him rest.

His brother, Mark Valentine, tells Here & Now that seeing his brother so close to death has motivated him and many other people who were hesitant about the vaccine to get the shot.

“As soon as I found out this thing had hit him like it hit him, I went directly to the Wal-Mart,” Mark Valentine said on the program Wednesday. “I said, you know, ‘Y’all pick the arm.’ The guy says, ‘Do you have any questions or concerns?’ I say, ‘Yeah, I got a bunch of them but do it anyway.'”

Devoted listeners have been leaving supportive messages on WTN’s Facebook page and some have also said they intend to follow the new advice and get the vaccine.

Mark Valentine says his brother regrets not taking COVID-19 more seriously and has vowed to advocate for the vaccine as soon as he’s back on the air.

Tennessee doctors are warning the state to consider more aggressive action in stopping the latest surge in COVID cases caused by the more contagious Delta variant.

Hospitalizations have quadrupled in Tennessee since July 4, and fewer of them are elderly, since they have the highest vaccination rates.

“These patients are skewing younger this time,” says Dr. Katrina Green, who works in emergency departments in Nashville and Lawrenceburg. “The problem is that we’ve stalled out on our vaccinations for younger people.”

The state suspended outreach efforts for several weeks over concerns from some Republican legislators that teens were being coerced into getting COVID shots, against their parents’ wishes. Those efforts have resumed. But school starts for most kids in the next two weeks, and children under 12 are the only people left who still don’t have an option to vaccinate.

Data kept by the American Academy of Pediatrics says 43 states have now reported fatal cases in kids, with a total of 349 compared to 76 pediatric deaths at the same time last year. Dr. Vidya Bansal, a Nashville pediatrician, says this is not the same set of circumstances when Tennessee school children got out for the summer.

“We need to shift our focus from when it was going on last year when it was ‘rare’ in children to what is going on right now,” Bansal says.

She and others are encouraging the state to require universal masking in schools, as newly recommended by the Centers for Disease Control and Prevention. Gov. Bill Lee said a week ago he’s leaving the decision up to local school districts. And nearly all schools are only planning to make masking optional, including Metro Nashville Public Schools.

COVID cases in Tennessee have been steadily rising all month but shot up by more than 2,000 on Tuesday, according to health department data.

Ascension Saint Thomas will require all employees to take the COVID vaccine following a corporate announcement on Tuesday.

“Ascension conducted a thorough moral and ethical analysis as part of the decision-making process,” the country’s largest Catholic hospital system says in a statement. “As a healthcare provider and as a Catholic ministry, ensuring we have a culture of safety for our associates, patients and communities is foundational to our work.”

Employees must be vaccinated or have an exemption approved by Nov. 12, which is roughly when hospital staff have to have their flu vaccine each year.

The announcement comes in a week when a critical mass of hospitals have announced mandates. Many had held off, even once a Texas hospital received a favorable case dismissal last month, partly for competitive concerns since unvaccinated staff could just leave for a competing hospital.

But, this week, the VA announced a mandate, as did the states of California and New York. In Nashville, Vanderbilt University Medical Center internally announced a requirement for leaders to take the vaccine on July 15, though it only became public this week. The entire workforce is expected to face a mandate too, with 72% currently vaccinated.

However, the country’s largest hospital chain is still holding off. Nashville-based HCA has not mandated vaccination, though its local hospitals in Nashville say in a statement that they are following all federal guidance.

“Our colleagues are not required to be vaccinated for COVID-19,” spokesperson Anna-Lee Cockrill says in an email. “But we highly encourage our employees and the public to consider vaccination to keep themselves, their families, and their communities safe.”

Cases and hospitalizations are continuing to spike among the unvaccinated in Tennessee. And now, Republican leadership in the state legislature is urging more residents to get vaccinated against COVID-19.

On Tuesday, 16 state senators signed a letter touting the benefits of getting the shots, explaining some of the science behind mRNA and warning about the dangers of not being inoculated. The letter says “vaccines have been saving lives for over a century,” and “virtually all of those currently hospitalized with COVID-19 have not been vaccinated.”

By the estimation of the Tennessee Department of Health, 97% of hospitalizations are among the unvaccinated. And hospitalizations for COVID-19 have nearly quadrupled since July 4. Among Tennessee patients in ICUs is conservative radio talk show host Phil Valentine, who was unvaccinated and now says through family members that he regrets leading listeners astray.

“Unfortunately, efforts to get more people vaccinated have been hampered by politicization of COVID-19. This should not be political,” the senators write. “Every life lost to this virus is tragic. The COVID-19 vaccines save lives.”

The joint letter, signed by Senate Speaker (and pharmacist by trade) Randy McNally, comes after the state’s top vaccine official was fired amid the debate about the health department promoting vaccinations to teens. The signatures of state senators who grilled health department officials — including Sens. Kerry Roberts, Janice Bowling and Mark Pody — are conspicuously absent. In all, 11 GOP senators chose not to sign.

Just 39% of Tennesseans are fully vaccinated, and the pace has slowed to a crawl. But, in the last few weeks, the state has seen a slight surge in uptake as the delta variant brings renewed concerns and a new wave of cases.

WPLN’s Marianna Bacallao contributed to this report.

Vanderbilt University Medical Center will become the first hospital system in the region to require COVID vaccination of employees, starting with those in leadership roles.

A recent message to the 25,000-person workforce says 72% of employees are fully vaccinated as of mid-July. The figure rises to 92% among the leaders, who are now being required to get their shots as a condition of employment.

“The highest responsibility of those in leadership roles at VUMC is to protect the safety of patients, coworkers, trainees and students,” the letter obtained by WPLN News says. “It is also important for those in leadership roles to be vaccinated to demonstrate VUMC’s overall commitment to promoting vaccination, both within VUMC and in our broader community.”

Employees who qualify as “leaders” are being contacted now and required to get their first dose by Aug. 15 or have a religious or medical exemption approved by then. The requirement applies even to those who have remote work or jobs that do not interact with patients.

The rest of the workforce is also expected to take the COVID vaccine, though a deadline has not been set.

Tennessee hospitals fought off a bill in the state legislature that would have banned employers from requiring COVID vaccination. At the time in May, no hospitals in the state had yet declared their intent for a mandate, but a few around the country were already making announcements.

The two other large health systems in Nashville — TriStar Health and Ascension Saint Thomas — have not yet announced plans to require COVID vaccinations. But more hospitals are making mandates, now that a federal court has thrown out a lawsuit from more than 100 nurses at Houston Methodist who challenged the hospitals mandate as “coercion.”

“This is not coercion,” the judge wrote in June. “Methodist is trying to do their business of saving lives without giving them the COVID-19 virus. It is a choice made to keep staff, patients and their families safer.”

Tennessee will resume school-based vaccination events next week after putting them on hold over concerns from state legislators.

The state health department will also continue providing the vaccine to older teens without parental consent if necessary, which is what Republican leaders had expressed urgent concerned about.

The state’s health commissioner, Dr. Lisa Piercey, says the pause was an effort to be responsive to concerns from the legislature, since they represent the will of the people. Several lawmakers had said the state should tone it down on outreach to kids about the vaccine.

“It is our job to educate and encourage and make it accessible, and then stop,” she said during a briefing with reporters Friday.

Last week, some of the same lawmakers who first raised concerns dropped their threats against the department. But the Tennessee Department of Health isn’t stopping much of what prompted the initial backlash over youth vaccinations, except deleting some social media posts.

Lawmakers printed out images of kids who’d been vaccinated and held them up during a hearing in June, insisting they be removed. Piercey says in the future, posts will also have a parent in the picture.

Piercey would not comment directly on firing her vaccine director, Dr. Michelle Fiscus, who wrote the memo laying out the precedent for vaccinating teens without parental consent as a last resort. In a previous written statement, she said her firing was related to poor performance, despite mostly glowing performance reviews.

But when asked on Friday, she did lay out her philosophy on hiring and firing in the health department, saying she works for Gov. Bill Lee and so does her team.

“It is my job and my responsibility to make sure the policies and the personnel within the department are operating in the course of his vision and in our belief about the appropriate role of government,” she said.

Urban health departments unaffected

Piercey says she has very little control over the six urban health departments in Tennessee, including the Metro Public Health Department. Nashville has been hosting vaccination events at schools for the last few weeks, including Thursday at John F. Kennedy Middle School in Antioch.

Brandon Williams — a father who brought his two middle schoolers to get routine vaccinations, not the COVID show — said he was glad to see lawmakers step in to tone down the vaccine push to teens.

“I’m not one of those people that particularly like the government forcing us to do things,” he said. “This is the land of the free.”

There’s no evidence any teens have been coerced to get a COVID shot, though state lawmakers have described anecdotes shared with them by constituents.

Even with the health department resuming the youth vaccination push, some pediatricians say the damage has been done with lawmakers amplifying vaccine misinformation during their debates.

“This just makes our job that much harder,” says Dr. Amy Evans, who runs a practice in the rural community of Sewanee. “I think we’ll see more vaccine hesitancy.”

‘It’s not just about me’

And the timing is not good.

School in Tennessee starts back for most students in a few weeks, in-person and maskless. The delta variant wave is threatening much of the under-vaccinated South — with infections rebounding 200% in Tennessee this month, almost entirely among the unvaccinated.

“This is like the black plague. People need to realize that,” says Kelley Foxworth, who was getting her sixth-grade grandson vaccinated this week at JFK Middle School. She says it was an easy decision given her family’s experience with COVID: Her aunt died on a ventilator in Detroit.

Foxworth says she’d prefer that parents be required to vaccinate their kids who are going back to school, because so many are only thinking of the risk to themselves or their children.

“Yes, it’s a personal choice. But I have to think about my neighbor,” she says. “So it’s not just about me. It’s about everybody around me.”

Tennessee Republicans say they are now pleased with state health officials after chiding them last month for being overzealous about vaccinating children. Lawmakers on the Government Operations Committee met Wednesday and made no mention of dissolving the state’s health department, as suggested at a meeting in June.

The health department has committed to stop marketing the COVID vaccine to teenagers, which includes vaccination events at schools. And state entities will no longer vaccinate teens without parental consent, though it is allowed under present law and had only happened a few times, according to the department.

“At this point, no state-related entity should be administering the COVID-19 vaccine … without parental consent or marketing to minors,” said Sen. Kerry Roberts, R-Springfield, who chairs the committee. “That is our desire and that is our intent.”

Roberts says he and others who raised concerns are not opposed to the COVID vaccine or even children taking it, but only with a parent’s consent. They add that the state’s urban health departments, which operate independently, are expected to follow the state’s new policy.

Nashville’s health department has not made any changes and continues holding vaccination events at schools.

At Wednesday’s hearing, Republican leaders made no mention of last week’s firing of the state’s vaccine director, Dr. Shelley Fiscus. A memo she wrote about when parental consent is required set off the initial backlash.

Democrats like Nashville Rep. Vincent Dixie accuse GOP lawmakers of trying to win favor of anti-vaccine conservatives by intentionally slowing down the COVID vaccination effort, even as the state has one of the lowest vaccination rates in the country.

“This is not a political game,” Dixie said outside the hearing, where Democrats were not allowed to speak against the joint statement issued by Chairman Kerry Roberts. “This is a health issue. We’re talking about lives, and they’re playing a political game.”

COVID hospitalizations have doubled in Tennessee since the Fourth of July — from 195 to 408. It’s a manageable number — given hospitals cared for more than 3,300 COVID patients at one point in January — but a worrying trend in a state with less than 40% of residents fully vaccinated.

The Tennessee Department of Health says 97% of the new COVID cases are among people who had not been vaccinated. And for most of those who get sick after vaccination, like Beth Downey of Nashville did this month, they almost certainly won’t need to be hospitalized. She says her symptoms were mild enough to pass for allergies.

“Due to traveling to see family, I thought just to be safe, go get a COVID test. And lo and behold, it was positive,” she says.

Her dry cough started July Fourth weekend. But none of the people she celebrated with got sick. Most, she says, were vaccinated.

“I’m very fortunately it was not anything very serious,” Downey says.

Metro health officials in Nashville say even with 50% of residents vaccinated, COVID doesn’t seem to be spreading as quickly. Clusters of cases are much smaller, even with very few people wearing masks. At a recent Davidson County wedding, three attendees got sick.

“A mask-less wedding is a really high risk activity. So the fact that there were only three cases, I think, is a pretty good thing, especially when you’re talking about a room of 150 people,” says epidemiologist Leslie Waller of the Metro Public Health Department.

‘It’s not a very comfortable situation’

The city’s health department is a long way from reimposing restrictions or mask requirements, but Waller says she and others in her office are wearing their masks again in public. They spent Monday testing 700 residents at the Nashville Rescue Mission after a handful of small outbreaks.

She says it’s hard to imagine the kind of community spread Tennessee had in December and January. But it’s also more difficult to control spread through contact now because people have resumed normal life — whether vaccinated or not.

“It’s not a very comfortable situation for any of us to be in,” Waller says. “My best educated guess is that we will not see those same levels of numbers, but of course, I’m not the one dictating what this virus does.”

Statewide, Tennessee hospitals should be able to handle the current load of COVID patients (updated daily here). But with a majority of residents still unvaccinated, state health officials are also gearing back up — publishing more frequent status reports on COVID cases and the delta variant, which is responsible for spikes in neighboring Arkansas and Missouri.

Shelby County, on the Arkansas state line, has already seen the state’s biggest jump in new cases and highest prevalence of the delta variant. Among the state’s urban counties, it also has the lowest vaccination rate.