NOT A PRO-LIFE PARTY:

The average age of patients in this healthcare network, the largest in Memphis, has now dropped by a decade, from 61 in December 2020 to 51 now. Months ago, the majority of people Robinson treated reminded him of grandparents and parents. Now, they remind him of himself.

He recalls the recent case of a young patient in their mid-20s being placed on a ventilator. "That could have been me," he said at the time, before reminding himself he was fully vaccinated.

"It just hits closer to home when it's someone your age sitting in that bed, or on a ventilator. It's heart-wrenching seeing that because we have a solution."

Still, many of Robinson's own colleagues remain unvaccinated as the hospital weighs up whether to make inoculation mandatory for staff. Earlier in the day, he spoke to one of his friends who had worked the Covid-19 wards during the height of the pandemic.

"I don't want to have to take care of you," he told her. "I don't want to have to see you here because I care for you and value you so much."

Just 38% of Tennessee's population is fully vaccinated, one of the lowest rates in the country, but slightly above the deep south states of Louisiana, Alabama and Mississippi that lag even further behind.

Unpicking the forces behind vaccine hesitancy is complex and multifaceted; from pervasive disinformation online, to skepticism tied to systemic medical failures and historic abuse on American communities of color.

But the political situation in Tennessee has undoubtedly exacerbated the issue and left many beleaguered healthcare workers frustrated and perplexed. Tennessee's Republican governor, Bill Lee, received his vaccine earlier in the year, but did not do so in public, mirroring a vaccine dog whistle initiated by Donald Trump.

Last week, under relentless pressure from conservative state lawmakers, Tennessee fired the head of its immunization program, Dr Michelle Fiscus, a respected pediatrician, after a rightwing backlash made her a major target. She was placed in the spotlight as the state expanded its vaccine outreach to eligible school students. Unlike most states, a legal precedent in Tennessee allows certain adolescents to be vaccinated without direct parental consent. On Friday the state reversed a decision to cancel vaccination outreach to all adolescents it had announced last week.

After authoring an innocuous memo to inform the state's medical providers of the precedent, Fiscus was targeted in a wave of online abuse. At a June hearing in the state legislature, conservative lawmakers threatened to dissolve Tennessee's entire health department for producing targeted vaccine advertising for adolescents.

"We know how impressionable our young people are. For a department of ours to make it seem like you need a vaccine ... to fit in is peer pressure applied by the state of Tennessee," said Republican state representative Scott Cepicky. "Personally, I think it's reprehensible that you would do that, that you would do that to our youth."

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