Updated June 24.
Ticks are small in stature, but their effect on the Vineyard community is larger than ever.
While they may be more common up-Island, the arachnids are present all across the landscape, which has put regional public health efforts at the forefront in recent months. Most, if not all, of those include the work of the Island’s only tick epidemiologist, Lea Hamner.
But the collaborative, regional aspects of Hamner’s job came into question at a contentious West Tisbury board of health meeting on Tuesday night. Sarah Toste, the West Tisbury assistant health agent, had pulled access to the primary source for the town’s share of regional health information from Hamner, citing a lack of transparency.
“For the past year I’ve been saying we need some sort of scope of work, a position, a budget, and a collective decision. I’ve seen nothing,” Toste said at the board of health meeting. “Nobody talked to me about anything.”
West Tisbury was the only town to revoke Hamner’s access to the statewide infectious disease database, called the Massachusetts Virtual Epidemiological Network, or MAVEN. As a result, Hamner couldn’t see data from West Tisbury residents regarding tick-borne conditions. Toste, who is the voting representative for her town in county health matters, was the only one to opt out of collaborating with Hamner on the work she does with the Inter-Island Public Health Excellence Collaborative, which includes health representatives from all Island towns. Hamner also helped make alpha-gal a reportable condition in Dukes County on April 1, which is done through MAVEN.
Representatives from the other town health boards showed up on Tuesday to support Hamner and advocate for continued data sharing with the epidemiologist. Some of them referenced the COVID-19 pandemic, and the importance of regional efforts in the face of a health threat that doesn’t abide by town lines. Several health agents said they’ve been navigating the soaring fear that the small arachnids have sparked from both year-round and seasonal residents.
“This is not the time to splinter off and isolate yourself from the rest of the Island,” Brice Boutot, the Edgartown health agent, said. “You have to ask yourself: ‘Does this help the community?’”
But Toste was concerned that Hamner hadn’t been communicative about her work. She also said the current memorandum of understanding, an agreement with Hamner through each town’s board of health, was no longer relevant. The contract was signed by all six towns, but Toste said five of those six agents have since retired. Toste said the entire situation has brought up “significant ethical concerns” for her, and that “this process needs to start from the beginning.”
Toste questioned Hamner at the meeting: “Who are you working for? Who’s asking you to provide this information?” Toste said in order to comply with state standards this year, the West Tisbury board of health hired the Visiting Nurse Association of Cape Cod, Martha’s Vineyard (VNA), which has an epidemiologist of its own to assist with public health matters, such as ticks.
“I think ticks and tick-borne diseases are the scourge of this Island,” Hamner said in defense of her position. “I am determined to be involved in the solution, and I uniquely bring the skill set of doing 10 years of this type of job.”
Hamner highlighted that she does have active contracts, and that she’s working for the county, state, and the public as an independent contractor. Since 2023, Hamner has had a contract with Dukes County for tick data collection and epidemiology. She has also attended 27 meetings in two years with the Inter-Island Public Health Excellence Collaborative, where she’s provided health agents with updates on her work so far.
As the only tick epidemiologist on the Island, Hamner works with both private and public groups across the Vineyard, such as towns and organizations like the Martha’s Vineyard Tick Program, which was started by Dick Johnson, and Tick Free MV. Understanding demographics, age ranges, and specific areas on the Island where people live or have been bitten by a tick, are all a part of that process. The primary way she gathers that information is through MAVEN.
The other town health board representatives in the room — from Chilmark, Tisbury, Edgartown, and Aquinnah — said that Toste’s decision to revoke Hamner’s access to MAVEN put the entire health system in jeopardy.
Tisbury Health Agent Drew Belsky said the data through MAVEN are important for Hamner “so she can follow the trends and document alpha-gal,” a mammalian allergy from lone star tick bites that he said is rising at alarming rates. Also a concern of health representatives is the fear that accompanies the tick-borne conditions on the Island, which is threatening the primary economic driver for the community: tourism.
The funding for Hamner’s work has been up in the air for the past year, so she started efforts to expand the sources she pulls from. She was recently awarded the Martha’s Vineyard Vision Fellowship, she works with nonprofits, and she started a GoFundMe fundraiser, and still has a few days left of funding from a COVID-era federal grant. That grant was nearly pulled by the U.S. Department of Health and Human Services last year, which put the Island’s only infectious disease investigator, Betsy VanLandingham, and Hamner, on uneven footing at the time.
“The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a nonexistent pandemic that Americans moved on from years ago,” the federal department said in a statement in April 2025 about its decision to halt the funding.
However, multiple states sued the federal government for trying to rescind the grant before its end date, and the funding remained. But it officially runs out on June 30, 2026, at which point Hamner will be reliant on the public and private funds she’s collected thus far.
Toste said the private and public conglomeration of funding sources raises additional concerns.
“So, the Inter-Island Public Health Excellence Collaborative is going to partner with a nonprofit?” Toste said, and again questioned Hamner: “Who do you work for?”
A physician’s assistant from Martha’s Vineyard Hospital, Aubrey Stimola Ryan, who has been active in the regional efforts against a rise in tick-borne conditions this year, was present at Tuesday’s meeting, and expressed support for Hamner. Ryan said there are six towns, but when it comes to disease and illness, “we’re one unit.” She also wondered aloud why there was tension about the topic.
“It’s not contentious,” Toste said.
“It feels contentious,” Ryan replied.
“This sounds like a bureaucratic boondoggle here,” West Tisbury board of health chair Erik Lowe interjected at the meeting after a back-and-forth between Toste and other health representatives. “We were obligated by the state to have an entity that did disease contact tracing for the town and we made the decision to go with the VNA.”
Lowe added that he felt there was simply a miscommunication.
Johnson chimed in and said there have been a lot of accomplishments in tick research, and that one of the strengths of the program he initiated, which helps fund Hamner’s research, is its regionality.
The Chilmark board of health agreed. In a letter to the West Tisbury board, it wrote, “Disease investigations do not stop at town boundaries, just as our schools, hospitals, emergency services, and conservation efforts do not — public health surveillance must work the same way.”
Toste said she felt as though she hadn’t properly been looped into the process, and pointed out that the inter-Island efforts go both ways. “It’s clear there’s been a lot of conversations going on outside of the boards,” she said. “Clearly you all talk to each other, but nobody talked to me.” Then she turned to address Aquinnah health agent Marina Lent: “Except for your vitriolic text messages.”
“I did overreact when I heard that we [the towns] are now excluded from West Tisbury access, because of the value I see in acting like a shared community when it comes to disease,” Lent said. She added that she worked intensively with MAVEN during the COVID pandemic, and it was “invaluable” in that case. Getting the whole picture, she said, mattered then, and it matters now.
The West Tisbury board of health was ultimately swayed from its decision. Lowe put forward a motion to give Hamner emergency access to MAVEN until the end of her contract with the county, at which point the board would meet again and re-evaluate the details of the arrangement.
All representatives underscored that communication between towns when it comes to an Island-wide issue is of the utmost importance, especially when it comes to the health and safety of the residents. Alpha-gal being a reportable condition on MAVEN is still in the early stages, and health officials are only just starting to see the effects of the condition Island-wide through that data.
“This is not the time to undo a collaborative process, it’s the time to start one,” Boutot, the Edgartown health agent, said.
Editor’s note: Updated with additional information from Lea Hamner.
How anyone can oppose anything that addresses ticks and tickborne illness in a responsible way is a mystery to me.
Agree. I’ve read the Times article carefully to try to understand West Tisbury’s position, but I’m baffled. How does it not make sense for everyone on the island to work together to address the tick crisis? A turf war doesn’t help anybody.
It was the genius of the town health agents working alongside the media and the hospital that kept the Island protected during Covid. This communication must continue with alpha gal as well. Islanders are very grateful for their work.
Thank you West Tisbury for not succumbing to the profitable business of hysteria.