Ada County commissioners gave Dr. Ryan Cole another five years on the Central District Health board on June 16, voting without dissent to extend his service through June 2031. Cole, an Idaho pathologist who has been an outspoken critic of COVID-19 vaccines, had his first term expire earlier this summer.

How the Re-Appointment Came Together

Cole originally joined the board in 2021, placed there by commissioners Rod Beck and Ryan Davidson. Central District Health covers Ada, Boise, Elmore, and Valley counties, and three of those four counties had already voted in favor of keeping Cole when Ada County cast its vote. Valley County had not yet formally weighed in at that point.

Greg Ferch, a chiropractor who chairs the Central District Health board, put Cole’s name forward for another term. When Cole’s regulatory record came up, Ferch acknowledged it without treating it as disqualifying. “That is something to be considered, but that didn’t have anything to do with why I suggested he retain or remain on the board,” Ferch said.

Commissioner Beck, who was among Cole’s original backers in 2021, brushed aside questions about the controversies surrounding Cole. “I’m not even going to respond to that because all I’m worried about is: Is the Central District Health functioning properly?” Beck said.

A Record Marked by Regulatory Actions and Legal Disputes

Cole’s tenure on the board has unfolded alongside a series of professional challenges. Washington state health regulators restricted his license there after concluding he had disseminated COVID-19 misinformation and treated patients with ivermectin in ways regulators found inappropriate. The Idaho Board of Medicine subsequently negotiated an agreement with Cole that obligated him to abide by Washington’s disciplinary requirements.

A separate malpractice case arose from a patient who underwent surgery after an alleged misdiagnosis of cancer attributed to Cole. Six physicians took issue with his findings, among them two independent pathologists who characterized the diagnosis as “reckless.” That litigation was eventually resolved and dismissed under a confidential settlement agreement.

Cole also let his Idaho medical license lapse in 2024 before moving to restore it. The reinstated license now carries an expiration date of May 2030.

New Role and Diverging District Policies

This past March, Cole took on the position of head of medical and scientific affairs at the Independent Medical Alliance, adding a national platform to his local board seat.

His continued presence on Central District Health’s governing board comes as neighboring districts have moved in a different direction on vaccines. In 2024, the Southwest Idaho Health District decided to stop providing COVID vaccines, a move that followed public testimony opposing the shots — testimony Cole contributed to. Central District Health, by contrast, continues to advertise COVID vaccine appointments on its website, placing the two districts on noticeably different paths.

What Cole’s Term Means Going Forward

With a seat secured through 2031, Cole holds a lengthy window of influence over a health district that still provides immunization services aligned with mainstream public health recommendations. Whether his presence on the board eventually nudges Central District Health toward the posture adopted by Southwest Idaho Health District remains an open question.

The appointment reflects the broader pull between conventional public health practice and vaccine skepticism that has surfaced repeatedly in Idaho’s local governance debates. That tension is unlikely to resolve itself quickly, particularly as Cole simultaneously holds a national advocacy role while governing a district that still administers the vaccines he has publicly questioned.