Health experts have widely denounced Florida’s decision to recommend against Covid-19 vaccinations for children, describing it as “irresponsible”, “reckless” and “dangerous”.
In a pronouncement which stunned experts on Monday, Florida’s controversial surgeon general Dr Joseph Ladapo said the state would be the first to “recommend against” Covid-19 vaccination for “healthy children”.
The move followed two recent Covid-19 surges in which pediatric hospitalization was believed to be higher because of low vaccination rates among children.
“It’s very generous to call it a recommendation, because recommendations come with supporting evidence and transparency,” said Saad B Omer, director of the Yale Institute of Global Health and professor of medicine in infectious diseases.
“Trying to interpret that is trying to create a GPS map from a dream. You don’t know where it’s coming from, what is the scientific rationale, if any,” said Omer. The announcement is “irresponsible … it is inappropriate and it is dangerous”, he said.
Ladapo made the announcement on Monday at the end of a roundtable discussion hosted by Republican governor Ron DeSantis, saying: “The Florida department of health is going to be the first state to officially recommend against the Covid-19 vaccines for healthy children.”
The state has not yet released a formal policy to describe exactly who would be included in the designation “healthy children”.
The move goes against accepted advice from federal health authorities and a large majority of independent experts, who recommend vaccines as a powerful tool to protect children from the worst outcomes of Covid-19.
The roundtable came as Covid-19 cases driven by the Omicron variant fall and federal health authorities seek to wind down pandemic prevention measures such as masking and social distancing.
Although children face much lower risks from Covid-19 than older adults, “there is a small minority who don’t do well with the infection and recent CDC data showed vaccines prevent half of urgent care and hospital visits,” said Dr Kawsar Talaat, a professor at the Johns Hopkins University School of Medicine.
“Our kids have lost a lot during the pandemic, and vaccines are one thing we can do to help give them a sense of normalcy.”
The Delta and Omicron Covid waves brought record-high levels of pediatric hospitalizations. These variants were not believed to be more dangerous to children. Instead, experts believe more children were hospitalized because they have low vaccination rates relative to the rest of the US population.
“Covid-19 is in the top 10 causes of deaths for every age group. That’s why we’re recommending the vaccines for everyone ages five and older,” said Noel Brewer, a behavioral scientist and professor at the University of North Carolina Gillings School of Public Health.
“No one needs these folks in Florida establishing policies around vaccines – they simply lack the expertise to do this well,” said Brewer, who is also a member of the Lancet Commission on Vaccine Refusal, Acceptance, and Demand in the US.
“People deliberately sowing doubt about Covid-19 vaccines undermines confidence and uptake in the vaccine,” said Brewer. “One of the clear effects of anti-vaccine propaganda is it harms the public. This announcement by the state of Florida is not helping anything. It will not save lives – in fact, it will cause more people to die.”
Nationally, just 26% of children aged five to 11 and 57% of adolescents aged 12-17 are fully vaccinated. Comparatively, 65% of the US population is vaccinated. In Florida, 66% of people are vaccinated, though coverage varies widely throughout the state.
The FDA authorized vaccines for adolescents in spring 2021 and for young children in the fall. In January, the FDA also authorized a booster dose for adolescents aged 12-15. The CDC has also recommended vaccines for these age groups, as independent expert advisory panels to both the FDA and CDC. Children younger than five are not eligible for a vaccine.
“This has been looked at independently by four groups of experts and for a very good reason, because during this Delta and Omicron wave we’ve seen unprecedented numbers of pediatric hospitalization,” said Dr Peter Hotez, dean for the National School of Tropical Medicine. Hotez is also developing a low-cost Covid vaccine.
DeSantis has attacked Covid-19 prevention measures throughout the two years of the pandemic. At the same time, regular Floridians have suffered greatly.
More than 71,000 people have died in the state, according to the Centers for Disease Control and Prevention (CDC), or 332 people for every 100,000 residents, far above the national average of 287 deaths per 100,000. By another metric, Florida would have the worst death rate in the world if it were a country.
Hotez said many experts believe another wave of Covid, perhaps caused by a new variant, could hit the south and Florida this summer, “just like it did in 2020 and 2021”.
Covid-19 “is a highly preventable death at this point,” said Talaat. “Almost nobody should be dying of Covid, especially over the last year and yet we’re almost at 1 million deaths in the US.”