A major debate during the height of the COVID-19 pandemic focused on mandates and whether to require people to get vaccinated or not. Advocates of mandates argued that vaccines represented the best tool for protecting people against a virus that has now killed more than 1 million Americans while those against them argued for personal freedom and the ability of people to make their own choices.
Medical and public health officials have largely lined up on one side, arguing that the vaccines are extremely safe and highly effective at preventing serious illness. Yet, there has been a notable and possibly solitary exception.
That exception: Florida Surgeon General and Secretary of Health Dr. Joseph Ladapo, who has criticized COVID-19 mRNA vaccines since the start of his appointment.
Recently, to the ire of the medical community and the denigration of public health professionals, he has asked Floridians to avoid COVID-19 mRNA vaccines altogether, citing bizarre, debunked claims that the vaccines contain DNA fragments that alter our genes.
First, a look at the facts is in order. It is essential to acknowledge that there are DNA fragments in most vaccines related to how they are produced. However, the notion that these fragments can mix with our genes, leading to potential cancer or reproductive risks is false. If it were easy for outside DNA to enter the nucleus of a cell and mix with genes, we would have had cures for genetic-based diseases and certain forms of cancer long ago.
When Dr. Ladapo relayed his concern to the Centers for Disease Control and Prevention and Food and Drug Administration in December, and later in his public recommendation, he ignored the FDA’s thoughtful and science-based rebuttal. In his announcement, any discussion about alternatives to mRNA vaccines, such as the protein-based Novavax COVID-19 vaccine, was notably absent.
Meanwhile, COVID-19 is still having a significant medical impact on Florida: more than 3,000 people were hospitalized and 53 died from Dec. 24 to Dec. 30, according to the New York Times COVID tracker. At least 8,000 individuals died from COVID-19 in Florida in 2023; a figure that could be higher, given that state officials mysteriously added more than 7,100 to the toll on Dec. 18, only to remove them days later, citing “data updates.”
Dr. Lapado’s war on individual rights regarding COVID-19 vaccines started about two years ago.
In March 2022, he announced that healthy children should not receive COVID-19 vaccines, ignoring data showing that more than half of pediatric patients with severe infections did not have underlying medical problems. There have also been more than 1,800 children in the U.S. who have died from COVID-19 since 2020, surpassing the number of children who died from flu or respiratory syncytial virus, or RSV, over the same time.
This was followed by Florida being the only state not to preorder COVID-19 vaccines for children when it was approved for those between six months and five years of age in June 2022. COVID-19’s impact on children was especially significant in the younger populations, as recently shown in the Advisory Committee for Immunization Practices meeting proceedings.
Under pressure from the public and the medical community, the state eventually ordered COVID-19 vaccines for the young age group. However, Florida Department of Health sites, which have historically played an essential role in vaccinating children, did not offer the vaccines for young children. In Florida, everyone doesn’t have easy access to a physician or a pharmacy in their county where vaccines can be administered.
The next step in undermining mRNA vaccines occurred on Oct. 7, 2022. Dr. Ladapo announced that young adult men should not receive COVID-19 vaccines due to an increased risk of cardiac deaths, potentially due to myocarditis. It has since been reported that this recommendation was based on a Department of Health report that he altered to support his conclusions. Of note, the risk of myocarditis following COVID-19 shots and boosters being currently offered is extremely rare, with two cases reported following more than 650,000 doses.
The anti-choice messaging and action continued in September, with the recommendation that individuals less than 65 years of age should not get COVID-19 mRNA vaccines. The Florida surgeon general called receiving such vaccines “anti-human.”
This ignores the fact that since the pandemic began, more than 25 percent of deaths have occurred in people younger than 65 years. His statement came with no recommendations for alternative vaccines or other preventative measures. If that weren’t enough, the Florida Department of Health website previously contained information about COVID-19 control measures and where one could get vaccinated — it is no longer there.
In November, the Florida surgeon general followed that announcement with a campaign event in New Hampshire with Gov. DeSantis, promoting of all things, personal medical freedom.
It is unheard of for a public health official to appear at a campaign event, and the University of Florida, which employs Dr. Ladapo, does not allow political activities during work time. State health officers have an allegiance to the public and public health, and their credibility can be undermined if their actions are viewed as politically motivated.
On Jan. 3, Dr. Ladapo topped all his previous statements by advising that no one should receive COVID-19 mRNA vaccines, not just those younger than 65 years.
We know that this virus is especially severe for those who are older. How will older people be protected if not vaccinated, as COVID-19 mRNA vaccines are nearly universally used? How will we stop the spread of COVID-19 through nursing homes? Let’s not forget that six months after the initial approval of COVID-19 vaccines, Florida led the U.S. in the number of individuals over 65 years who were vaccinated.
In the future, will the Florida Department of Health still offer COVID-19 vaccines at all? Or will new orders stop, and existing COVID-19 mRNA vaccine stocks be returned to the manufacturer?
Florida’s COVID-19 death toll has just reached or is closing in on 100,000. Florida has gone from a state with among the lowest COVID-19 mortality rates in the U.S. over the first 18 months of the pandemic, including the pre-COVID-19 vaccine era, to one of the highest.
As much as we would like to forget the pain, tragedy and social isolation of the pandemic, and as tired we are of hearing about COVID-19, we still need to acknowledge that it is a severe respiratory pathogen that is now with us like the flu. In 2023, there were more than 70,000 deaths due to COVID-19 in the U.S., accounting for 2 percent of deaths from all causes. This greatly exceeds the number of individuals who will die from RSV or flu this year.
But it does not have to be this way. Data clearly show that if even medically vulnerable individuals are up to date on COVID-19 vaccines and get treated with antiviral agents when ill, mortality will be very low.
If we are going to respect the rights of individuals to make their own medical decisions, it is essential that we also respect their right to have accurate information. In doing so, those in public health and medicine must fulfill their obligation to obtain expert and thoughtful input, which is vetted in developing recommendations.
This duty is especially critical for public health officers, who must protect all the people in their state above personal crusades and politics.
Scott A. Rivkees, M.D. is a professor of practice at the Brown School of Public Health. He is the former state surgeon general and secretary of health of Florida.