This week, news broke that Florida's Department of Health will recommend against healthy children getting vaccinated against COVID-19, defying federal guidance from the Centers for Disease Control and Prevention (CDC) and numerous other scientists and public health experts.
"The Florida Department of Health is going to be the first state to officially recommend against the COVID-19 vaccines for healthy children," Florida Surgeon General Joseph Ladapo said during a Monday roundtable with experts. As it stands, a formal policy around the agency's soon-to-be guidance remains unclear, as does what will be included in the designation "healthy children." But Ladapo noted Florida was the first state to issue such a recommendation — and it is one that many infectious disease doctors and pediatricians are forcibly pushing back against.
Indeed, Florida's announcement has stunned health officials, who characterized it as a concerning trajectory for children in the Sunshine State. Doctors whom Salon spoke with were disturbed by a public health official making a recommendation with no basis in science, concerned about how this will be perceived by parents who can more easily get caught up in the throes of misinformation, and — most importantly — fearful for the health and safety of children.
"It has never been more important to look at the source of recommendations, and whether the recommendations are coming from a specific political agenda and conspiracy theories, or from mainstream scientific data," Dean Blumberg, chief of pediatric infectious diseases and associate professor in the Department of Pediatrics at the University of California, Davis, told Salon. "The American Academy of Pediatrics (AAP), the Pediatric Infectious Disease Society, and a host of mainstream respected professional medical organizations wholeheartedly recommend Covid vaccines for children."
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Indeed, AAP President Moira Szilagyi released a statement confirming that the agency — which represents 67,000 pediatricians across the country — will still recommend vaccines to eligible children.
"The American Academy of Pediatrics continues to recommend the COVID-19 vaccine as the best way to protect every eligible child from COVID-19. Children can get sick from Covid, and some get very sick," Szilagyi said. "Children make up a significant part of our population, and vaccinating children must be part of our strategy to control this virus so it cannot continue to spread."
While children are at a much lower risk from COVID-19 than adults, they still can get the disease and face severe outcomes. According to the AAP's most recent report, over 12.7 million children have tested positive for COVID-19 in the United States since the beginning of the pandemic as of March 3, 2022. The omicron variant led to a huge spike in pediatric cases— over 4.8 million since the beginning of January. Since not all states report children's hospitalizations and deaths from COVID-19, there isn't a precise number for hospitalizations; however, AAP estimates that between 1.3 percent to 4.7 percent of infected children have been hospitalized. The AAP also estimates that up 0.01 percent of children who have been infected with COVID-19 have died from it, according to the data from the states that are reporting pediatric mortalities.
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There's also the risk of long Covid, which can affect children even after a mild infection. Data is limited on how frequent and common this is among young children and adolescents, but the symptoms can be debilitating. One study suggested as high as 10 percent of children afflicted with COVID-19 will develop long Covid.
Yet there is plenty of data that shows that the COVID-19 vaccines are safe for children — and that they reduce the risk of infection, hospitalization, ICU admission, and multisystem inflammatory syndrome in children (MIS-C), which can be serious and is associated with COVID-19. During the omicron surge, hospitals saw a surge in hospitalizations among children under the age of 5 — the cohort that still remains ineligible for vaccination. Yet only 26 percent of children aged five to 11 are vaccinated in the U.S., and 57 percent of adolescents aged 12-17 are fully vaccinated. In Florida, an estimated 68.9% of the overall population is vaccinated.
Amesh Adalja, an infectious disease and critical care medicine doctor, told Salon "there is no basis for a blanket recommendation against COVID vaccination for children."
"While it is true that children are spared the severe consequences of COVID-19 for the most part, the vaccine is safe and something that does offer a benefit to the individual child," Adalja said.
Experts say the responsibility will be on pediatricians in Florida to accurately inform parents about the effectiveness and importance of COVID-19 vaccines for kids. After Ladapo's comments, the Florida Chapter of the American Academy of Pediatrics (FCAAP) released a statement in support of the vaccines for kids, too.
"The COVID-19 vaccine is our best hope for ending the pandemic," said FCAAP President Lisa Gwynn, adding that Ladapo's comments "misrepresent the benefits of the vaccine, which has been proven to prevent serious illness, hospitalizations and long-term symptoms from COVID-19 in children and adolescents, including those who are otherwise healthy."
Gwynn added: "There is widespread consensus among medical and public health experts about the life-saving benefits of this vaccine."
Andrew Pavia, MD, chief of pediatric infectious diseases at the University of Utah, told Salon the announcement is certainly "confusing to parents and harmful to children."
"They are not based, as far as anyone can tell, on careful balancing of the obvious benefits and very limited risks. It does not appear to be based on any reliable research," Pavia said. "Parents should get their advice from their pediatrician and from vaccine experts like those advising CDC and FDA, not from politicians and their appointees."
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