As the Covid wave continues in Florida, Gov. Ron DeSantis' administration is again advising against mRNA vaccines — this time for the most vulnerable residents.
In the updated guidance for healthcare providers In a statement released Thursday, the Florida Department of Health and state Surgeon General Joseph Ladapo questioned the safety and effectiveness of the Pfizer and Moderna mRNA Covid vaccines, including for older adults and people with underlying health conditions. “Any provider concerned about the health risks associated with Covid-19 for patients 65 years of age or older or with underlying health conditions should prioritize patient access to non-mRNA Covid-19 vaccines and treatment,” according to the state guidance.
Contrary to advice from federal health agencies and other medical experts on the safety of Covid vaccines, the Florida Department of Health said the recommendation was based on high rates of immunity from prior infection and “currently available data.”
Without mentioning the high risk of severe Covid infection or hospitalization for older adults, the guidance listed safety concerns for mRNA vaccines, including the risk of a rare heart condition called myocarditis, as well as the risk of POTS, or postural orthostatic tachycardia syndrome, a debilitating heart condition.
Numerous studies have shown that both the Pfizer and Moderna vaccines are indeed associated with a small but increased risk of myocarditis. However, most cases occur in young men and most people make a full recovery. Studies have also shown that the risk of myocarditis is much higher in the case of COVID-19 infection and is often more severe than the vaccine-associated condition.
A study published in Nature Cardiovascular Research also found that people diagnosed with Covid are five times more likely to develop POTS after infection than after Covid vaccination, emphasising the importance of the vaccine.
Dr. Paul Offit, a vaccine expert at the Children's Hospital of Philadelphia, said the Florida surgeon general's guidance is unnecessarily alarming people about Covid vaccines.
“It's a very dangerous game that they're playing,” said Offit, who has served on the FDA's independent vaccine advisory committee. “You're only about 1,000 times more likely to die.” [from Covid] “If you are over 65, more than if you are under 18.”
“mRNA vaccines are remarkably safe,” he added.
In August, the Food and Drug Administration approved new doses of the Pfizer and Moderna vaccines. Experts say they target the constantly mutating KP.2 version of the virus and should provide good protection against severe disease, hospitalization and death.
The United States offers only one non-mRNA-based COVID-19 vaccine: Novavax. Novavax's traditional protein-based vaccine offers an alternative vaccine technology to mRNA.
In a statement, a Novavax spokesperson said its updated vaccine is now available at thousands of retail locations and pharmacies nationwide.
The Florida Department of Health did not immediately respond to a request for additional comment.
Dr. Isaac Bogoch, an infectious disease specialist at the University of Toronto, called Florida's recommendation “unfortunate” and said it could put older adults and people with underlying health conditions at risk.
“While the vaccine does not protect against infection as well as it once did, there is very good data showing how COVID vaccines can reduce the risk of severe COVID-19 in those most at risk,” said Boguch, who has no ties to the vaccine makers.
Covid cases remain high in the US after a summer surge. Wastewater data collected between August 25 and 31 show that 23 states, including Florida, are reporting “very high” levels of the virus, according to the CDC. Emergency room visits and hospitalizations also remain elevated, though they show signs of declining. In Florida nursing homes, after declining from summer highs, Covid infections are rising again, according to CDC data.
The CDC currently recommends that everyone 6 months or older get an up-to-date COVID vaccine this fall, through any of the three options.
This is not the first time Ladapo has ignored CDC recommendations. Last year, Ladapo also recommended that Florida residents under 65 not get the mRNA COVID-19 vaccine, citing widespread immunity and the “questions we have about safety and efficacy.”
“My view is that it's not a good decision for young people and for people who are not at high risk at this time of the pandemic,” he said.
