OPINION: Florida's Surgeon General Is Sending a Dangerous Message

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At the end of a roundtable discussion last week, Florida's new surgeon general, Joseph Ladapo, MD, PhD, announced that COVID-19 vaccines are not recommended for "healthy children." This came as a complete shock to the scientific community, including pediatricians across the country.

A critical question to ask the surgeon general is: How do you define "healthy?" Would a child with asthma be considered "healthy?" Would a child who is overweight or obese be considered "healthy?" In many cultures, the parents may answer yes. Yet, one in four children in the state has a comorbidity such as asthma, obesity, diabetes, or seizures that increases the risk of having a more severe case if infected with COVID-19. Florida's rate for overweight and obesity in children ages 2 to 18 is more than 25%.

So, what was Ladapo's rationale for making this statement, which goes against CDC's recommendation? The Florida surgeon general said the risks of vaccination are higher than the risks of infection. This is false.

We have been in pandemic mode for more than 2 years and almost a million lives have been lost in the U.S. Thousands of people have been left with lingering symptoms such as exhaustion, respiratory issues, loss of smell, and headaches. People have had lung transplants or ended up in rehabilitation centers, relearning how to walk after being hospitalized and intubated for weeks to months. Yes, it's true that children have not suffered as severely; many children do get milder illnesses -- but they are still at risk. More than 1,000 children have died from COVID-19. Kids may suffer multisystem inflammatory syndrome in children (MIS-C), where different organs become inflamed. Research shows somewhere between 2% to 50% of kids with COVID-19 suffer from long-COVID symptoms, with some experts suggesting the number is close to 10%.

I've seen the impact of pediatric COVID-19 first-hand. One 2-year-old patient, a previously healthy child, had respiratory issues for months after infection. The main symptom was that she would stop playing and go lie down because she was having trouble breathing. Thankfully, after 4 months of inhaled corticosteroids, she improved. I saw an 11-year-old with panic attacks that started after a COVID-19 infection, leading to emergency department visits for chest pain. She was diagnosed with anxiety, is now taking medication, and is in therapy. I also took care of an 18-year-old with autism and a history of hypertension who had been admitted several times with uncontrolled blood pressure and subsequently developed type 2 diabetes. We cannot always predict who will have a worse COVID-19 infection, nor who will have sequela.

After 2 years of educating parents about the risks of this illness, 2 years of being supportive to parents and kids who have had to home school, and 2 years of seeing many kids left behind or suffering from anxiety and/or depression, I'm now supposed to say their kids shouldn't get vaccinated? That the long-awaited vaccines for younger persons, which we know are safe and effective in protecting children (ages 5 and older) against severe disease and long-COVID -- and are the only way we can end this pandemic -- don't really work? No way! I understand the data, I have spent my Sundays reading journals, studies, and yes, even following the media. Everyone who can be vaccinated should get vaccinated. The evidence is clear that the risk of vaccination does not outweigh the risk of the infection.

Following this roundtable discussion with Ladapo, which had no pediatricians at the table, the American Academy of Pediatrics and the Florida Chapter of the American Academy of Pediatrics responded with a joint official statement recommending all eligible children and adults get the vaccine as soon as they are able. Evidence shows that vaccinated persons are significantly less likely to get very sick and need hospital care. The vaccine offers children the best opportunity to continue in-person learning, which is vital to their mental and emotional health. It allows them to partake in family gatherings, school, and social activities without as much fear of illness.

Over the past 2 years, many parents have come in with questions; many have expressed their concerns, their worries. I have also seen several families personally affected by COVID-19, parents now unable to work due to ongoing symptoms, kids left without a parent due to death. It has been a grueling time for the families, my coworkers, and myself. But the data are clear: vaccination decreases severe illness and deaths, and the surgeon general bucking the recommendations of science -- of the CDC, FDA, healthcare workers, medical societies, and pediatricians -- just makes it more confusing for families.

Since Ladapo's announcement, parents have continued to ask me what I think. I share with them the data and strongly recommend vaccination. I share the information that has come out of the studies and scientific reviews, provide insights into the situation in hospitals, and offer guidance on where to go to get the vaccination, including the vaccine fairs available in our clinic. Florida's vaccination rate for children trails other large states including California, New York, and Texas. In Florida, the fully vaccinated rates are 18.8% for kids ages 5 to 11 and 54.7% for those ages 12 to 17.

Our leaders must share a unified message to protect Florida's children. Vaccinations by far have been the biggest success in public health. How many of our younger doctors and doctors in training have seen a child die from vaccine-preventable diseases such as epiglottitis, tetanus, or measles? Vaccines have saved millions of lives. Since spring 2021, COVID-19 vaccination has been recommended for those 12 years of age and older. We can now vaccinate children 5 years of age and older. Let's stick with the science and universally recommend protecting our children.

Thresia B. Gambon, MD, MBA, MPH, is vice president of the Florida Chapter of American Academy of Pediatrics, and a pediatrician in Miami.