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Coronavirus


HOW LAWMAKERS IN TEXAS AND FLORIDA UNDERMINE COVID VACCINATION EFFORTS

State legislatures and politicians are pressuring public health officials to
keep quiet about Covid vaccines.


A registered nurse administers a dose of a Covid vaccine in St. Petersburg,
Fla., in 2021.Octavio Jones / Reuters
SHARE THIS —
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Nov. 7, 2023, 4:30 AM EST
By Amy Maxmen | KFF Health News

Katherine Wells wants to urge her Lubbock, Texas, community to get vaccinated
against Covid-19. “That could really save people from severe illness,” said
Wells, the city’s public health director.

But she can’t.




A rule added to Texas’ budget that went into effect Sept. 1 forbids health
departments and other organizations funded by the state government to advertise,
recommend, or even list covid vaccines alone. “Clinics may inform patients that
COVID-19 vaccinations are available,” the rule allows, “if it is not being
singled out from other vaccines.”

Texas isn’t the only state curtailing the public conversation about Covid
vaccines. Tennessee’s health department homepage, for example, features the flu,
vaping, and cancer screening but leaves out Covid and Covid vaccines. Florida is
an extreme case, where the health department has issued guidance against Covid
vaccines that runs counter to scientific studies and advice from the Centers for
Disease Control and Prevention.

Notably, the shift in health information trails rhetoric from primarily
Republican politicians who have reversed their positions on covid vaccines.
Fierce opposition to measures like masking and business closures early in the
pandemic fueled a mistrust of the CDC and other scientific institutions and
often falls along party lines: Last month, a KFF poll found that 84% of
Democrats said they were confident in the safety of covid vaccines, compared
with 36% of Republicans. It’s a dramatic drop from 2021, when two-thirds of
Republicans were vaccinated.

As new vaccines roll out ahead of the expected winter surge of Covid, some
health officials are treading carefully to avoid blowback from the public and
policymakers. So far, vaccine uptake is low, with less than 5% of Americans
receiving an updated shot, according to the Department of Health and Human
Services. Wells fears the consequences will be dire: “We will see a huge
disparity in health outcomes because of changes in language.”



A study published in July found that Republicans and Democrats in Ohio and
Florida died at roughly similar rates before Covid vaccines emerged, but a
disparity between parties grew once the first vaccines were widely available in
2021 and uptake diverged. By year’s end, Republicans had a 43% higher rate of
excess deaths than Democrats.

Public health initiatives have long been divisive — water fluoridation, needle
exchanges, and universal health care, to name a few. But the pandemic turned up
the volume to painful levels, public health officials say. More than 500 left
their jobs under duress in 2020 and 2021, and legislators in at least 26 states
passed laws to prevent public officials from setting health policies. Republican
Arkansas state Sen. Trent Garner told KFF Health News in 2021, “It’s time to
take the power away from the so-called experts.”

At first, vaccine mandates were contentious but the shots themselves were not.
Scott Rivkees, Florida’s former surgeon general, now at Brown University, traces
the shift to the months after Joe Biden was elected president. Though Florida
Gov. Ron DeSantis initially promoted Covid vaccination, his stance changed as
resistance to Covid measures became central to his presidential campaign. In
late 2021, he appointed Joseph Ladapo surgeon general. By then, Ladapo had
penned Wall Street Journal op-eds skeptical of mainstream medical advice, such
as one asking, “Are Covid Vaccines Riskier Than Advertised?”

As bivalent boosters rolled out last year, the Florida health department’s
homepage removed information on Covid vaccines. In its place were rules against
mandates and details on how to obtain vaccine exemptions. Then, early this year,
the department advised against vaccinating children and teens.



The state’s advice changed once more when the CDC recommended updated covid
vaccines in September. DeSantis incorrectly said the vaccines had “not been
proven to be safe or effective.” And the health department amended its guidance
to say men under age 40 should not be vaccinated because the department had
conducted research and deemed the risk of heart complications like myocarditis
unacceptable. It refers to a short, authorless document posted online rather
than in a scientific journal where it would have been vetted for accuracy. The
report uses an unusual method to analyze health records of vaccinated
Floridians. Citing serious flaws, most other researchers call it misinformation.

Scientifically vetted studies, and the CDC’s own review, contradict Florida’s
conclusion against vaccination. Cases of myocarditis following mRNA vaccines
have occurred but are much less frequent than cases triggered by covid. The risk
is sevenfold higher from the disease than from mRNA vaccines, according to an
analysis published in a medical journal based on a review of 22 other studies.


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Since leaving his post, Rivkees has been stunned to see the state health
department subsumed by political meddling.

About 28,700 children and adults from birth to age 39 have died of Covid in the
United States. Florida’s anti-vaccine messaging affects people of all ages,
Rivkees added, not just those who are younger.



He points out that Florida performed well compared with other states in 2020 and
2021, ranking 38th in Covid deaths per capita despite a large population of
older adults. Now it has the sixth-highest rate of Covid deaths in the country.

“There is no question that the rise of misinformation and the politicization of
the response has taken a toll on public health,” he said.

As in Florida, the Texas health department initially promoted Covid vaccines,
warning that Texans who weren’t vaccinated were about 20 times as likely to
suffer a Covid-associated death. Such sentiments faded last year, as state
leaders passed policies to block vaccine mandates and other public health
measures. The latest is a prohibition against the use of government funds to
promote Covid vaccines. Uptake in Texas is already low, with fewer than 4% of
residents getting the bivalent booster that rolled out last year.

At Lubbock’s health department, Wells managed to put out a press release saying
the city offers Covid vaccines but stopped short of recommending them. “We
aren’t able to do as big a push as other states,” she said.



Some health officials are altering their recommendations, given the current
climate. Janet Hamilton, executive director at the Council of State and
Territorial Epidemiologists, said clear-cut advice to get vaccinated against
Covid works when people trust the scientific establishment, but it risks driving
others away from all vaccines. “It’s important for public health to meet people
where they are,” Hamilton said.

Missouri’s health department took this tack on X, formerly known as Twitter:
“COVID vaccines will be available in Missouri soon, if you’re in to that sort of
thing. If not, just keep scrolling!”

KFF Health News, formerly known as Kaiser Health News (KHN), is a national
newsroom that produces in-depth journalism about health issues and is one of the
core operating programs at KFF — the independent source for health policy
research, polling, and journalism.

Amy Maxmen | KFF Health News

Amy Maxmen | KFF Health News



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