ST. PETERSBURG, Fla — In an unprecedented step, Florida’s surgeon general announced the state’s health department will no longer recommend “healthy” children be vaccinated against COVID-19.
The new guidance doesn’t specify criteria for “healthy.” It contradicts recommendations from the Centers for Disease Control and Prevention and the American Academy of Pediatrics.
Gov. Ron DeSantis said studies show there is “very little benefit” for healthy kids to get the vaccine.
In its official guidance, the state’s health department said, “healthy children aged 5 to 17 may not benefit from receiving the currently available COVID-19 vaccine,” and that “there are certain risks to consider that may outweigh benefits among healthy children.”
Children with underlying conditions are the best candidates for the vaccine, the state says.
The health department cites data from a New York state study – which has yet to be peer-reviewed – and concerns raised by an FDA advisory committee on vaccines and myocarditis in children.
The New York State Department of Health study analyzed data from more than 365,000 fully vaccinated children aged 5-11 years old and more than 850,000 children aged 12-17 years old at the peak of the omicron surge — mid Dec. 2021 – January
Protection from infection decreased from 68 percent to 12 percent in younger kids and was around 51 percent in older kids.
Protection from hospitalization was around 48 percent in younger kids and 73 percent in older kids.
Dr. Sonja Rasmussen, a pediatrician and epidemiologist with the University Florida, said the main takeaway is that the vaccines are still largely effective at preventing hospitalization and death, even if they aren’t as effective at preventing infection.
“Of course we also know omicron was a variant when the vaccine wasn’t as protective, so I think it makes sense they can see some waning,” she said. “We also know kids 5-11 haven’t gotten a booster yet.”
The CDC recently published data from 10 states from last April to January that showed similar waning in protection against hospitalization and severe illness.
Protection from hospitalizations dropped to 46 percent for younger kids 5-11 years old and was similarly lower for older kids. But, notably, protection for older children who were boosted rose to 81 percent.
Pfizer currently is testing a booster dose for 5- to 11-year-olds.
Florida’s health department also cited concerns raised by an FDA advisory committee in October about myocarditis – inflammation of the heart muscle – in teens who get the vaccine.
But Dr. David Berger, a Tampa pediatrician who often works with skeptical parents given he accepts families at his office who don’t follow the traditional vaccination schedule, said myocarditis after vaccine, while possible, continues to be an extremely rare occurrence.
“Yes myocarditis can happen following the vaccine, especially in adolescent males,” he said.
“But we also know that COVID (infection) can cause myocarditis which is more severe than the myocarditis one could get from the vaccine – even though both are incredibly rare situations.”
The risk of vaccine-induced myocarditis in children is low, according to a December study published in the Journal of the American Medical Association. This is the same study cited by the Florida Department of Health. It found it was around 70 cases per million vaccine doses in boys between 12 – 15 years old and 105 per one million doses in 16-17-year-olds.
Those cases were mild compared to cases brought on by the virus itself, the study finds.
Both doctors say available data continues to show the benefits of the vaccine generally outweigh the risks.
“Lots of things that we do that are prevention are not perfect," Rasmussen said. "But we still do it because we know it provides some protection.”
Berger said it's a decision that each family must make for themselves, but he sees no reason for a government health agency to advise against children receiving the COVID vaccine.
“I call out people on both sides of being too absolutist and not recognizing this is a subtle but important decision that each family has to make," he said.