Florida Surgeon General Joseph Ladapo warns against COVID boosters for people under 65

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Florida Surgeon General Joseph Ladapo on Wednesday recommended against newly federal-approved COVID-19 boosters for people under 65, expressing safety concerns.

Ladapo called for more research prior to widespread administration during a virtual panel, which included Gov. Ron DeSantis alongside several other doctors who have been notoriously critical of COVID-19 vaccinations.

“With virtually every walking human being having some degree of immunity, and the questions we have about safety, and about effectiveness — especially about safety — my judgment is that it’s not a good decision for young people, and for people who are not at high risk at this point in the pandemic,” Ladapo said. “For people who are older, that’s really in Florida where we’re seeing impacts in terms of hospitalizations and deaths.”

Ladapo’s recommendation to medical professionals is not binding, though DeSantis has previously vowed to investigate and potentially punish physicians who have spread what he labels as COVID-19 misinformation.

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In response to Ladapo’s recommendation, University of South Florida associate professor of epidemiology Jason Salemi pointed out that COVID-19 cases are on the rise again. Florida currently has the highest COVID-19 hospitalization rate in the U.S., according to Centers for Disease Control and Prevention data.

The 65 and older age group is at highest risk for severe disease and death after catching the virus, with a 3% death rate, according to both the CDC and Florida Department of Health.

Even though people over 65 make up four out of five of the state’s 90,232 COVID deaths, according to the most recent biweekly report, Salemi emphasized that tens of thousands of people under 65 have died, too.

“COVID-19 clearly has demonstrated the potential to impact people younger than 65,” Salemi wrote in an email to the Orlando Sentinel and several other outlets.

Ladapo’s recommendation comes one day after the CDC’s vaccine advisory panel voted to recommend everyone 6 months and older get an updated COVID-19 vaccine, explaining in a news release that protection from vaccination declines over time and the virus has evolved since the last shots.

The CDC’s recommendation is in line with other countries such as Canada and the European Union, which also recommend the new booster shot for people 6 months and up.

“We have more tools than ever to prevent the worst outcomes from COVID-19,” said CDC Director Dr. Mandy Cohen in a Tuesday news release. “CDC is now recommending updated COVID-19 vaccination for everyone 6 months and older to better protect you and your loved ones.”

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Ladapo multiple times in the roundtable repeated an incorrect assertion that there was “not a drop of clinical trial data” supporting the boosters.

The coming mRNA COVID-19 booster shots, made by Moderna and Pfizer, contain updated spike proteins targeted toward the XBB.1.5 sublineage of COVID-19. Human clinical trials by Moderna indicate these shots boost people’s immune responses against the currently circulating variants, which evolved from XBB.1.5 and are in the same family, according to a news release from the pharmaceutical company. Pfizer’s shot only had preclinical trial data backing it up according to a news release.

Hundreds of millions of doses of this vaccine have been administered so far with few adverse effects and the CDC in its Tuesday news release called its monitoring of people who have received the vaccine so far “the most intense safety monitoring in U.S. history.”

“The external advisory committee to CDC provided a great deal of data that weighs heavily in assessing the risk-to-benefit ratio of a booster shot for many subgroups in our communities,” said Salemi. “No treatment carries zero risk – whether of myocarditis or other adverse events. The question is whether the benefits outweigh those risks.”

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Ladapo has for years asserted that the risks of complications such as myocarditis may outweigh the benefits of COVID-19 vaccination, drawing criticism from federal agencies and peers alike.

In March 2022, Florida became the first and only state to recommend against COVID-19 vaccines for healthy children and later became the only state not to pre-order vaccines for children under 5.

In an October 2022 study led by Ladapo, the Florida Department of Health found that catching COVID-19 was associated with a “substantially higher” risk of both total deaths and cardiac-related deaths.

Ladapo touted a part of the study that he said found that the COVID-19 vaccine was associated with a “modestly increased” risk of cardiac-related deaths, and used that to justify recommending against the vaccine for young men.

Public records obtained by the Orlando Sentinel and South Florida Sun Sentinel revealed Ladapo removed statistical analysis from the study prior to its publication that would have weakened evidence of an association between cardiac-related death and vaccination.

U.S. and world health authorities have studied several instances of rare but serious side effects associated with vaccination, such as myocarditis or a severe allergic reaction, but have concluded that the benefits still outweigh risks.

Ccatherman@orlandosentinel.com; @CECatherman Twitter