Doctors with the Florida chapter of the American Academy of Pediatrics are speaking out against recent COVID-19 vaccine guidance from the Florida Department of Health and state surgeon general Dr. Joseph Ladapo. The recommendation says healthy children may be better off not getting the shots.
State health officials say kids ages five to 17 with underlying conditions are the "best candidates" for COVID vaccines but they argue other kids have little to no risk of developing severe illness.
RELATED: Florida's new COVID vaccine guidance for "healthy" kids 5-17
It's true that children aren't nearly as likely to go to the hospital or die from COVID as adults. But Dr. Mobeen Rathore, professor and associate chair of the department of pediatrics at the University of Florida’s College of Medicine in Jacksonville, said he and other physicians have still treated children for COVID who were otherwise healthy.
“We see these sick children who don't need to be that sick if they would have gotten the vaccine,” he said. “And you know, tell that to a parent whose child is in the ICU or is very ill or intubated or very sick, ‘Oh, you know, most children don't really get very sick with this,’ and see the reaction you get.
“I think that's really sad that we feel that it’s ok for some children to get sick, get hospitalized and die of this disease, when we could clearly prevent that.”
Contradicting advice
The state also points to a recent study from New York that found the Pfizer vaccine's effectiveness reduced dramatically in children in just a couple months amid the omicron surge. That variant proved to evade vaccines more successfully than others in all age groups.
Kids younger than 12 receive doses that are a third of the size of doses that teens and adults get, and authors of the study suspect that could have contributed to the sharp decline in effectiveness at preventing infection.
But they found the shots still were successful at protecting kids against severe disease. That’s why they continue to recommend vaccination (read "Conclusions and Relevance" section of report).
Rathore said state officials fail to acknowledge that in their guidance.
“You know they have picked and choosed (sic) some stuff but ignored others,” he said.
Health News Florida asked the department of health why it would use a study that concluded all kids should get vaccinated to defend its guidance.
Spokesman Jeremy T. Redfern replied, “The researcher’s conclusions are their assessment of the data. The Surgeon General disagrees."
"Disagreements on conclusions are normal during the scientific process, and it is what helps science progress," he went on. “Remember: Dr. Ladapo is a physician, but he is also a research scientist. He spends a lot of time reviewing the relevant scientific literature.”
Rathore said Ladapo's interpretation of the data from that study concerns him.
“The question is do we increase the dose of the vaccine, do we increase the schedule, meaning give more vaccine shots — the answer is not to stop giving the vaccine,” he said.
What about myocarditis?
Ladapo’s guidance cautions the risks from COVID vaccines may outweigh the benefits for kids without underlying conditions. He focuses on myocarditis, which occurs when the heart muscle becomes inflamed. Some symptoms include chest pain and irregular heartbeat.
The state points to a study that found more cases of myocarditis occurred after COVID vaccination than expected, especially in adolescent males. But Rathore said state officials don't put things in perspective.
“You know millions and millions of doses of this vaccine have been given and myocarditis has not come out as a major issue,” he said. “I won't say it doesn't happen, it does, but I think any risk the vaccine may pose because of myocarditis is so small compared to the benefit the vaccine provides.”
That study found 1,626 cases that met the definition of myocarditis among more than 192.4 million people vaccinated. That's .0008%.
The rates were higher among adolescent males, particularly after the second dose of vaccine, though they were still very low. The study found 70.7 cases per million doses in boys aged 12 to 15, or .007%, and 105.9 cases per million doses in teens aged 16 to 17 years, or .01%.
Researchers also provided context (read 'Discussion' section of report), saying young men are more likely to get myocarditis in general, and that symptoms in people who got it after getting vaccinated resolved faster than in typical myocarditis, which is usually caused by viral infection.
The Centers for Disease Control points out people are much more likely to get myocarditis from COVID infection.
A report published last September recorded about 150 cases of myocarditis per 100,000 COVID-19 patients, and found COVID patients’ risk for developing the condition was about 16 times higher than non-COVID patients.
Among COVID patients, scientists found older adults were most likely to develop myocarditis, followed by children younger than 16, who had a .133% risk.
Rathore said the virus can also cause other rare but serious complications in kids, such as multisystem inflammatory syndrome or long COVID.
He is urging all kids ages five and older to get vaccinated.
“You know, the health of our children and all of our citizens is paramount and vaccines are really the best tool, if you will, in our toolkit,” Rathore said.
Another tool is natural immunity to the virus. State health officials say a large number of kids already have built up protection against COVID, citing the CDC’s seroprevalence survey that uses antibodies present in blood samples to estimate how much of the population has had the virus.
Rathore said existing immunity is important to protect the community, but is not enough to end the pandemic long-term.
As with vaccine-acquired protection, data shows natural immunity to COVID wanes over time. Since scientists don't expect the virus to go away anytime soon, families have a choice moving forward: get their kids a shot to boost that immunity, or risk them getting sick again.
