Florida’s top health official, who touts unproven COVID-19 treatments, is once again urging a large group of people to skip vaccination, drawing rebuke from doctors who point out his recommendation lacks evidence.
Florida Surgeon General Joseph Ladapo wants men younger than 40 to avoid the Moderna and Pfizer shots, he said Friday in a statement. Ladapo cited an “analysis” done by unnamed authors from the state Health Department, claiming those men faced higher risks of dying from heart problems after inoculation.
“The benefit of vaccination is likely outweighed by this abnormally high risk of cardiac-related death among men in this age group,” the Health Department said Friday.
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Doctors and scientists, as well as the federal government, have since called out Ladapo’s advice, saying the “analysis” it’s based on does not support his conclusion. Florida is the only state that recommends against vaccinating men ages 18 to 39.
“It’s irresponsible for a state health agency to put out something like that,” said Dr. Daniel Salmon, director of the Institute for Vaccine Safety at Johns Hopkins University.
Florida’s eight-page “analysis” does not name its authors, their fields of expertise or their experience. It examined just 20 deaths among men in that age group within four weeks of inoculation.
The state Health Department ignored requests from The Palm Beach Post to provide details on its report, including who conducted the “analysis” and their professional backgrounds. The governor’s office also did not return requests for comment.
Whoever wrote the report said in it that they cannot confirm the underlying cause of those deaths. They could not verify whether anyone they analyzed was infected with COVID. The Health Department also did not compare cardiac death rates among vaccinated younger men to those infected by the respiratory disease.
“If that were submitted to a journal, that would be rejected promptly,” Salmon said.
Using only death certificates can be misleading, doctor says
Another flaw in the state’s reporting — it examined only death certificates. Epidemiologists say those often list cardiac arrest because other diseases cause the heart to stop. Former Palm Beach County Medical Society President Dr. Larry Bush called the state’s examination “a misinterpretation of death certificates.”
Cardiac arrest is often listed on death certificates, Bush said. “It’s the most common pathway to death.”
A death certificate, Bush said, “is really not relevant except in situations like this where people are trying to use it for misinformation or legal situations.”
Ladapo claimed in his Friday statement that men younger than 40 faced an “84% increase” in cardiac-related death within four weeks of mRNA vaccination. He repeated that claim Monday on Fox News’ Tucker Carlson show.
Over the weekend, Twitter removed Ladapo’s statement for spreading COVID misinformation before restoring it.
University of South Florida epidemiologist Dr. Jason Salemi criticized the state Health Department’s report for not comparing the risks of vaccination to its benefits. He also noted that department staff could have analyzed the men’s medical records to see if the causes of death listed there lined up with the death certificates in the state’s report.
“Considering the relatively small sample size, even a modest amount of misclassification of the cause of death could have meaningful implications for the study’s findings,” Salemi said in an email.
Salemi noted that more than 940 COVID deaths among men under 40 were logged during the time frame the Health Department said it examined, Dec. 15, 2020, to June 1 this year.
“Knowing the quality of work that has come from epidemiologists and other scientists at the state Department of Health, I would have fully expected these other issues to be addressed in their analyses,” Salemi said. “Were these assessments really not done, or were they for some reason just not provided with what was shared publicly?”
Risk of heart inflammation alleged
Ladapo tried defending his advice Monday. “Is it really that hard to imagine that mRNA COVID-19 vaccines that increase myocarditis in young men by 10x, 20x, or 30x … also increase the risk of cardiac death in that age group?” he wrote on Twitter.
The “analysis” he cited did not mention myocarditis, known also as heart inflammation. “You’re talking about something that’s really really really rare,” Salmon said.
Out of all age and gender groups, boys ages 12 to 17 may be most likely to develop heart inflammation post-vaccine, according to a December study by a team of scientists led by Dr. Anders Husby of Statens Serum Institut in Denmark. The rate was low, between 1 in 2,500 boys to 1 in 10,000, researchers found.
Federal health officials have also blasted Ladapo’s recommendation.
“This decision is flawed and a far cry from the science: COVID-19 vaccines have been proven safe and effective, and severe adverse reactions are rare,” U.S. Department of Health and Human Services spokeswoman Sarah Lovenheim told The Orlando Sentinel on Monday. “Vaccines were evaluated in tens of thousands of participants in clinical trials and since then, tens of millions of Americans have received COVID-19 vaccines.”
About 14.6% of Floridian men younger than 50 have gotten at least one booster shot, the 17th lowest of all states, CDC data shows. About 60% have gotten the initial Moderna and Pfizer vaccines, or the one-shot Johnson & Johnson dose.
Joseph Ladapo’s history of anti-vaccine messaging
Ladapo has a history of pushing anti-vaccine views.
In June, he advised against inoculating children younger than 5, saying the risks outweighed benefits. Florida was the only state to block pediatricians this past summer from preordering COVID shots for children, infuriating parents statewide.
In March, he advised against vaccinating children ages 5 to 17. Florida is the only state that recommends not vaccinating children against COVID.
Before Gov. Ron DeSantis appointed him as Florida’s top health official, Ladapo touted unproven treatments against COVID. He wrote in support of an anti-parasitic livestock medicine Ivermectin in November 2020 in The Wall Street Journal.
The University of Florida fast-tracked Ladapo’s hiring, knowing that DeSantis was eyeing him in 2021 to replace outgoing predecessor Scott Rivkees, The Tallahassee Democrat reported last year. He had the backing of UF leaders, including major Republican donor and DeSantis supporter Mori Hosseini, Board of Trustees chairman.
A former supervisor of Ladapo’s from the University of California in Los Angeles declined to endorse him for the job, a state background check revealed. “In my opinion the people of Florida would be better served by a surgeon general who grounds his policy decisions and recommendations in the best scientific evidence rather than opinions,” the unnamed ex-boss said.
DeSantis’ core constituency has refused inoculation.
Just 13% of Republicans nationwide said in a September survey by healthcare research group The Kaiser Family Foundation that they plan to get, or have gotten, the latest coronavirus booster shots designed to fight the pathogen’s omicron variant mutations. About 32% of all adults surveyed said same.
States, including Florida, have counted 203 COVID deaths among adults ages 18 to 29 as of July, the U.S. Centers for Disease Control and Prevention reports. Unvaccinated deaths in that age group total 2,527.
Among COVID victims ages 30 to 49, states have counted 2,177 vaccinated victims and 21,235 unvaccinated fatalities.
The data does not break deaths down by gender. The Florida Department of Health could release state-specific numbers on deaths by vaccination status but chooses not to.
“Clearly the vaccines made a difference,” Bush, the Palm Beach County infectious disease specialist, said. “If someone doesn’t want to believe that, then the earth is flat.”
Chris Persaud is The Palm Beach Post’s data reporter. Email him at cpersaud@pbpost.com.
