Catherine Wells wants to urge her community in Lubbock, Texas to get vaccinated against Covid-19. “It can really save people from serious illness,” said Wells, the city’s director of public health.
But he can’t.
A rule was added to the Texas budget that took effect in September. 1 Prohibits the Department of Health and other state government-funded agencies from advertising, recommending or listing only the Covid vaccine. “Clinics may inform patients that a COVID-19 vaccine is available,” the rule allows, “if it is not separated from other vaccines.”
Texas isn’t the only state to curtail public conversation about the Covid vaccine. The Tennessee Department of Health’s homepage, for example, features the flu, vaping and cancer but leaves out screenings for Covid and Covid vaccines. Florida is an extreme case, where the Department of Health has issued guidelines against Covid vaccines that run counter to scientific research and advice from the Centers for Disease Control and Prevention.
Notably, the change in health information comes largely from Republican politicians who have reversed their position on the Covid vaccine. Strong opposition to measures like masks and business closures early in the pandemic fueled distrust of the CDC and other scientific institutions and often fell along party lines: Last month, a KFF poll found that 84% of Democrats said they were confident in the safety of the Covid vaccine, compared to 36% of Republicans. compared to That’s a dramatic drop from 2021, when two-thirds of Republicans were vaccinated.
As new vaccines are being developed ahead of an expected winter wave of Covid, some health officials are treading carefully to avoid pushback from the public and policymakers. So far, vaccine uptake is low, with fewer 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’re going to see huge disparities in health outcomes because of language change.”
A study released in July found that Republicans and Democrats in Ohio and Florida died at roughly the same rate before the Covid vaccines became available, but disparities between the parties widened after the first vaccines became widely available in 2021 and uptake varied. By the end of the year, Republicans had a 43% higher excess death rate than Democrats.
Public health initiatives have long been divisive — water fluoridation, needle exchange and universal health care, to name a few. But the pandemic has turned the volume to painful levels, public health officials say. More than 500 people quit their jobs in 2020 and 2021, and at least 26 state legislators have passed laws to prevent public officials from setting health policy. Republican Arkansas state Sen. “It’s time to take the power away from the so-called experts,” Trent Garner told KFF Health News in 2021.
At first, the vaccine order was controversial but the shots themselves were not. Scott Rivkis, Florida’s former surgeon general, now at Brown University, sought the transfer months after Joe Biden was elected president. Although Florida Gov. Ron DeSantis initially promoted covid vaccination, his position changed as prevention of the covid system became a focus of his presidential campaign. In late 2021, he appointed Joseph Ladapo as Surgeon General. By then, Ladapo had written a Wall Street Journal op-ed skeptical of mainstream medical advice, such as one asking, “Are Covid vaccines riskier than advertised?”
The Florida Department of Health’s homepage removed information on the Covid vaccine as the bivalent booster was introduced last year. In its place were rules against mandates and details on how to get vaccine exemptions. Then, earlier this year, the department advised against vaccinating children and teenagers.
State advice changed once again when the CDC recommended an updated Covid vaccine in September. DeSantis incorrectly stated that vaccines “have not been proven safe or effective.” And the Department of Health revised its guidelines to say men younger than 40 should not be vaccinated because the department conducted research and estimated the risk of heart complications, such as myocarditis, to be unacceptable. It refers to a short, authoritative document posted online rather than in a scientific journal where it would have been scrutinized for accuracy. The report used an unusual method to analyze the health records of vaccinated Floridians. Citing serious flaws, most other researchers call it misinformation.
Scientifically tested studies, and the CDC’s own review, contradict Florida’s conclusion against vaccination. Cases of myocarditis have occurred after mRNA vaccine but are much less frequent than cases caused by Covid. According to an analysis published in a medical journal based on a review of 22 other studies, the risk of the disease is seven times higher than with mRNA vaccines.
Since leaving his post, Rivkis has been shocked to see the state’s health department mired in political interference.
About 28,700 children and adults from birth to age 39 have died from Covid-19 in the US. Florida’s anti-vaccine messaging affects people of all ages, Rivkis added, not just the young.
He noted that Florida fared better than other states in 2020 and 2021, ranking 38th in per capita Covid deaths despite having a large population of older adults. It now has the sixth-highest rate of Covid deaths in the country.
“There is no question that the rise of misinformation and the politics of backlash has had an impact on public health,” he said.
Like Florida, the Texas Department of Health initially promoted the Covid vaccine, warning that Texans who had not been vaccinated were nearly 20 times more likely to die of Covid-related deaths. Such sentiments faded last year, as state leaders passed policies blocking vaccine mandates and other public health measures. The latest is the prohibition against using government funds to promote the Covid vaccine. Uptake in Texas is already low, with less than 4% of residents receiving the bivalent booster introduced last year.
In Lubbock’s health department, Wells was able to get a press release out saying the city offers Covid vaccines but stops recommending them. “We are not able to push as big as other states,” he said.
Some health officials are changing their recommendations in light of the current climate. Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists, said clear advice to vaccinate against Covid comes when people trust the scientific body, but this risks turning others away from vaccines altogether. “It’s important for public health to meet people where they are,” Hamilton said.
The Missouri Department of Health adopted this measure
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