Is Florida’s government doing enough to encourage vaccine in face of COVID surge?

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In January, when the coronavirus vaccines were new, Gov. Ron DeSantis was all over the state touting their availability and efficacy.

In the first month of 2021 alone, DeSantis made at least 27 vaccine-related public appearances. He visited vaccination sites, held news conferences and released videos touting the state’s progress in vaccinating seniors. In those early days, Florida ranked consistently as one of the 10 best states at vaccinating its residents.

Since then, the state’s vaccination rates have lagged considerably. As of Thursday, Florida had inoculated enough residents to rank just 22nd among states in vaccination rate, even though the shots are free and now widely available.

The reasons are complex, with some hesitant because of the speed with which the vaccines were produced, others wary of government intervention and potential side effects, and others still who say they don’t have the time to get the shot or take time off from work to recover. The vaccines have proven to be safe and effective and most recipients suffer no serious side effects.

Still, some experts and physicians say DeSantis has not done enough in recent months to urge Floridians to get vaccinated. Although DeSantis has repeatedly touted the safety and efficacy of the coronavirus shots, critics argue he has put the vaccination effort on the back burner at the worst possible time: ahead of Florida’s summer respiratory virus season.

“While hospitals in our state were filling up, DeSantis was shouting about freedom over Fauci-ism,” Dr. Bernard Ashby, a Miami cardiologist, said on a press call Thursday, referring to jabs DeSantis has taken at infectious disease expert Dr. Anthony Fauci. “DeSantis has been bragging about his so-called better approach to the pandemic for months. But look at us now.”

Coronavirus cases in Florida are rising ‘at an alarming rate,’ surgeon general warns

The call in which Ashby made his remarks was hosted by the Committee to Protect Health Care, a national organization that was founded as a response to then-President Donald Trump’s promise to repeal the Affordable Care Act, also known as Obamacare. The group has more than 400 members in Florida, according to a spokesperson.

On the call, the doctors suggested DeSantis needed to change his messaging around vaccines. For instance, he should stop taking shots at federal authorities like Fauci and focus instead on improving access to healthcare for the state’s residents, they said. Expanding Medicaid under the Affordable Care Act could bring some of Florida’s 2.3 million uninsured adults closer to a trusted medical professional who could convince them to get vaccinated, the doctors said.

The Sunshine State is feeling the consequences of its slowing vaccination effort. Hospital systems all over the state are filling once again with largely unvaccinated COVID-19 patients amid a summer case surge. The hospitalized are younger than in past spikes, and even otherwise spry patients are at risk of serious illness when confronted by the virus’ Delta variant, local officials say.

DeSantis’ office pushed back on the idea that the governor could be doing more to encourage vaccination. In an email, press secretary Christina Pushaw said Florida sent teams to knock on nearly 1.1 million doors in March, April and May to get the word out about vaccines. Those teams answered people’s questions, distributed pamphlets and emphasized reaching “underserved communities,” she said. The Department of Health is also in the middle of a statewide public service messaging campaign around vaccinations, Pushaw noted.

“Since these vaccines received emergency use authorization, Governor DeSantis has made it his top priority to ensure that any Floridian who wants a vaccine can get it,” Pushaw said.

Dr. Frederick Southwick, another of the participants in the Committee to Protect Health Care, said DeSantis still could be making more of a personal effort.

“Those that would be susceptible to advertising have already gotten the vaccine,” said Southwick, an infectious disease specialist. “Governor DeSantis, go to all of these rural communities and talk to the people about getting vaccinated. Tell them you got the vaccine, [and] it didn’t cause a problem. That will have an impact.”

What works, and what doesn’t?

Vaccine hesitancy is not unique to Florida, or to the coronavirus.

Polls show a political polarization in how people view the COVID-19 vaccine, with Democrats more likely to be enthusiastic than Republicans. None of the states that rank ahead of Florida in vaccination rate voted for Donald Trump in 2020. With a treatment that’s so closely tied to trust in the federal government, DeSantis can only do so much to influence hesitancy.

This is especially true for a state whose main message for more than a year was centered on protecting the elderly from the virus, said Mary Mayhew, the president and CEO of the Florida Hospital Association, and a former top DeSantis health official.

“This is just a different age bracket, and it’s going to take a lot of effort and creativity,” Mayhew said.

Pushaw noted that Florida has vaccinated nearly 85% of its seniors. It hasn’t proven as easy to get younger folks to take the shots. For example, just about 47% of Floridians age 30-39 have gotten at least one shot, according to the most recent state report. The disparity between the vaccination rates of older people and younger people is also national trend.

Some have criticized how DeSantis’ vaccine messaging has at times emphasized the importance of personal choice over the efficacy of the vaccines. The governor received a vaccine, but he did not do so in public as many other elected officials have done. (Pushaw said that DeSantis “feels that medical decisions are personal.”)

The governor also pushed for and signed into law a measure that prohibits businesses from asking customers to provide evidence of vaccination upon entry. That same law limits municipalities’ abilities to pass pandemic-related restrictions.

Dr. Jill Roberts, a professor at the University of South Florida’s College of Public Health who specializes in molecular epidemiology, said consistent government messaging around vaccines is key from the federal government down. Mixed messages between the state and federal governments hurt the vaccination effort. And championing personal responsibility is not sufficient when trying to end a pandemic, she said.

“The personal freedom things generally tend to end at the one individual,” Roberts said. “The reality is we have to give up some of those to be a part of a community.”

New year, same virus, different response?

On Wednesday, Jacksonville Mayor Lenny Curry, a Republican, held a news conference with some of his city’s top health officials in which he pleaded with his city’s residents to get vaccinated.

“We need to do what we’re doing today and push, push, push the facts about vaccinations and get people out to get vaccinated,” Curry said.

In some ways, Curry’s event resembled a summer 2020 DeSantis coronavirus press conference. The mayor spoke soberly, surrounded by hospital executives. Last year, DeSantis held numerous events where he discussed the seriousness of the state’s outbreak.

But while local officials sound the alarm across the state, DeSantis has held no such events this month.

Some of that is timing. DeSantis has had to navigate numerous recent crises: the Surfside condominium collapse, a presidential assassination in Haiti, political unrest in Cuba, Tampa Bay’s Red Tide outbreak and a tropical storm.

This summer surge also looks different than last summer’s. Mayhew said the state’s hospitals are prepared to withstand this latest COVID-19 surge. Unlike last summer, personal protective equipment is readily available, and at least some staff members are themselves vaccinated against the virus.

One similarity between the 2020 and 2021 summer surges: the months of relative calm in May and June that perhaps lured Floridians into a false sense of security.

“As things were improving, it’s not surprising that it would reduce the intensity of the focus or of the sensitivity to getting vaccinated,” Mayhew said.

Whatever the reason for the state’s vaccination stagnation, it’s clear that the coronavirus is not finished with Florida. Justin Senior, the CEO of the Safety Net Hospital Alliance of Florida, said that any Floridian expecting to be able to ride out the pandemic without getting vaccinated or infected should reassess.

Roberts, the USF epidemiologist, said the surge of hospitalizations will likely come with one positive side effect for a sick state: vaccine motivation.

“The other thing that also, unfortunately, does work is fear,” Roberts said. “You will see vaccination rates increase as cases increase.”

Clarification: An earlier version of this article used an imprecise figure to illustrate the point that Florida has had a more difficult time vaccinating younger residents than it has giving shots to seniors. The story has been updated, using the latest available data from the state.

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