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Katherine Wells wants to urge her Lubbock, Texas, community to get vaccinated against Covid-19. “That could really save people from severe illness,” said Wells, the city’s public health director.
But she can’t.
A rule added to Texas’ budget that went into effect Sept. 1 forbids health departments and other organizations funded by the state government to advertise, recommend, or even list covid vaccines alone. “Clinics may inform patients that COVID-19 vaccinations are available,” the rule allows, “if it is not being singled out from other vaccines.”
Texas isn’t the only state curtailing the public conversation about Covid vaccines. Tennessee’s health department homepage, for example, features the flu, vaping, and cancer screening but leaves out Covid and Covid vaccines. Florida is an extreme case, where the health department has issued guidance against Covid vaccines that runs counter to scientific studies and advice from the Centers for Disease Control and Prevention.
Notably, the shift in health information trails rhetoric from primarily Republican politicians who have reversed their positions on covid vaccines. Fierce opposition to measures like masking and business closures early in the pandemic fueled a mistrust of the CDC and other scientific institutions and often falls along party lines: Last month, a KFF poll found that 84% of Democrats said they were confident in the safety of covid vaccines, compared with 36% of Republicans. It’s a dramatic drop from 2021, when two-thirds of Republicans were vaccinated.
As new vaccines roll out ahead of the expected winter surge of Covid, some health officials are treading carefully to avoid blowback from the public and policymakers. So far, vaccine uptake is low, with less 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 will see a huge disparity in health outcomes because of changes in language.”
A study published in July found that Republicans and Democrats in Ohio and Florida died at roughly similar rates before Covid vaccines emerged, but a disparity between parties grew once the first vaccines were widely available in 2021 and uptake diverged. By year’s end, Republicans had a 43% higher rate of excess deaths than Democrats.
Public health initiatives have long been divisive — water fluoridation, needle exchanges, and universal health care, to name a few. But the pandemic turned up the volume to painful levels, public health officials say. More than 500 left their jobs under duress in 2020 and 2021, and legislators in at least 26 states passed laws to prevent public officials from setting health policies. Republican Arkansas state Sen. Trent Garner told KFF Health News in 2021, “It’s time to take the power away from the so-called experts.”
At first, vaccine mandates were contentious but the shots themselves were not. Scott Rivkees, Florida’s former surgeon general, now at Brown University, traces the shift to the months after Joe Biden was elected president. Though Florida Gov. Ron DeSantis initially promoted Covid vaccination, his stance changed as resistance to Covid measures became central to his presidential campaign. In late 2021, he appointed Joseph Ladapo surgeon general. By then, Ladapo had penned Wall Street Journal op-eds skeptical of mainstream medical advice, such as one asking, “Are Covid Vaccines Riskier Than Advertised?”
As bivalent boosters rolled out last year, the Florida health department’s homepage removed information on Covid vaccines. In its place were rules against mandates and details on how to obtain vaccine exemptions. Then, early this year, the department advised against vaccinating children and teens.
The state’s advice changed once more when the CDC recommended updated covid vaccines in September.
DeSantis incorrectly said the vaccines had “not been proven to be safe or effective.”
And the health department amended its guidance to say men under age 40 should not be vaccinated because the department had conducted research and deemed the risk of heart complications like myocarditis unacceptable. It refers to a short, authorless document posted online rather than in a scientific journal where it would have been vetted for accuracy. The report uses an unusual method to analyze health records of vaccinated Floridians. Citing serious flaws, most other researchers call it misinformation.
KFF Health News, formerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
