Florida Releases Anti-Vax Guidance Using Same Argument From Trans Care Bans

The Florida Department of Health announced a recommendation against the use of COVID vaccines, citing a lack of randomized controlled trials, a similar argument it used to attack trans care.

Photo by Hakan Nural on Unsplash

The Florida Health Department released guidance “strongly advising against the use of mRNA COVID-19 vaccines” and urging doctors to avoid administering them. The state justified this recommendation by citing a lack of “booster specific…randomized controlled trials.” This stance sharply contrasts with the guidance from federal agencies and health officials. Notably, the state's rationale mirrors the approach it has taken in its anti-transgender attacks on gender-affirming healthcare—a tactic commonly employed by Florida agencies and many anti-transgender activists.

“The most recent booster approval was granted in the absence of booster-specific clinical trial data performed in humans…Although randomized clinical trials are normally used to approve therapeutics, the federal government has not required COVID-19 vaccine manufacturers to demonstrate their boosters prevent hospitalizations or death from COVID-19 illness,” reads the press release from the Florida Health Department.

This is not the first time Florida has used the absence of randomized controlled trials (RCTs) to justify bans on best-practice medical care—a tactic familiar to the state’s transgender community. During debates by the DeSantis-appointed Florida Board of Medicine over whether to ban gender-affirming care for transgender youth and many adults—a decision they ultimately made in favor of—the Florida Agency for Healthcare Administration issued guidance against transgender healthcare, stating, “There are no randomized control trials on the effectiveness of ‘gender affirming’ treatment.”

Randomized controlled trials are often difficult to perform, take time, and may not be practical. Over 90% of all medical care does not have “high-quality” GRADE scores, which often require randomized controlled trials to receive. This does not mean that the treatments are deficient or harmful, rather, they are driven by other forms of evidence, such as observational studies, which are easier to perform, and individualized patient responses to treatment.

Writing about the decision by the Florida Health Department, prominent physician Dr. David Gorski of Science-Based Medicine calls the decision designed to sow doubt and mistrust against public health: “Notice the methodolatry, defined as the profane worship of the double-blind randomized clinical trial (RCT) above all other forms of evidence and devoid of context regarding whether an RCT would be feasible or practical. Basically, when you see someone invoking RCTs regarding updated vaccines to target variants, you are very likely looking at methodolatry that weaponizes EBM against public health and vaccines to sow doubt and mistrust.”

Gorski has made similar critiques on attacks on transgender healthcare, calling it “an impossible burden of proof for this clinical question” and stating that “As for RCT, there is consensus in the field that such a trial would be unethical given the body of literature we have so far indicating that those in the control group would be likely to suffer adverse mental health outcomes compared to those randomized to the treatment groups.”

Attacks on transgender healthcare often extend beyond the transgender community. The Florida Department of Health is now drawing from its playbook of anti-transgender tactics to target COVID vaccination in the state, despite scientific evidence showing that COVID vaccines reduce the risk of harmful side effects compared to contracting the virus.

The CDC currently recommends everyone older than 6 months get the updated COVID vaccine.