An anesthesiologist friend who lives in Orlando refers to her state as "Flori-Dumb," mainly because of the danger to public health posed by misinformation and disinformation from Florida's Surgeon General, Dr. Joseph Ladapo. Like a bizarre character from the fictional books of Florida writer Carl Hiaasen, who once depicted a crazed governor fleeing into the Everglades and living on roadkill, Ladapo seems to be scientifically illiterate and completely clueless about the danger of infectious respiratory diseases such as COVID-19, how they're spread, and how they can be prevented.
Ladapo has long questioned the safety of COVID vaccines and early in the pandemic joined a petition opposing the FDA's rapid Emergency Use Authorizations of the Pfizer and Moderna mRNA vaccines. He also wrote op-ed articles that criticized community lockdowns and the use of facemasks.
In February, Ladapo sent a letter to FDA Commissioner Robert Califf and CDC Director Rochelle Walensky that was filled with erroneous claims about dangers of the mRNA vaccines (and in which he even misspelled the city in which FDA's headquarters are located). Some of the data in the letter appeared to be completely fabricated — that is, inconsistent with safety data found elsewhere, and it was clear that Ladapo fails to understand the purpose and mode of reporting of vaccine side effects, or "adverse events," to the federal Vaccine Adverse Event Reporting System (VAERS). Ladapo cited numbers of adverse effects from the vaccines reported to VAERS, but as spelled out clearly on the CDC website, "As an early warning system, VAERS cannot prove that a vaccine caused a problem. Specifically, a report to VAERS does not mean that a vaccine caused an adverse event."
And yet, Ladapo's condemnation of the mRNA vaccines is based almost entirely on reports to VAERS.
The FDA's Califf and CDC's Walensky did not allow Ladapo's misapprehensions and misrepresentations go unchallenged. They sent him a scathing four-page letter, condemning his assertion that COVID-19 vaccines are "harmful."
"The claim that the increase of VAERS reports of life-threatening conditions reported from Florida and elsewhere represents an increase of risk caused by the COVID-19 vaccines is incorrect, misleading and could be harmful to the American public," they wrote. "Reports of adverse events to VAERS following vaccination do not mean that a vaccine caused the event."
Their letter concluded: "Misleading people by overstating the risks, or emphasizing the risks without acknowledging the overwhelming benefits, unnecessarily causes vaccine hesitation and puts people at risk of death or serious illness that could have been prevented by timely vaccination."
Even if Ladapo doesn't trust federal officials, there are other reliable sources. For example, an analysis by The Commonwealth Fund, a nonprofit that conducts independent health care research, has estimated that COVID-19 vaccination in the U.S. prevented more than 3 million additional deaths, 18.5 million additional hospitalizations, and 120 million more cases from December 2020 through November 2022.
But there's more. Ladapo's announcement last October that young men should not get the COVID-19 vaccine, which was based on a state analysis that purportedly showed that the risk of cardiac-related deaths increased significantly for some age groups after receiving a vaccine, runs counter to medical advice issued by the CDC. However, it appears Ladapo himself improperly manipulated the Florida data: The early drafts of the analysis showed that a COVID infection could increase the risk of a cardiac-related death more than vaccination, but that information was missing from the final version put out by the Florida Department of Health.
Ladapo's recommendation and the state's analysis have been excoriated by experts, including professors and epidemiologists at the University of Florida, where he is a professor. Matt Hitchings, an infectious disease epidemiologist and professor of biostatistics at the university, said it seems that sections of the analysis were omitted simply because they did not fit the narrative the surgeon general was pushing. He added, "This is a grave violation of research integrity."
Florida, the third most populous state in the U.S., has the highest percentage of seniors, and is woefully under-vaccinated — almost certainly in part because of the anti-vaccine advocacy by the state's surgeon general. That makes him responsible for many of the roughly 90,000 COVID deaths in Florida during the pandemic thus far. Because of the legal principle of qualified immunity, Ladapo is unlikely to see the inside of a courtroom, but I believe there are several sanctions that he deserves.
The first is the obvious one: Now that Ladapo has been approved for his next term by the Florida Senate, it's up to Gov. Ron DeSantis to fire Ladapo for professional misconduct that has harmed the citizens of Florida. In fact, DeSantis should not have appointed him to the surgeon general's position in the first place.
Second, the University of Florida College of Medicine should strip him of his faculty position, citing professional misconduct. In addition to the improper manipulation of the data in the vaccination study, it is noteworthy that a faculty committee found that in Ladapo's hiring there were numerous "irregularities" that were of concern and "appeared to violate the spirit, and in review, the exact letter, of UF hiring regulations and procedures, particularly in the vital role faculty play in evaluating the qualifications of their peers."
Third, the website of the Florida Board of Medicine says that it "was established to ensure that every physician practicing in this state meets minimum requirements for safe practice" and that it "will license, monitor, discipline, educate and when appropriate, rehabilitate physicians and other practitioners to ensure their fitness and competence in the service of the people of Florida." Ladapo does not meet that standard, and his medical license should be suspended.
Finally, Florida Attorney General Ashley Moody should investigate whether Ladapo's actions meet the required elements for civil or criminal negligence.
As Drs. Califf and Walensky wrote in their letter, "It is the job of public health officials around the country to protect the lives of the populations they serve."
Ladapo has done exactly the opposite.
Henry I. Miller, of Redwood City, California, is a physician and molecular biologist and the Glenn Swogger Distinguished Fellow at the American Council on Science and Health. He was the founding director of the FDA's Office of Biotechnology.