A Florida pediatrician was removed from her position on a state board last week after advocating for equitable access to COVID vaccines for kids under 5.
Lisa Gwynn, MD, president of the Florida chapter of the American Academy of Pediatrics, was notified last Wednesday that she had been removed from her position on the board of Florida Healthy Kids Corporation, a public insurance provider for children.
Gwynn, who also runs a mobile vaccination program for the University of Miami health system, called the decision "disappointing" on Twitter, noting that her removal was directly tied to her advocacy for equitable distribution of COVID vaccines for underserved communities.
"This strikes a chord for me," Gwynn told MedPage Today. "I've seen firsthand, every single day, how difficult it can be for kids to access care."
Gwynn received a letter from the desk of the organization's chief financial officer, Jimmy Patronis, stating that she would be removed after she "went on to make some very political statements that do not reflect the CFO's point of view." The letter, which was obtained by MedPage Today, added that the pediatrician even went "so far as to say that the state is 'obstruct[ing]' access to vaccines."
"The CFO does not share your opinion and believes that the state has gone to great lengths to protect lives in the face of the Coronavirus," the letter stated.
Florida officials have consistently made statements against COVID vaccination in kids. In March, Florida Surgeon General Joseph Ladapo, MD, said that "healthy" kids should not be vaccinated against COVID-19, in direct opposition to guidance from the CDC and medical organizations.
Then, leading up to the approval of COVID vaccines for kids under 5, Florida was the only state that did not pre-order the shots, delaying the arrival of their supply. The state's governor, Ron DeSantis, said that Florida was "affirmatively against" COVID vaccination in this age group.
"These prior two years in Florida have been very challenging for us in health care, and specifically in pediatrics," Gwynn said in an interview. State opposition to evidence-based care, she said, has made practicing medicine increasingly difficult.
When Gwynn first heard that Florida was not planning to pre-order COVID vaccines for its youngest residents, she began speaking out. The Florida AAP chapter issued a statement saying "the state's decision to obstruct access to COVID-19 vaccines is anti-science, an affront to parental rights, and an intrusion into the relationship between doctors, patients, and the families they serve."
"Pediatricians were all up in arms," Gwynn said. Because clinicians have to go through the state to order authorized vaccines, this effectively delayed their supply.
Gwynn repeatedly contacted members of the state health department, and even the Biden administration, to find a solution to get young kids vaccinated in Florida. Finally, she received a message from a state health department official after the vaccines were authorized stating that providers could order the shots.
But shortly after, Gwynn learned that there was another barrier -- local health departments would not carry the COVID vaccines for kids under 5.
The decision not to allow local health departments to carry COVID vaccines for this age group created significant access issues, Gwynn said. Firstly, many families who do not have health coverage often go to local health departments to get their kids vaccinated. In addition, because clinicians are required to order a minimum number of vaccines through the state, some physicians in smaller practices who likely will not meet that requirement typically get the resources from their health departments.
"Kids that normally access vaccines ... through their local health departments now cannot access the vaccine," Gwynn said. "I had a real problem with that."
While federally qualified community health centers and retail pharmacies are allowed to carry the vaccine for younger kids, Gwynn said that likely will not provide enough coverage. "We should have as open access as possible," she said.
Since Gwynn learned that local health departments would not carry COVID vaccines for kids under 5, she has repeatedly met with health department officials to try to change the state's policy, she said. While there is no current plan to offer COVID vaccines at local health departments for this age group, Gwynn said she will continue to meet with officials to improve access.
While Gwynn was disappointed by the decision of Florida Healthy Kids to remove her from the board, she said it's more important to provide access to COVID vaccines. As a pediatrician, it is her job to vaccinate her patients, but lawmakers are interfering with that job, Gwynn added.
"Which vaccines we can give, and the benefits and the risks and all of that, that belongs in the exam room with patients and physicians," Gwynn said. "This is a threat to that."
Misinformation peddled by politicians presents additional barriers for providers, who spend their time debunking myths in an attempt to provide patients with the best care, she added.
"That's very frightening," Gwynn said. "But that's our new reality if we don't stand up for what we believe in."