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MIAMI — Dr. Lisa Gwynn can order a COVID-19 vaccine for a Florida 7-year-old, but she can't for a immunocompromised toddler.

Gwynn, a pediatrician with the University of Miami Health System and president of the Florida Chapter of the American Academy of Pediatrics, is outraged over Gov. Ron DeSantis' decision not to preorder COVID-19 vaccines for children under 5, the only state in the country that has not done so.

His decision leaves Florida pediatricians, hospitals and healthcare centers scrambling to obtain the supply on their own, potentially delaying vaccines for tens of thousands of children across the state.

"We are devastated," Gwynn said in an interview with the Herald Thursday. "You know, this goes against all scientific recommendations. We've waited for a long time for the data to be made available. And now we know that the vaccine is safe and effective for children under 5.. And to have this happen, without any warning, it's just unbelievable."

The Herald reported Wednesday that Florida was the only state in the country that had not preordered the vaccines from the federal government.

A Food and Drug Administration committee voted unanimously Wednesday to recommend the FDA authorize emergency use of the Moderna and Pfizer-BioNTech coronavirus vaccines for all children under age 5 — a group that numbers about 19 million in the United States. In Florida, there are approximately 1 million children under 5, according to 2021 Census estimates. It was the last group to be authorized for the vaccines.

DeSantis: Vaccine not 'appropriate' for small children

On Thursday, DeSantis defended his decision, saying parents who want to vaccinate their children under 5 can do so without the state's help. The Florida Department of Health has said the risk of vaccination outweighs the benefits for children in this age group.

DeSantis, speaking Thursday at a press conference in the Everglades, said the state doesn't think the vaccine is "appropriate. So, that's not where we're going to be utilizing our resources in that regard."

He said doctors and hospitals can get the vaccine, but that is not exactly the case, Gwynn said.

The federal government sends the coronavirus vaccines to each state. With previous coronavirus vaccines, the Florida Department of Health distributed them through the Vaccine For Children Program, an electronic system for pediatricians to order the vaccines. Florida hospitals have also ordered their coronavirus vaccines from the state throughout the pandemic.

Since Florida did not preorder the vaccines, the state's distribution channel has been cut off.

"At this point in time, pediatricians cannot order the COVID vaccine directly from manufacturers … so we're left to not be able to immunize our most vulnerable patient populations, the youngest children who need the vaccine the most," she said.

In Florida, the health department has confirmed 386,196 COVID-19 cases among children aged 5 to 11 since the pandemic began. At least 45 children under 16 have died from the virus in Florida.

'Let the parents choose'

Pediatricians across the state told Gwynn they were unable to preorder the shots.

"Let's focus on getting vaccines into arms, and let the parents choose — make sure that the vaccine is available to parents and to children, and let the parents decide whether or not they want to have their child vaccinated," she said. "Isn't that what this is all about?"

If they want to get their child under 5 vaccinated, parents would have to rely on retail pharmacies, like CVS and Walgreens. The pharmacies are enrolled in the Federal Retail Pharmacy Program for COVID-19 vaccines and get their allocations directly from the federal government.

In Florida, 11 retail pharmacies are enrolled in the program: CVS Health, Walgreens, Publix, Southeastern Grocers (Winn-Dixie, Fresco y Mas, Harveys Supermarket), Walmart (including Sam's Club), Costco and Kroger.

Concern about impact on Black children

Gwynn was not the only physician upset with DeSantis and Florida Surgeon General Joseph Ladapo, who earlier this year went against the recommendations of the American Academy of Pediatrics and the Centers for Disease Control and Prevention, which recommended giving the vaccine to healthy children.

"It is very difficult to understand how any person can ethically or morally put political considerations ahead of proven science," said Dr.. Reed Tuckson, co-founder of the Black Coalition Against COVID. "How could anyone jeopardize the safety and health of children in the middle of this pandemic, which continues to rage forward, for political posturing. This is almost unconscionable behavior."

Tuckson believes the state's decision could endanger children and their families, potentially harming Black and brown children the most.

Florida's Black residents have lagged behind Florida's white residents in vaccination rates. Since the pandemic began in March 2020, 59 percent of whites ages 5 and over have been vaccinated in Florida, compared with 43 percent of Blacks, according to the state's June 2 weekly COVID report.

"You just have to wonder what these people are thinking," Tuckson said. "This will only make things worse and it will have long-term implications not only for COVID, but can you imagine the decisions they're going to be making about other health issues that may come down the road?"

Mary Jo Trepka, an infectious disease epidemiologist and professor at Florida International University, reiterated the risk COVID-19 posed to children.

"Young children can benefit from the vaccine because it will prevent them from getting a severe illness, long COVID and a very rare, but extremely serious condition called multi-system inflammatory syndrome," she said, noting how Florida is amid another COVID surge.

And with school out and young children attending camps, "their risk is potentially quite great of being exposed," Trepka said.

Miami-Dade school district spokeswoman Jackie Calzadilla said the coronavirus vaccines aren't mandatory for school entry, so students "should not be impacted."

However, MDCPS will continue to offer COVID-19 vaccinations through its partnership with the UHealth Pediatric Mobile Clinic, she added. Gwynn oversees that program.

"We reached out to the local health department to verify and we were told that moving forward, medical providers wishing to offer the COVID-19 vaccine will need to request them from Tallahassee," Calzadilla said.

Keyla Concepción, a Broward County Public Schools spokeswoman, deferred questions to the Broward County Health Department, part of the Florida Department of Health.

"The vaccines are coordinated through the Department of Health-Broward," she said. "You'll have to reach out to them to address the question."

Miami Herald staff writer Jimena Tavel contributed to this report.

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