How safe are Floridians from COVID? State overcounts vaccinations by 600,000 people
More than 100 Florida ZIP codes report more than 100% of their residents are vaccinated. DeSantis and health officials don't plan to investigate this.
Florida has overstated how many residents are vaccinated against COVID-19 by more than half a million people, a Palm Beach Post analysis shows.
Health officials and Gov. Ron DeSantis, who were alerted last year about impossibly high inoculation rates across the state, say they have no plan to fix or investigate this statistical flaw, driven by out-of-staters.
At the same time, Florida does not reveal to the public the number of nonresidents infected in the state.
That means Floridians don't know the true picture of how safe they are from the deadly disease.
More than 100 Florida ZIP codes each report that more than 100% of their residents have gotten at least one coronavirus vaccine shot. In some cases, the number of vaccine recipients recorded by the state Health Department exceeded U.S. Census population estimates by more than 1,000%.
These ZIP codes — popular among seasonal residents and tourists — together counted about 622,000 more inoculations than people living there year-round.
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That comprises 4% of vaccine recipients tracked by a database state health officials gave on Wednesday to lawyers representing a consortium of news outlets, including The Palm Beach Post.
About 74% of eligible "residents" ages 5 and older are at least partially inoculated, state health officials reported March 11. And about 24% have received a booster shot. The overcounted inoculations are equivalent to about 3% of vaccine-eligible Floridians.
Vaccinations have been shown to be the most effective protector against COVID infection and the dire effects that can stem from it. Most COVID-positive hospital patients and those who died from the disease lacked immunization, data collected by the Centers for Disease Control and Prevention show.
COVID-19 vaccination rates in Florida ZIP codes
As of March 21, 2022. Vaccination rates cover residents ages 5 and older.
Sources: 2016 to 2020 American Community Survey, Florida Department of Health. Map created by Palm Beach Post data reporter Chris Persaud.
“If this is happening a non-trivial percentage of the time, you could be overestimating the total number of people vaccinated, which could lead to unintentionally inflated percentages,” said University of South Florida epidemiologist Dr. Jason Salemi. He tracks a myriad of Florida COVID-19 statistics on his website covid19florida.mystrikingly.com.
Florida's official data also underestimates how many residents have never been vaccinated, Salemi said.
During Florida's tourist season, as the omicron's coronavirus mutation engulfed the state, the airborne pathogen hospitalized people here at higher levels than in comparable states.
Florida had 53 COVID-positive patients for every 100,000 residents during the worst of the omicron wave in January, according to a Post analysis of data from the Census and the U.S. Health and Human Services Department.
That rate was higher than two other big warm-weather states, California (40 patients per 100,000 residents) and Texas (47 per 100,000). It was also worse than another Sunbelt state that, like Florida, is popular among retirees: Arizona, with 49 patients per 100,000.
Florida reported a total of more than 5.8 million infections and 71,860 deaths as of March 11. But those numbers exclude tourists, snowbirds and other visitors who caught the virus here.
Florida stopped publishing numbers last June showing how many nonresidents tested positive here for the disease.
Palm Beach County Commissioner Maria Sachs knows that three ZIP codes in her district have 100%-plus vaccination rates because of winter visitors. She was there, she said, when some of the first shots were administered in late 2020 and early 2021 in large gated senior communities west of Delray Beach and Boca Raton.
In places such as Kings Point, Whisper Walk and Century Village Boca Raton, Sachs said, “Many folks … were not, shall we say, Florida residents. They were seasonal residents. I know from my own personal experience that many of the people who received Florida's vaccinations had given different ZIP codes.”
Nearly 2.3 million immunized people across Florida listed their residences in ZIP codes with impossible vaccination rates, according to the state Health Department database.
But fewer than 1.7 million vaccine-eligible people live in these places for more than half the year, Census surveys conducted from 2016 to 2020 found. ZIP code-level estimates for 2021 are not yet publicly available.
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Discrepancy driven largely by out-of-state residents
Florida’s growth since 2020 does not fully explain the six-figure discrepancy between immunizations and estimated population in ZIP codes analyzed. Much of it is driven by out-of-state residents who stay here during winter.
About 20% of households in the 101 ZIP codes with impossible inoculation levels are vacant for the majority of the year because seasonal residents use them, Census estimates show.
The ratio is about 8% in the other 873 ZIP codes in the state data.
Vaccinations fell continuously throughout summer 2021 in ZIP codes where inoculation rates now exceed 100%, despite the delta variant surge, the data shows. Meanwhile, the share of residents in normal ZIP codes seeking shots spiked during the delta wave. Most part-time residents leave at the end of spring.
Sachs said she and her staff fielded phone calls early on from worried Snowbirds stuck in Florida due to travel restrictions. They wanted to know how they could get the shots here. “We happened to take good care of everyone who happened to be in Florida at the time,” she said.
Miami Beach Mayor Dan Gelber realized last year that visitors and part-time residents were being incorrectly classified in state inoculation data as full-time residents. He raised the alarm during the summer to state officials, who ignored him. “I was very excited when I saw how high our vaccination rates are,” he said. “Then we broke 100%, and it just kept going.”
ZIP codes up and down the barrier islands in Miami-Dade County, as well as the Keys and inland, boast impossible immunization levels. ZIP code 33122, containing Miami International Airport, reports an inoculation rate of 1,786%.
“My own ZIP code is close to 200%,” Gelber said. “They’re obviously including people … who are not residents.”
The state Health Department reports that 98% of eligible Miami-Dade County “residents” have gotten at least one shot as of March 11, a level far higher than any of Florida’s other 66 counties.
Infection rates revealed the faultiness of Florida’s reporting in its most populous county during the omicron variant wave. Some 18% of Miami-Dade County residents caught the coronavirus between Nov. 24 and March 11, data collected by the White House shows. That’s the highest share of all the state’s counties.
During a Jan. 3 news conference in the county, DeSantis referenced its on-paper immunization rate when he bad-mouthed the shots. “With omicron, you know, the vaccinations are not preventing infection,” he said.
When a vaccine provider administers a shot, they record the home address the recipient writes on their vaccination form. But many people who got the jab live out of state and gave medical staff their Florida homes’ addresses, Palm Beach County Health Department director Dr. Alina Alonso said.
“Some of those (people) have legitimate addresses here even though they are not counted by the census,” Alonso said. “In the very beginning when we started vaccinating people, we were asking for IDs and all kinds of proof, and pretty soon that got left behind.”
Much of the impossible immunization rates in Miami-Dade County can be explained by “international people who give a local address just to get the vaccine,” Alonso said. “We have vaccinated almost all of Colombia. That's one of the jokes.”
Pharmacists The Post called said that unvaccinated people seeking shots do not need to provide ID proving they live at the address they list on inoculation forms.
“Whatever address you want to put down, it doesn’t matter,” one Publix pharmacist said when asked whether proof of address was required for an unvaccinated person to get the shot. “It doesn’t have to be here in Florida.”
DeSantis required proof of residence for shot seekers in January 2021
DeSantis decreed in January 2021 that shot seekers must provide proof of residence. He wanted to prevent out-of-staters from visiting Florida just to get inoculated. Vaccines back then were in limited supply. DeSantis restricted them at the time to seniors ages 65 and older, along with medical workers and immunocompromised people.
But, he said, "We do have part-time residents who are here all winter. They go to doctors here or whatever, that's fine. What we don't want is tourists, foreigners.”
Immigrant rights groups and state Agriculture and Consumer Services Commissioner Nikki Fried pleaded with DeSantis to drop the ID restriction, saying it prevented undocumented immigrant laborers from getting the shots.
The ID restrictions lasted until April 2021. Florida also lowered age limits for vaccine eligibility to all adults 18 and older. But during those early months, vaccination rates surged faster in ZIP codes popular with Snowbirds than in most places with lots of elderly residents.
By April, ZIP codes where at least one-fifth of houses are used by part-time residents boasted 62% inoculation rates, compared with 51% in ZIP codes where seniors comprise an estimated one in five residents.
“There was nothing the (Florida) Health Department could do,” Florida International University epidemiologist Dr. Mary Jo Trepka said. “You’ve got an elderly person in front of you. What are you gonna do? Say, ‘Do you live here two months out of the year or eight?’
“This is probably a bigger problem for Florida than other states because we have so many Snowbirds,” she said.
Gelber, the Miami Beach mayor, emailed a letter to DeSantis in July, urging the state to examine its vaccination data to weed out part-time residents, tourists and other visitors from Florida’s official inoculation tally. “This would go a long way in calculating how many of our residents actually remain at risk, where they are, and, therefore, how to reach them,” the letter said.
Gelber never heard back, he said. The state Health Department has no plans to investigate or fix the data. “It is a (vaccine) provider’s responsibility to input accurate data,” spokesman Jeremy Redfern said March 3 in an email.
Redfern noted that other states also report immunization rates higher than 100% in some of their ZIP codes. He pointed to California, whose health department states on its website that “vaccination coverage may exceed 100%” in some ZIP codes due to “many people from outside the county coming to that (ZIP code) to get their vaccine and providers reporting the county of administration as the county of residence.”
But California, the most populous state, reported about 471,000 vaccine recipients in the wrong ZIP codes as of Tuesday, about 25% less than what The Post found in Florida.
Those excess shots in California represent about 1.5% of all immunizations there, about one-third of Florida’s level.
The rate is similar in Arizona, another popular state for winter tourists, with 1.4%. (Arizona does not yet report data for tribal areas).
Arizona and California regularly release ZIP code-level vaccination data to the public and keeps it updated. Florida does not.
Snowbirds aren’t the only ones who inadvertently pushed some Florida ZIP code immunization rates above 100%.
Cruise line crews push Cape Canaveral ZIP over the top
The Cape Canaveral ZIP code of 32920 counts 19,565 “residents” vaccinated but a population just north of 10,000.
That’s because crew members for cruise lines and cargo ships listed the ZIP code as their home address when they got immunized, Port Canaveral spokesman Steve Linden said.
The port coordinated with the state and Parrish Medical Center in Titusville to inject the COVID vaccine into about 8,600 people, most of them crew members of cruise or cargo ships, Linden said.
Port Canaveral was the first port in Florida to vaccinate crew members following a public health advisory approved by DeSantis, Linden said. Cruise terminals where the vaccine was administered were used as the home addresses of the crew receiving vaccinations while protocols were being developed.
"The mission was to get people vaccinated," Linden said.
Since then, the state established protocols so that crew members who are vaccinated at the port — most of whom are from other countries — are listed by their home addresses.
“What’s important for the general public is to appreciate the challenges with collecting data on this many people throughout the country, especially with somewhat fragmented data systems,” said Salemi, the USF epidemiologist.
“Clearly that’s something we need to work on. But it does NOT mean there is an intentional effort to mislead or misrepresent data. The data are simply dirty – some COVID-19 indicators more than others – but they are still effective enough to be used as a gauge for assessing the state of the pandemic.”
FLORIDA TODAY Business Editor David Berman contributed to this article.
Chris Persaud is The Palm Beach Post's data reporter. Email him at firstname.lastname@example.org or on Twitter at @chrismpersaud.
Here are some ZIP codes where inoculations far exceed the estimated vaccine-eligible population of people ages 5 and older.
- 33132, covering downtown Miami and PortMiami, lists 55,925 vaccinated people but has an estimated 14,673 vaccine-eligible residents.
- 33178, in western Miami-Dade County, covering Doral, lists 125,711 vaccine recipients but 49,677 residents.
- 32819, covering Universal Studios theme park southwest of Orlando, lists 43,956 vaccine recipients but 17,384 residents.
- 34211, east of Bradenton, covering gated neighborhoods and farms, lists 15,084 vaccine recipients but just 10,218 residents.
- 32461, a tiny ZIP code near Florida Scenic Highway 30A, between Panama City Beach and Santa Rosa Beach, lists 2,194 vaccine recipients but an estimated population of 42 residents at most.