SARASOTA, Fla. — Florida plans to eliminate nearly half a century of mandatory childhood vaccines against diseases that have killed and sickened millions of children. Many critics, including medical experts, are afraid to publicly voice their opposition to this decision.
With the support of Republican Gov. Ron DeSantis, the state’s surgeon general, Joseph Ladapo, announced his intention Sept. 3 to eliminate all vaccination requirements for school-age children.
“These rules are all wrong and smack of contempt and slavery,” he told an anti-vaccine crowd in Tallahassee. “Who am I, as a government or as an individual, to tell you what to put in your body?” He added:
History shows that mandates increase vaccine use.
However, if immunization rates decline, cases of diseases such as measles, hepatitis, meningitis, and pneumonia may increase, and diseases such as diphtheria and polio may recur.
Many of these diseases pose a threat not only to unvaccinated people but also to those around them, including infants and the elderly with weakened immune systems.
But in Florida, that science was ignored. Health officials have remained silent about Radapo’s campaign. This is not because they agreed. The University of Florida has silenced infectious disease experts, according to Professor Emeritus Doug Barrett, former chief of pediatrics and senior vice president for health at the University of Florida.
“They were instructed not to speak to anyone without permission from the supervisor,” he said. A university spokesperson did not respond to a request for comment.
The same goes for county health department officials, according to John Sinnott, a retired University of South Florida professor and friend of one of the local leaders.
The Sarasota County Health Department referred reporters to state officials in Tallahassee, who issued a statement saying the city “will continue to provide vaccines” to families who want them. The state did not respond to requests for an interview with Ladapo or other questions.
Many pediatricians also remain silent, at least publicly.
“A lot of people are unclear about whether or not they should vaccinate their children,” said Neil Manimala, a urologist and president-elect of the Hillsborough County Medical Association. “They don’t want to lose patients, and there are enough anti-vaccine people out there who will destroy you with Google reviews, saying they want to ‘inject poison’ into your doctors.”
History of modern vaccination obligations
Some states abolished vaccination mandates early in the last century, when smallpox was the only widely used vaccine, according to Robert Johnston, a historian at the University of Illinois-Chicago.
No state has done so since other vaccines were added to the schedule. (Routine smallpox vaccination ended in 1972.)
As measles outbreaks continued in the 1970s, authorities strengthened child protection by enforcing compulsory education in all states. Today, political polarization over vaccines in the wake of the COVID-19 pandemic has changed the situation.
This is especially evident in Florida, although legislators in Texas and Louisiana are also considering eliminating vaccination requirements, although in Idaho it is enough for parents to request a waiver.
“This is a turning point for many families who were already hesitant to vaccinate their children and are now receiving the message that vaccination is not necessary,” said Jennifer Takagishi, vice president of the Florida Chapter of the American Academy of Pediatrics.
If Florida lifts its order, it’s unclear how quickly vaccine-preventable diseases could return and how the public will react.
negotiated interview Asked whether his office had mapped out possible pandemic scenarios before the September announcement, Radapo said: “Absolutely not.” According to the surgeon, parental freedom is not a scientific issue, but rather a matter of “right and wrong.”
A month later, the Florida Department of Health did not respond to questions about whether it was developing an emergency plan for a possible outbreak. During a measles outbreak in Broward County in 2024, Ladapo ignored evidence-based recommendations from the Centers for Disease Control and Prevention (CDC) and sent letters to parents authorizing unvaccinated children to attend school.
A 1977 measles outbreak that killed two children in Los Angeles County sparked a national backlash against vaccine deniers.
However, due to the recent pandemic that resulted in the deaths of two minors in Texas. Mexico 14Republican Texas Gov. Greg Abbott has signed a bill that will make it easier for parents to avoid mandatory vaccinations.
Takagishi asked, “How many deaths or serious illnesses do we need for people to say, ‘No, we want a vaccine?’” “We don’t know what that threshold is.”
“There is no answer,” said Walter Orenstein, a professor emeritus at Emory University who studied measles issues at the CDC for 26 years and led the agency’s immunization program from 1988 to 2004. “In the past, measles outbreaks have generated the political will to support immunization programs, but this time, that’s not the case. That’s very sad.”
Children in Florida are already among the least vaccinated in the country due to lax requirements, post-pandemic vaccine hesitancy and the state’s liberal stance.
Statewide, only about 89% of kindergartners are fully vaccinated, with Sarasota County having the lowest rate at about 80%. Preventing the spread of measles requires at least 95% immunization coverage in the community.
With Health and Human Services Secretary Robert F. Kennedy Jr. cutting funding for vaccine research, bringing anti-vaccine activists into the agency and growing mistrust about the safety and usefulness of vaccines, there are few obstacles standing in the way of decisions that could further lower Florida vaccination rates.
The Radapo-led health ministry is already waiving vaccine requirements for hepatitis B, chicken pox, the bacteria that cause meningitis and pneumonia.
Early next year, Florida lawmakers are expected to consider repealing a 1977 law requiring children attending schools and day care to be vaccinated against seven life-threatening childhood diseases: whooping cough, measles, polio, rubella, mumps, diphtheria and tetanus.
What diseases come back after measles?
In the face of these attacks, the scientific community is trying to predict which diseases will first reemerge and when.
and Study published in April Matthew Kiang, an epidemiologist at Stanford University, estimates that even with current vaccination levels, measles, which was declared eliminated from the United States in 2000, could once again become common. A further 10% reduction in measles coverage could lead to an estimated 450,000 cases per year, hundreds of deaths and brain damage.
But the study may overstate the threat, said Shaun Truelove, an infectious disease modeling expert at Johns Hopkins University. He expressed concern that he would lose public trust with his alarmist predictions.
But he warned that the measles outbreak would get worse. The United States is already facing its worst year in three decades, with more than 1,500 cases and active outbreaks in South Carolina and Minnesota.
“If we stop vaccines, we don’t have to use measles as a model,” Truelove said. “Where an outbreak occurs, every unvaccinated child will be infected.”
Measles is the “canary in the mine” among other preventable diseases, said Sal Anzalone, a pediatrician at Healthcare Network in Naples, Florida. “Once measles starts to appear, other diseases will come as well.”
Ladapo said people who wish to be vaccinated will continue to be able to do so without the requirement.
But according to Anzalone, the state’s message is confusing for families, especially those who are low-income or underserved. Many of them find it difficult to take their children to the hospital when it is not mandatory, she explained. In his practice, 80% of patients receive Medicaid benefits. If policies shift more costs to parents, fewer children will be vaccinated, he added.
And if vaccination rates fall and infections rise, children will not be the only ones affected. Cancer patients and the elderly (of which there are many in Florida) may also be at risk.
Schools and businesses may face disruption. The tourism industry, which attracted 143 million visitors last year, could also be affected. (The Florida Chamber of Commerce did not respond to a request for comment.)
“The pandemic is not limited to people who say they are willing to take the risk,” said Megan Fitzpatrick, a vaccine expert at the University of Maryland. He explained that because of the potential for spread, “in the case of an infectious disease, vaccination is never just an individual decision.”
Health experts fear there will be a resurgence of hepatitis B, a chronic liver disease that affects about 2 million people in the country with the virus.
There may be a return to the days when babies with high fevers had to undergo painful spinal taps and blood tests to rule out meningitis or bacterial infections that have been prevented by vaccines since the 1990s.
In the early 1980s, Barbara Loe Fisher, a co-founder of the modern movement against vaccine mandates, suspected that Floridians would stop getting vaccinated en masse despite the end of the requirement after her son suffered an adverse reaction to the whooping cough vaccine (which has since been replaced by a safer vaccine).
Fisher, director of the National Vaccine Information Center, moved from Virginia to Southwest Florida in 2020. She believes vaccine injuries are underreported and children are being vaccinated without informed consent. He acknowledged that the mandate expands coverage but said repealing it would strengthen public health and trust in health care.
“It is time for biological products such as vaccines to follow the laws of supply and demand like other products on the market,” he said.
Sinnott expects a resurgence of measles, along with stronger outbreaks of whooping cough, flu and COVID-19.
“They think nothing will happen. Maybe they’re right,” said Sinnott, a retired teacher. “It’s an experiment.”
Polio can also recur. And for Sinnott, 77, it’s not a theory.
He was seven years old when he contracted the disease and spent six months in a wheelchair. In recent years, he has suffered from post-polio syndrome (difficulty swallowing, stiffness and pain in extremities).
The first polio vaccine was licensed in 1955, the year he became ill. “I remember my mother telling me one time, ‘The line is too long,’” he said.
Sinnott forgives her own parents, as well as current parents who are hesitant to vaccinate their children. He is less tolerant of certain public health leaders. “They need to know,” he said.
