Doctors are silent as Florida seeks to end decades of child vaccination mandates

SARASOTA, Fla. – Florida plans to eliminate nearly half a century of mandatory childhood vaccinations against diseases that have killed and sickened millions of children. Many critics, including health workers, are afraid to speak out against the decision.

With the support of Republican Governor Ron DeSantis, Joseph Ladapo, the state’s surgeon general, announced on September 3 his intention to eliminate all vaccination requirements for school-age children.

“Every one of these rules is wrong and smacks of contempt and slavery,” he told a crowd of anti-vaccine people in Tallahassee. “Who am I, as a government or an individual, to tell you what to put in your body?” He added.

History shows that mandates increase the use of vaccines.

However, if vaccination rates decline, cases of diseases such as measles, hepatitis, meningitis and pneumonia – and even diseases such as diphtheria and polio – may return.

Many of these diseases pose a threat not only to those who are not vaccinated, but also to those around them, including infants and the elderly with weakened immune systems.

But this scientific fact was ignored in Florida. Health authorities have remained silent in the face of Ladapo’s campaign, not because they agree with it. The University of Florida has silenced infectious disease specialists, according to Professor Emeritus Doug Barrett, former chair of the Department of Pediatrics and senior vice president for health affairs at that university.

He added: “They ask them not to talk to anyone without getting permission from their supervisors.” University spokesmen did not respond to requests for comment.

The same is true for county health department officials, according to John Sinnott, a retired University of South Florida professor who is a friend of one of those local leaders.

The Sarasota County Health Department referred a reporter to state officials in Tallahassee, who responded with a statement noting that vaccines “will continue to be available” to families who want them. The state did not respond to further requests for an interview with Ladapo or other questions.

Many pediatricians are also silent, at least publicly.

“Many were not clear about whether children should be vaccinated,” said Neil Manimala, a urologist and president-elect of the Hillsborough County Medical Society. “They don’t want to lose patients. There are enough anti-vaccine people to destroy you with Google reviews that say doctors want to ‘inject poison.'”

The history of the states in modern vaccination

Several states eliminated vaccination mandates early last century, when smallpox was the only widely used vaccine, according to historian Robert Johnston of the University of Illinois-Chicago.

No country has done so since other vaccines were added to the schedule. (Routine smallpox vaccination ended in 1972.)

In the 1970s, an ongoing measles outbreak prompted authorities to strengthen child protection by mandating compulsory schools in all states. Today, political polarization around vaccines following the Covid pandemic has changed the landscape.

This is especially noticeable in Florida, although lawmakers in Texas and Louisiana are also considering eliminating vaccination requirements, and in Idaho it is enough for parents to request an exemption.

“This is a turning point for many families who were already hesitant about vaccinating their children and are now receiving the message that it is not necessary,” said Jennifer Takagishi, vice president of the American Academy of Pediatrics Florida chapter.

It’s unclear how quickly vaccine-preventable diseases could return if Florida lifts mandates, or how the public would respond.

Consulted in interview Regarding whether his office had designed possible pandemic scenarios before the September announcement, Ladapo replied: “Absolutely not.” According to the Surgeon General, parental freedom is not a scientific question, but rather a question of “what is right and what is wrong.”

A month later, the Florida Department of Health did not respond to questions about whether it was making contingency plans for potential outbreaks. during Measles outbreak In Broward County in 2024, Ladapo sent parents a letter allowing unvaccinated children to attend school, defying evidence-based recommendations from the Centers for Disease Control and Prevention (CDC).

In 1977, a measles outbreak killed two children in Los Angeles County, sparking a strong national backlash against vaccine refusers.

But during the recent epidemic that caused the death of minors in Texas and… 14 people in MexicoTexas Republican Gov. Greg Abbott signed a law that makes it easier for parents to avoid mandatory vaccinations.

“How many deaths or serious illnesses will it take for people to say: ‘No, we want vaccines,’” Takagishi wondered. “We don’t know what that breaking point is.”

“I don’t have the answer,” said Walter Orenstein, a professor emeritus at Emory University, who worked on measles issues during his 26 years at the CDC and ran the agency’s immunization program from 1988 to 2004. “In the past, measles outbreaks have generated political will to support vaccination programs. But that’s not the case this time. It’s very sad.”

Children in Florida are already among the least vaccinated in the country, due to lax enforcement of requirements, refusal of vaccines after the pandemic and the liberal stance of state authorities.

Statewide, only about 89% of kindergartners are fully vaccinated, with Sarasota County having the lowest rate, at about 80%. To prevent the spread of measles, a community must be at least 95% immunized.

With Health and Human Services Secretary Robert F. Kennedy Jr. By cutting funding for vaccine research, bringing anti-vaccine activists into the agency and increasing mistrust about the safety and usefulness of vaccines, little stands in the way of decisions that could push Florida’s vaccination rates further down.

The Ladapo-led Ministry of Health has already begun waiving vaccine requirements against hepatitis B, chickenpox, and the bacteria that cause meningitis and pneumonia.

Early next year, the Florida Legislature is expected to consider repealing a 1977 law requiring school and kindergarten vaccinations against seven other life-threatening diseases: whooping cough, measles, polio, rubella, mumps, diphtheria and tetanus.

After measles, what disease will return?

In the face of these attacks, the scientific community is trying to predict which diseases might reappear first and when.

and A study published in April Epidemiologist Matthew Kiang of Stanford University estimates that even with current vaccination levels, measles — which was declared eliminated in the United States in 2000 — could once again become a common disease. If measles coverage fell by another 10%, there could be about 450,000 cases a year, with hundreds of deaths and brain injuries.

But this study could exaggerate the threat, said Sean Truelove, an expert in epidemiological disease modeling at Johns Hopkins University, who expressed concern about the loss of public trust due to alarmist projections.

However, he warned that the measles outbreak is certain to get more severe. The country is already facing its worst year in three decades, with more than 1,500 cases and active outbreaks in South Carolina and Minnesota.

“There is no need to model measles if vaccines are stopped,” Truelove said. “In places where the disease is endemic, every unvaccinated child will become infected.”

Measles is “the canary in the lexicon” of other preventable diseases, said Sal Anzalone, a pediatrician at Healthcare Network in Naples, Florida. “When measles starts coming, there are other diseases coming.”

Those who want to get vaccinated will be able to continue doing so, even without mandates, Ladapo said.

But the state’s messaging confuses families, especially low-income or disadvantaged families, according to Anzalone. She explained that it is difficult for many of them to take their children to medical appointments if it is not mandatory. In his practice, 80% of patients have Medicaid coverage. He added that if policies shift more costs to parents, fewer children will be vaccinated.

If vaccination rates decline and infection rates increase, children will not be the only ones affected. People with cancer and the elderly — of which there are very many in Florida — will also be at risk.

Schools and businesses may face disruptions. The tourism industry, which attracted 143 million visitors last year, could also be affected. (The Florida Chamber of Commerce did not respond to requests for comment.)

“Infectious diseases don’t stop with those who say they’re willing to take risks,” said Megan Fitzpatrick, a vaccine expert at the University of Maryland. He explained that due to its ability to spread: “In the event of an infectious disease, vaccination is never just an individual decision.”

Health workers fear the end of the mandate will allow a return of hepatitis B, a chronic liver disease, with an estimated two million people in the country carrying the virus.

The days may also return when children with a high temperature would have to undergo painful spinal taps and blood tests to rule out meningitis or bacterial infections that vaccines have prevented since the 1990s.

Barbara Lou Fisher, co-founder of the modern movement against vaccine mandates in the early 1980s, after her son suffered an adverse reaction to the pertussis vaccine (which has since been replaced by a safer vaccine), doubts Floridians will stop vaccinating en masse, even though the requirements expire.

Fisher, president of the National Vaccine Information Center, moved from Virginia to Southwest Florida in 2020. She believes infections caused by vaccines are underreported and children are being vaccinated without informed consent. He acknowledged that mandates are increasing coverage, but he believes eliminating them would boost confidence in public health and medicine.

“It is time for biological products such as vaccines to be subject to the law of supply and demand, just like any other product on the market,” he said.

For his part, Sinnott expects a return of measles, accompanied by more severe outbreaks of whooping cough, influenza and Covid.

“They think nothing will happen,” said Sinnott, the retired teacher. “Maybe they’re right.” “It’s an experience.”

Polio may also return. For Sinnott, 77, this is not a theory.

He was 7 years old when he became ill and spent six months in a wheelchair. In recent years, he suffered from post-polio syndrome: difficulty swallowing, stiffness and pain in the extremities.

The first polio vaccine was licensed in 1955, the year the disease struck. “I remember my mother once said to me, ‘The line is so long,’” he said.

Sinnott forgives her parents, as well as current parents who are hesitant to vaccinate their children. He’s less forgiving with some public health leaders. “They should know,” he said.