Wasting no time to start on his pledge last week to remove all vaccine mandates in Florida, Surgeon General Joseph Ladapo quickly removed four of them from school immunization requirements starting as soon as December. He can remove only those four unilaterally but pledged to push lawmakers to abolish “every last one of them.”
The four vaccines soon to be stripped from those required for public and private school attendance fight Hepatitis B, Varicella (chickenpox), Haemophilus influenza type b (Hib), and a fourth one that fights Pneumococcal bacteria that causes pneumonia, meningitis and other bacterial infections, a Florida Department of Health representative confirmed on Sunday. All of those vaccines are recommended for school-age children by state and federal health authorities and medical associations.
In remarks reported nationally since Wednesday, Ladapo, four years at his post, is suddenly calling for “freedom” from vaccine mandates – which he equated with “slavery” – but he proffered no medical rationale for eliminating them. He neither suggests a benefit to families from declining the recommended vaccines, nor encourages parents to use their freedom to seek the vaccines out. Ladapo’s actions come amid vaccine-related turmoil at the U.S. Department of Health and Human Services (HHS) and in the Centers for Disease Control and Prevention (CDC).
“Medical freedoms are the focus, and these vaccines will remain available to families throughout Florida,” the state Health Department representative wrote in a Sunday email responding to press questions. “Parents are encouraged to consult with their health care providers when making health care decisions for their children.”
The Florida Chapter of the American Academy of Pediatrics condemned the plan, saying vaccine uptake in Florida needs to be greater, not reduced, in order to protect communities.
“The ripple effect of removing vaccine entry requirements would affect all of us, not just those with children in school,” the chapter’s president, pediatrician Rana Alissa, said in a press statement. “Infants, the elderly, and those with compromised immune systems would be at much higher risk. Our state’s theme parks, grocery stores, movie theaters, sports arenas, and the waiting rooms in doctor’s offices and hospitals will all become places for contagious disease to spread easily – making every outing or gathering a risk.”
The pediatricians report fewer than 89 percent of Florida kindergartners are vaccinated as required for the 2024-25 school year, lower than the national average of 93 percent, and short of the 95 percent immunization threshold to ensure “widespread community immunity from the most infectious diseases, like measles.” Florida law allows parents to exempt their children from the state’s school vaccine requirements for specific cause, such as religious exemptions or allergies to vaccines, but ”herd immunity” can protect even those from uncontrolled outbreaks.
Changing directions on vaccines
It is unclear how Lapado’s actions will affect availability and affordability of various vaccines in Florida. Nationally, insurance companies and chain pharmacies recently pulled back on COVID-19 vaccines after new leadership at the U.S. Food and Drug Administration changed direction on COVID-19 vaccines, restricting who can get a vaccine without a doctor’s prescription. The change raises questions about whether those doses will be covered by insurance. Even medical offices in Florida were scrambling this week to clarify how to write vaccine prescriptions for their patients that will be honored at pharmacies and covered by insurance.
The only vaccine Ladapo actively rails against is mRNA COVID-19 vaccine, which is not mandated in Florida schools. He calls that one “poison,” contradicting broad medical consensus based on 13.6 billion doses given around the world declaring that vaccine to be safe and highly effective. In 2023, then-directors of the FDA and the CDC disputed Ladapo’s claims in an open joint letter. (The Trident asked if Ladapo also opposes non-mRNA COVID vaccines, such as Novavax spike-protein vaccine, but that question went unanswered by press time).
COVID-19 killed more than 1.2 million Americans, including 89,000 in Florida, and more than 7 million people worldwide, according to the World Health Organization and the CDC. It also ignited hot debate in the modern age of information and misinformation over how to handle public-health emergencies: as individuals doing whatever they choose, or collectively guided by federal health authorities as in the height of the polio pandemic.
America’s elders and their descendants may recall how polio killed or paralyzed a half-million people a year worldwide at its peak in the 1940s and 1950s, according to the World Health Organization. Millions of children and adults suffered symptoms that left them dependent on orthopedic braces to walk and “iron lungs” to breathe. Polio was largely wiped out in the 1960s by Jonas Salk’s famous vaccine, administered federally in mass vaccination events, according to CDC archives. One of the world’s ancient diseases, polio is controlled but not eradicated.
Ladapo has not responded to the Trident’s request that he project what Florida could be like if all vaccines are optional, vaccination rates plummet, and conquered diseases resurge, as measles has begun to do. He did say this last Wednesday: If people start getting legacy diseases from unvaccinated children who bring infections home, “That is part of the experience of life.”
Four vaccines now, more pending
On Wednesday in the Tampa Bay area, Ladapo and Gov. Ron DeSantis announced at Grace Christian School in Valrico their campaign to abolish all vaccine mandates and to permanently outlaw epidemic-control measures such as shutdowns, vaccine passports, and mask mandates.
In sync, the state Department of Health, which Ladapo leads, filed rule changes under its administrative authority to strike the four vaccines – against Hepatitis B, Varicella (chickenpox), Haemophilus influenza type b (Hib), and Pneumococcal bacteria – from required school immunizations later this year. Additional vaccine mandates set in state law by the Florida Legislature are unaffected.
Florida law at this time requires children attending public and private schools – unless they qualify for an exemption – to be vaccinated against those four and seven more infectious diseases: measles, mumps, and rubella (combined into an MMR shot); and diphtheria, tetanus, and acellular pertussis (combined into a DTaP shot); and polio. Pertussis is whooping cough.
It will be up to the Florida Legislature, convening in January, to abolish or revise the remaining vaccine mandates and act on DeSantis’ “freedom” agenda.
Florida Education Commissioner Anastasios “Stasi” Kamoutsas lent his endorsement in advance by appearing with DeSantis and Ladapo at the Valrico event.
Leading Florida Democrats in the GOP-controlled Legislature have declared their opposition to removing vaccine mandates without medical justification for doing so. How Republican leaders feel about it is unclear and may be divided, as reported here by the Florida Phoenix.
Like feds, like Florida
DeSantis appointed Ladapo surgeon general in September 2021. The American Medical Association and the Florida Chapter of the American Academy of Pediatrics are among the medical societies that condemn Ladapo’s plan to abolish all vaccine mandates.
As stated since Wednesday, Ladapo’s views echo those of DeSantis, who has branded their campaign against vaccine mandates as “medical freedom.” They also reflect the views of Robert F. Kennedy, Jr., President Donald Trump’s secretary of Health and Human Services. Kennedy has a long history of anti-establishment views on vaccines and public health [see his record as reported by TIME, the Associated Press, and Politifact], and in June he fired all 17 members of the nation’s vaccine advisory council.
In late August, Kennedy also fired Susan Monarez, confirmed just a month ago as director of the CDC, amid strife over new vaccine guidance that changes course and substantially cuts support for COVID-19 vaccinations. Several key members of her leadership team resigned in protest.
Ladapo was considered for the CDC leadership post that went to Monarez, and at Wednesday’s big event in Valrico, DeSantis doubled down on the idea.
“I hear there’s an opening for a new CDC director. Maybe we can help send Joe on his way up there. I know I’d support that. I think it’d be a great choice,” DeSantis said there.
The Trident sent messages asking if Ladapo wants the job but the question went unanswered by press time.
Roots in the pandemic
Ladapo’s confirmation as Florida’s surgeon general was contentious, with critics calling him unsuitable despite his medical credentials because of questionable associations and incidents such as visiting a state senator being treated for breast cancer during the height of the COVID-19 pandemic without wearing a mask in her office despite her asking him to.
He arrived on the Florida scene after former Surgeon General Scott Rivkees, speaking candidly at a coronavirus press conference with DeSantis in April 2020, was abruptly pulled out of the conference by DeSantis’ communications director and was rarely seen again for the rest of his tenure. Rivkees, now a professor and assistant dean at Brown University, told reporters last week he disagrees with what Ladapo is doing.
On Wednesday, Ladapo called FDA-approved mRNA COVID-19 vaccines “poison” yet in July 2020 he pitched hydroxychloroquine as a COVID remedy. That was at a press conference in Washington, D.C., a full month after the FDA revoked hydroxychloroquine’s short-lived “early use authorization” as an off-label treatment for COVID.
The press conference, conducted by a group called America’s Frontline Doctors (AFD), was steeped in right–wing, anti-establishment connections, including Breitbart News, co-founded by former Trump ally Steve Bannon. Ladapo, wearing a white lab coat bearing the AFD insignia, expressed his support for hydroxychloroquine while standing alongside a pro-hydroxychloroquine doctor in an identical lab coat who said in 2013 that many gynecological diseases are caused by demon sperm.
That was Stella Immanuel, praised by Trump, who himself touted the use of questionable remedies including ivermectin, an anti-parasitic, and bleach. Immanuel said any studies dismissing hydroxychloroquine, used to treat malaria and auto-immune diseases, as a treatment for COVID-19 are “fake science.” Rick Bright, a vaccine expert who directed the federal Biomedical Advanced Research and Development Authority, was fired in April 2020 after refusing to endorse it when Trump did.
Also standing with Ladapo and Immanuel at the press conference was the founder of America’s Frontline Doctors, Simone Gold, a doctor who was later convicted of storming the Capitol on January 6, 2021, and was sentenced to 60 days in prison. Ladapo’s images and remarks are still live on the AFD website.
Laura Cassels is a veteran Florida journalist and former Capitol Bureau chief who specializes in science, the environment, and the economy.