The door to the resuscitation room burst open as nurses rushed to lay a seizing infant on the table. A 7-month-old was in status epilepticus, his convulsions refusing to stop on their own. The attending emergency medicine physician readied himself to intubate. IVs pulsed with fluids, antiseizure medications and antibiotics.
Hours later, testing revealed the diagnosis: Streptococcus pneumoniae meningitis, a bacterial infection against which he had not been vaccinated.
“This case has always stayed with me,” the doctor, who practices in Miami, later said. “The kid didn’t do well.”
Allison Ong is a resident physician of internal medicine and pediatrics. (courtesy, Allison Ong)
Stories like these may become more common if Florida becomes the first state to repeal a vaccine mandate for schoolchildren. Surgeon General Joseph Ladapo made the announcement in September targeting shots against hepatitis B, chickenpox, haemophilus influenzae type b (Hib) and pneumococcal bacteria.
Eliminating vaccine mandates urgently concerns us as pediatricians and internal medicine physicians. This urgency is amplified by the CDC’s announcement of a concerningly abbreviated vaccine schedule and a vote to stop recommending the hepatitis B shot universally at birth, dismissing evidence-based guidelines from the American Academy of Pediatrics.
Decades of medical literature reinforce the power and efficacy of vaccines. High vaccination rates build herd immunity, which helps prevent disease transmission to high-risk groups including newborns, the elderly and cancer patients undergoing chemotherapy. Herd immunity in Florida is under threat with kindergartner vaccination rates dropping steadily below the national average, from 93.3% in the 2014-2015 school year to 88.8% in the 2024-2025 school year.
Providers can expect more parents questioning and declining vaccines, even from the first day of life. A doctor I know who works in a newborn nursery has seen this situation develop for years.
“I am constantly surprised that the first-year residents know how to approach these discussions early on in their rotations,” she said. “They tell me they’ve already done this in clinic. It’s becoming bread and butter for pediatricians.”
Parents have the right to make decisions regarding their children’s health. We encourage them to bring us questions about the guidance we give. If parents ask me why their newborn needs a hepatitis B shot, for example, I reply that hepatitis B affects the liver and that infants infected under one year have a 90% chance of developing chronic liver disease.
In return, parents have shared plenty of concerns with me: their baby is too young to be poked, will get a fever, or may experience side effects from vaccine additives and ingredients they’ve heard about from social media. Their concerns affirm what we know at the deepest of our caretaker hearts: Parents would do anything to protect their children. However, as physicians, we also have a duty to protect by correcting misinformation, such as debunked links between autism and vaccines or counseling parents that expected side effects including fever are milder and less dangerous than contracting the illness itself.
Mandate repeals may set off an avalanche of other consequences. Repeals could change the way insurances cover vaccines, potentially widening disparities in immunization rates between children living in and out of poverty. And without vaccines required for school, families who face barriers to doctor visits — including transportation, work, or copays — may go less frequently.
Vaccines carry economic benefits as well. In the past 30 years alone, vaccines have prevented about 508 million illnesses, resulting in societal savings of $2.7 trillion. This amounts to medical care, resources to contain the outbreak, and lost wages and productivity from caregivers who stayed home with their children during quarantine.
Consider how this could play out in Florida. The confirmed measles case in a high school last year prompted a panic of headlines and questions of whether students should quarantine — questions Ladapo responded to by stating that parents could decide because of “the high immunity rate in the school.” Especially in a tourism-heavy state, outbreaks of vaccine-preventable diseases could cost millions in the form of staffing shortages and canceled plans, packed ERs and empty classrooms.
Physicians know that vaccines aren’t the end-all cure for disease. We also recognize that vaccines are imperfect. But we are not asking you to blindly trust us. We are asking you to listen as we advocate for policies that reflect evidence-based medicine.
And please — talk to your pediatricians about the shots your kids need.
Allison Ong is a Miami-based resident physician of internal medicine and pediatrics. Her views do not represent those of her employer.
