The elimination of vaccine requirements in Florida schools announced by the state’s surgeon general on Wednesday marks a significant shift in how the state has long protected children against contagious diseases.
Now, as the state potentially steps back from those safeguards, Florida finds itself at the center of what could be a high-stakes public health experiment — one with consequences that could ripple from the classroom to the community.
For more than 40 years, Florida law required children entering kindergarten to be immunized against a list of highly contagious diseases. Those rules helped push measles out of classrooms, contained outbreaks of whooping cough and chicken pox, and kept polio a distant memory. While Florida’s Surgeon General Joseph Ladapo advocates freedom of choice for childhood immunization, the medical community fears that contagious diseases eradicated by vaccines will surface again in the state.
“Without requirements, you will see fewer kids vaccinated and you will see more kids infected with diseases like measles,” said Dr. Jason Schwartz, an associate professor at the Yale School of Public Health. “Unfortunately, it is a fact; we have seen it in the past with outbreaks and will see it more frequently if Florida follows through.”
States traditionally follow federal guidance when it comes to vaccines, but school mandates are set by state health departments. Florida’s school vaccine requirements have evolved over decades. In the early 1980s, proof of immunizations against measles, mumps, rubella, polio and diphtheria-tetanus-pertussis (DTaP) was standard for kindergarten entry. Over time, the list of shots grew: hepatitis B was added in 1998, followed by varicella (chickenpox) in 2001 and a second dose of varicella in 2008.
Ladapo announced Wednesday that the department he oversees would begin taking steps immediately to eliminate these mandates, calling them “immoral” intrusions on people’s rights that hamper parents’ ability to make health decisions for their children. “We’re going to end it,” Ladapo said, without providing details or a timeline.
The effects of Ladapo’s Wednesday announcement could extend beyond choices to vaccine access.
To help families meet vaccine requirements, Florida’s health departments offer free immunization clinics. Concern is rising that these free vaccines and outreach efforts also will be eliminated.
“Typically, there are other things that come along with these requirements to make it a little easier for kids to get vaccinated,” said Emily Smith, an expert in infectious diseases and epidemiology at the George Washington Milken Institute School of Public Health. “There may be a clinic at your school where you can get vaccinated or there may be open days at the public health department clinic for people to come in and get their school physical and get their vaccines. The vast majority of parents in Florida are getting their kids vaccinated and are supportive of it. But I suspect we’ll see hits to these other public health programs that were making it easier for parents to do that.”
Florida vaccination rates had plunged
Even before Ladapo’s announcement, Florida’s vaccination rates already were on the decline. According to the Florida Department of Health, kindergarten coverage in Broward and Palm Beach counties is below 90% for key vaccines — well under the 95% threshold needed to maintain herd immunity, the level makes it unlikely that a single infection will spark a disease cluster or outbreak.
Exemptions from vaccine requirements for religious reasons in Florida have been rising in recent years, soaring to more than double the national average. Now, should Florida eliminate vaccine requirements, health officials warn, numbers of the vaccinated would likely drop further, leaving schools — and communities — vulnerable to outbreaks.
Infectious disease specialists warn that illnesses such as measles and mumps could resurface in classrooms within just a few years.
“It’s a little hard to think about, but with low immunization rates, it’s like a roll of the dice,” Smith said. “If no one in the community has measles, well, in theory, then it doesn’t matter. But if someone shows up with measles, then it matters a lot and you have an outbreak.”
Nationally, the Centers for Disease Control and Prevention reported an uptick in measles cases last year, many of them tied to clusters of unvaccinated schoolchildren. Florida experienced its own outbreak in Broward County last year at Manatee Bay Elementary School. Measles, often contracted during travel, spreads through coughing and sneezing and can linger in the air for several hours. An infected person can pass it on even before they feel sick.
“Measles is remarkably transmissible,” said Schwartz at the Yale School of Public Health. “If someone is infected with measles and in the company of someone susceptible, there’s a 90% chance that the person susceptible will be infected.”
In addition, pertussis — also known as whooping cough — is among the preventable diseases doctors are concerned about seeing more of if Florida’s plan succeeds. Florida already has had a record number of whooping cough cases in 2025 — more than 1,100 cases compared with 391 in 2019, before the pandemic.
Dr. Jennifer Takagishi, a Tampa pediatrician and vice president of the Florida Chapter of the American Academy of Pediatrics, said she has seen children die from vaccine-preventable diseases. “I’ve seen a two-week-old baby get whooping cough and die from it.”
“It’s been progress seeing some of these diseases prevented so people aren’t dying, but we could see those come back quickly,” she said.
Not just children will be affected
Medical experts note that vaccine requirements protect everyone because schools are a microcosm of society and could easily become launchpads for the spread of disease. When students go home or to parties, they can bring diseases to vulnerable people such as infants, the elderly, and those going through cancer treatments. Florida has one of the nation’s largest populations of the elderly.
Students can also spread it to teachers, educational staff and school nurses — who are angry about eliminating vaccine requirements.
“If they’re able to go through with it, they’re just opening a door to a health crisis that’s 100 percent preventable,” said Lynn Nelson, president of the National Association of School Nurses.
Andrew Spar, president of the Florida Education Association, said a rise in unvaccinated students could put anyone at a school at risk and potentially disrupt the learning environment with more absenteeism.
“Public school teachers already are incredibly burdened, so this just adds to it,” he said. “There are teachers certainly who are high risk and so they would be very concerned if more kids are coming to school unvaccinated.”
Dr. Scott Rivkees, Ladapo’s immediate predecessor as surgeon general, said kindergarten immunization rates vary across Florida, leaving some school districts more vulnerable.
“So what will happen is that it’s not like you’ll see measles spreading throughout the state,” he said. “You’ll see isolated pockets of infectious disease outbreaks of vaccine-preventable illnesses in these undervaccinated areas.”
Rivkees, now a professor at Brown University’s School of Public Health, said the medical community is united in recommending vaccinations because it’s good for public health.
“I think the message which really comes through loud and clear is until now, we’ve kept our children safe, we’ve kept our children healthy, we’ve kept our children in school, we’ve kept our children from spreading infections into the community and this is because of vaccines,” he said.
Some parents support a change
Supporters argue that Ladapo’s stance on vaccines restores parental choice in medical decisions.
Ebony Walker, the mother of a first-grader at Bayview Elementary School in Fort Lauderdale, said she’s “all for” removing the mandates. She said “it was scary” when her son had to get so many vaccines shortly after being born. Now she’s got him a religious exemption from other inoculations.
“Florida’s always setting the trend, doing different stuff … and setting the bar for the other states to follow along,” Walker said.
Juliana Alaskewicz, a Fort Lauderdale mom, homeschools her young daughter to keep her safe.
“There is no reason to expose my child to all these diseases,” she said. “There is so much proof that vaccinations work. We have eradicated awful diseases by putting out vaccines into the world. I don’t understand why anyone would want to bring us back to a primitive way of living.”
If parents do have more choice, doctors will play an even bigger role in battling the misinformation spreading online, by “trying to explain how vaccines work and how they’re developed,” said Dr. Joshua Laban, a primary care physician in Miami.
“I think the worst-case scenario is that, you know, our vaccination rate declined and some of these diseases become emergent and then become endemic in our communities once again,” Laban said.
Ladapo’s announcement comes as the anti-vaccine stance of Robert F. Kennedy Jr., President Donald Trump’s health secretary, is causing chaos across federal public health agencies, which led this week to a contentious hearing before Senate lawmakers
It’s unclear what role state lawmakers will play in approving the elimination of vaccine mandates. Ladapo said state lawmakers “are going to have to make decisions. That’s how this becomes possible.”
South Florida Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com.
Information from the Associated Press was used in this report.
https://www.sun-sentinel.com/2025/09/06/floridas-high-stakes-public-health-experiment-with-vaccines/
