It took barely two days, and some huffs of disapproval from the White House, before Joseph Ladapo’s bold plan to eliminate all vaccine mandates in Florida began to deflate.
The action, the fervently religious state surgeon general had asserted at a fire and brimstone press conference in Tampa, came straight from the heavens: “Who am I, as a man standing here now, to tell you what you should put in your body?” he opined, framing the freedom to reject vaccines as a “reflection of God’s light against the darkness of tyranny and oppression”.
Mandates were akin to “slavery”, he said, in comments presumably intended to align with the ongoing anti-vaccination campaign of misinformation and myth of the health secretary, Robert F Kennedy.
“The Florida department of health, in partnership with the governor, is going to be working to end all vaccine mandates in Florida law. All of them. Every last one of them,” he insisted.
It turns out, however, that parents, public health experts, many Republican politicians and even the president himself, quite like the idea that children being sent to school are protected from, and protecting others against, highly contagious diseases such as measles, polio and chickenpox.
Now, Florida’s health department is walking back the scale of Ladapo’s commitment. They have acknowledged that he doesn’t have the power to arbitrarily chop every mandate he promised he would.
And the lawmakers who do, Florida’s Republican-dominated legislature that has traditionally walked in lockstep with Ron DeSantis, the Florida governor and Ladapo’s champion, are so far showing reluctance to get involved.
The reason for that is the Oval Office: Donald Trump denounced Ladapo’s edict as “a tough stance” less than 48 hours after he issued it.
“You have vaccines that work. They just pure and simple work. They’re not controversial at all,” the president said.
“I think those vaccines should be used, otherwise some people are going to catch it, and they endanger other people. I think people should take it.”
Trump’s observations came alongside a furious backlash from medical experts and political opponents to the surgeon general’s grand plan for Florida to become the first state not to require vaccinations for school-age children.
One Democratic state representative called it “a public health disaster in the making”, while the Republican senator Rick Scott, a former Florida governor, told Axios the state already had a “good system” that allowed parents to opt out of vaccinating their children on medical or religious grounds.
On Sunday, after four days of silence about how Ladapo’s all-encompassing goal would be achieved, the health department issued a statement saying it was proposing a rule change “to remove requirements for childhood immunizations … not required for school entry” such as hepatitis B, varicella (chickenpox), and influenza.
Vaccine requirements for polio, diphtheria, measles, whooping cough, mumps and tetanus, it said, “remain in place, unless updated through legislation”, and “all vaccines will remain available to families throughout Florida”.
Scott Rivkees, an infectious diseases expert at Brown University and former Florida surgeon general under DeSantis, told the Guardian it appeared Ladapo was in retreat.
“The public is overwhelmingly supportive of children being vaccinated. They don’t want their kids to get sick, even President Trump and Senator Scott said things that were contrary [to Florida’s position], so now they’re saying, ‘All right, what we will do is we will take away the vaccines that aren’t in there by legislation. We’ll do what we can’,” he said.
“He’s sort of backtracking. But there will be consequences for children in Florida if you get rid of chickenpox vaccines, if you get rid of hepatitis and strep. These are effective vaccines that have an excellent safety profile. There’s no scientific rationale for this.”
Rivkees pointed to already declining rates of childhood vaccinations in Florida, down 10% in a decade according to the health department’s own figures, and said he expects a further drop.
“You’re hearing people like RFK Jr, the secretary of health and human services, discredit vaccines. You’re hearing somebody like Dr Joseph Ladapo discredit vaccines. There’s this very large anti-vaccine movement that has hit this wagon with the Maha [Make America healthy again] movement, and a lot of anti-physician, anti-expert messaging that leaves parents in the middle, confused,” he said.
“The medical community will say, ‘Get vaccinated, follow our schedules’ but so much skepticism, so much confusion, so much distrust has been put in place that makes those of us in medicine less effective than we would have been even just just six months ago.”
The future of Ladapo’s push in Florida rests in the hands of senior Republicans Ben Albritton, the senate speaker, and Daniel Perez, the House speaker. Both are Trump loyalists who have clashed publicly with DeSantis.
Asked if they would be introducing legislation to repeal mandatory school entry vaccinations, a spokesperson for Albritton said they “don’t have anything to share at this time”. Perez’s office did not respond to a request for comment.
Robert Speth, professor of pharmaceutical sciences at south Florida’s Nova Southeastern University, said it was crucial for the politicians to stand up to the surgeon general.
“It can’t just be done by edict, and I would hope that the state legislature is going to exert a whole lot more wisdom about this issue than Dr Ladapo,” he said.
“It’s just totally irresponsible to not be requiring children who are entering school to have to be vaccinated against these communicable diseases. You’ll see an increase in polio, in measles, all these diseases that are easily preventable by vaccination, and that’s the absolutely insane aspect of it.”
Speth said children who could not receive vaccinations for medical or other reasons would be most at risk.
“It’s really worse than drunk driving,” he said. “Children who are unable to protect themselves from communicable diseases are now metaphorically being placed in the path of intoxicated drivers.”
