With a brief memo, Florida Surgeon General Joseph Ladapo has subverted a public health standard that’s long kept measles outbreaks under control.
On Feb. 20, as measles spread through Manatee Bay Elementary in South Florida, Ladapo sent parents a letter granting them permission to send unvaccinated children to school amid the outbreak.
The Department of Health “is deferring to parents or guardians to make decisions about school attendance,” wrote Ladapo, who was appointed to head the agency by Florida Gov. Ron DeSantis, whose name is listed above Ladapo’s in the letterhead.
Ladapo’s move contradicts advice from the Centers for Disease Control and Prevention.
“This is not a parental rights issue,” said Scott Rivkees, Florida’s former surgeon general who is now a professor at Brown University. “It’s about protecting fellow classmates, teachers, and members of the community against measles, which is a very serious and very transmissible illness.”
Most people who aren’t protected by a vaccine will get measles if they’re exposed to the virus. This vulnerable group includes children whose parents don’t get them vaccinated, infants too young for the vaccine, those who can’t be vaccinated for medical reasons, and others who don’t mount a strong, lasting immune response to it. Rivkees estimates that about a tenth of people in a community fall into the vulnerable category.
The CDC advises that unvaccinated students stay home from school for three weeks after exposure. Because the highly contagious measles virus spreads on tiny droplets through the air and on surfaces, students are considered exposed simply by sitting in the same cafeteria or classroom as someone infected. And a person with measles can pass along an infection before they develop a fever, cough, rash, or other signs of the illness. About 1 in 5 people with measles end up hospitalized, 1 in 10 develop ear infections that can lead to permanent hearing loss, and about 1 in 1,000 die from respiratory and neurological complications.
“I don’t know why the health department wouldn’t follow the CDC recommendations,” said Thresia Gambon, president of the Florida chapter of the American Academy of Pediatrics and a pediatrician who practices in Miami and Broward, the county affected by the current measles outbreak. “Measles is so contagious. It is very worrisome.”
Considering the dangers of the disease, the vaccine is incredibly safe. A person is about four times as likely to die from being struck by lightning during their lifetime in the United States as to have a potentially life-threatening allergic reaction to the measles, mumps, and rubella vaccine.
Nonetheless, last year a record number of parents filed for exemptions from school vaccine requirements on religious or philosophical grounds across the United States. The CDC reported that childhood immunization rates hit a 10-year low.
In addition to Florida, measles cases have been reported in 11 other states this year, including Arizona, Georgia, Minnesota, and Virginia.
Only about a quarter of Florida’s counties had reached the 95% threshold at which communities are considered well protected against measles outbreaks, according to the most recent data posted by the Florida Department of Health in 2022. In Broward County, where six cases of measles have been reported over the past week, about 92% of children in kindergarten had received routine immunizations against measles, chickenpox, polio, and other diseases. The remaining 8% included more than 1,500 kids who had vaccine exemptions, as of 2022.
Broward’s local health department has been offering measles vaccines at Manatee Bay Elementary since the outbreak began, according to the county school superintendent. If an unvaccinated person gets a dose within three days of exposure to the virus, they’re far less likely to get measles and spread it to others.
For this reason, government officials have occasionally mandated vaccines in emergencies in the past. For example, Philadelphia’s deputy health commissioner in 1991 ordered children to get vaccinated against their parents’ wishes during outbreaks traced to their faith-healing churches. And during a large measles outbreak among Orthodox Jewish communities in Brooklyn in 2019, the New York City health commissioner mandated that anyone who lived, worked, or went to school in hard-hit neighborhoods get vaccinated or face a fine of $1,000. In that ordinance, the commissioner wrote that the presence of anyone lacking the vaccine in those areas, unless it was medically contraindicated, “creates an unnecessary and avoidable risk of continuing the outbreak.”
Ladapo moved in the opposite direction with his letter, deferring to parents because of the “high immunity rate in the community,” which data contradicts, and because of the “burden on families and educational cost of healthy children missing school.”
Yet the burden of an outbreak only grows larger as cases of measles spread, requiring more emergency care, more testing, and broader quarantines as illness and hospitalizations mount. Curbing a 2018 outbreak in southern Washington with 72 cases cost about $2.3 million, in addition to $76,000 in medical costs, and an estimated $1 million in economic losses due to illness, quarantine, and caregiving. If numbers soar, death becomes a burden, too. An outbreak among a largely unvaccinated population in Samoa caused more than 5,700 cases and 83 deaths, mainly among children.
Ladapo’s letter to parents also marks a departure from the norm because local health departments tend to take the lead on containing measles outbreaks, rather than state or federal authorities. In response to queries from KFF Health News, Broward County’s health department deferred to Florida’s state health department, which Ladapo oversees.
“The county doesn’t have the power to disagree with the state health department,” said Rebekah Jones, a data scientist who was removed from her post at the Florida health department in 2020, over a rift regarding coronavirus data.
DeSantis, a Republican, appointed Ladapo as head of the state health department in late 2021, as DeSantis integrated skepticism about covid vaccines into his political platform. In the months that followed, Florida’s health department removed information on covid vaccines from its homepage, and reprimanded a county health director for encouraging his staff to get the vaccines, leading to his resignation. In January, the health department website posted Ladapo’s call to halt vaccination with covid mRNA vaccines entirely, based on notions that scientists call implausible.
Jones was not surprised to see Ladapo pivot to measles. “I think this is the predictable outcome of turning fringe, anti-vaccine rhetoric into a defining trait of the Florida government,” she said. Although his latest decision runs contrary to CDC advice, the federal agency rarely intervenes in measles outbreaks, entrusting the task to states.
In an email to KFF Health News, the Florida health department said it was working with others to identify the contacts of people with measles, but that details on cases and places of exposure were confidential. It repeated Ladapo’s decision, adding, “The surgeon general’s recommendation may change as epidemiological investigations continue.”
For Gambon, the outbreak is already disconcerting. “I would like to see the surgeon general promote what is safest for children and for school staff,” she said, “since I am sure there are many who might not have as strong immunity as we would hope.”
Amy Maxmen, CBS News/Kaiser Health News
Laurel says
“Dr. Joseph Ladapo, in an “America’s Frontline Doctors” lab coat, speaks at a July 2020 event that included Stella Immanuel, a doctor who said “demonic seed” causes ovarian cysts and endometriosis.”
Looks like stupid is contagious.
These people have medical degrees? From where, the dollar store in a plastic frame?
I’ll betcha DeSantis’ kids are vaccinated.
Shark says
He has a medical degree from t-rump university !!!
The Sour Kraut says
And DeSantis made sure his kids got the COVID Vaccine too. Hypocrite.
Just Saying says
Have you ever asked apediatrician how long do measles last if caught? I did, the answer I got was 3 days. The problem os the propganda of fear regarding certain illness that encourage a jab when its. ot needed. Chickenpox last longer than measles. Don’t let the lab coats make you believe getting sick is a unalive sentence.
Samuel L. Bronkowitz says
Interesting. 3 seconds of searching the internet for the answer and browsing legitimate information sourcews says that you don’t know what you’re talking about and are an idiot.
Nancy N. says
Did you even read the statistics? Measles can be serious in unvaccinated people…why do you think the world felt a need for a vaccine in the first place? Yes, if it goes well and is uncomplicated…a few days. If it doesn’t, however:
“About 1 in 5 people with measles end up hospitalized, 1 in 10 develop ear infections that can lead to permanent hearing loss, and about 1 in 1,000 die from respiratory and neurological complications.”
Laurel says
Justsaying: Measles lasts from three to five days. Mayo Clinic states measles are highly contagious and can be life threatening to small children.
Back in the 1950s, when we got chickenpox we were encouraged to play together so that we would get it and be done with it. The logic was that if you got it as an adult, it would be much worse. The chickenpox virus continues to live at the base of your spine throughout your life, and erupts as shingles (herpes zoster) should your immune system get run down. However, there is a vax for that!
Why go through it if you don’t have to?
No Political Affiliation says
If a civilian was in a criminal defense case, demonic influence is not admissible in court, because it’s obviously nonsense. The court would laugh you all the way to a prison sentence. But if you are a politician, or hold public government office, you get extra points for peppering in biblical word salad.
Deirdre says
I guess the anti vax movement will ultimately help with overpopulation problems, along with assault weapons being easily available to anyone with murder on their mind.
Overpopulation will be more of an issue now since unplanned pregnancies must be carried to term, as women no longer have the right to seek medical care for this issue anymore.
Sickening (no pun intended) that an actual medical doctor in a position of great power doesn’t understand the hippocratic oath; first, do no harm. Where does DeSantis find these idiots?
ASF says
This is incredibly dangerous.
Michele says
Let me guess..a DeSantis appointee?
The Sour Kraut says
How else could such a moron (More Ron?) get such a position?
JEK says
Two complete morons!
DaleL says
I’ll add to the chorus of voices against Ladapo. Here is my testimonial concerning measles. I had measles when I was 9 years old in 1958. There was no vaccine to prevent it then. I remember being miserable and avoiding any light. I was recovering, when on the night of May 13, I developed acute appendicitis, a rare dangerous complication of measles (and other severe viral infections). I woke up in incredible pain screaming. I had emergency surgery. Because of how infectious measles is, I got a private room. I was hospitalized from May 14 through May 18. I know this because I still have the hospital receipt that my parents saved.
Vaccines save lives in a similar manner to how seat belts save lives. If one is never in a car wreck, then a seat belt doesn’t do anything. If a person is never exposed to a disease, then a vaccine doesn’t do anything. It is criminal to not use seat belts and/or child car seats. It should be equally criminal not to have children vaccinated. Even worse, an unvaccinated child, by becoming infected, can spread the disease to those children who are too young to get vaccinated.
I know from my personal experience, that measles can be life threatening.
Donald J Trump says
Idiots like this one causes many people to question the intelligence of Black people. You can’t be this dumb without either inbreeding or a genetic defect.
JV says
This Surgeon general should be fired!
The antivax movement becomes dangerous and again demonstrates how education (including messages from Ladapo and DeSantis) in the US and particularly in Florida is becoming deplorable.
I studied virology 50 years ago (in Europe). I know that Ladapo is not a virologist but every physician should have a minimum understanding of it. So should DeSantis. Shame on both of them and the broader GOP.
Measles and COVID are public health issues. People need to understand this, but then I guess this demonstrates that anti-social behavior (partly driven by religion) is the new standard. Enjoy your smartphone!
dave says
Stupid is as Stupid does. Maybe its just time to start suing this far out stupid example of the state highest medical representative. So leave it up to the parents to make a medical decision that could harm others, kinda like gun control.
dave says
And just think, we in Fla have to wait until Nov 2026 to deal with these two delusional Trump butt kissing clowns.
Enough says
The Voodoo “so called” doctor strikes again!! I don’t know about you, but I sure as hell would never go to him for advice unless you have a death wish. Of course, a DUH Santis moron looking for that next paycheck. It is really scary realizing that Florida is being run by people that are threatened daily to do their “Lord and Master’s” bidding, or face termination from their jobs. Disgusting!!
Samuel L. Bronkowitz says
Isn’t Joseph Ladapo the guy that the University of Florida bent all sorts of rules for, giving him fast-tracked tenure because desantis brought him into florida to be the surgeon general? Man, if I were UF I would put as much distance between myself and this guy, but I’m not UF and they aren’t. I wonder why that is?
Stephen says
I thought loser Desantis moved to Iowa? Why is he still in Florida after losing primary? Florida Republicans do not want him anymore.
TR says
He’s still in Florida because before he ran for President he sign into law that during his run for President he did not have to give up his Governorship. So when he dropped out of the race he just went back to being Florida’s Governor. However, you are wrong about the Republicans not wanting him anymore. You also can not speak for any other person but yourself, so you don’t know what anyone else wants. Just more false statements from someone who has no clue.
JP says
I don’t want him. He’s an awful human and a disgrace to humanity.
Atwp says
Do believe Desantis children have the shot. Parents who follow this Dr. need mental help. If the parents don’t care about their children why should the state care about the children’s health. I don’t if they don’t.
Endless dark money says
You should question any African American that supports or was appointed by r -cons. They are literally racist and ignorant and against nearly everyone’s best interests. I bet he thinks drinking his own piss is the cure.
Mothersworry says
Just when you thought it couldn’t get dumber. Do these people stay up all night thinking of stupid things to say. But, you have the ex president at one time suggesting injecting bleach to prevent the corona virus. Will it ever end????
Skibum says
Nothing would surprise me coming out of the mouth of this quack. The very unfortunate thing about what he says is the fact that, as this state’s highest level medical authority, there will undoubtably be quite a few people, including parents of young children and school administrators, who will give credence to his dangerous, outright falsehoods and disingenuous misrepresentations of medical science when it comes to the efficacy of vaccinations. When DeathSantis was looking for a state surgeon general, he was not seeking out the most qualified and experienced medical doctor. He only wanted a puppet person who agreed with our horrid governor’s political talking points, no matter how incorrect they happened to be. And behold, Lapado was the perfect lap dog, and together, these two individuals are wholly responsible for Florida’s extremely high mortality rate during the covid pandemic. But that wasn’t enough for them… now they are encouraging parents to NOT vaccinate their children and then to send them to schools where an out-of-control measles outbreak is occurring! As far as I am concerned, both DeathSantis AND Lapado should be held criminally liable from this day forward for any school student in any of the measles outbreak schools who either has to be hospitalized or dies as a result of their parents relying on the outright lies and disinformation from these two state officials.
Steve says
Dr Lapdog speaks and inserts foot yet again. He really is a quack Dr
Michael J Cocchiola says
Sadly, children will suffer most from Floriduh’s medical quackery.
George says
Did Ladapo really attend medical school? Where does DeSantis find these people?
John says
Ladapo should be fired a long with DeathSantis who hired him. Ladapo is like a Witch Doctor with no medical training or education. If you trust what he says you can be sure to end up in the hospital very sick. DeathSantis is unqualified to be a Governor see what happened to him trying to run for the White House, he got the boot just like he needs in Florida, booted out.
Former Grandhavener says
So glad I moved the F out of FL