By Lauren MacIvor Thompson and Stacie Kershner
On Sept. 3, 2025, Florida announced its plans to be the first state to eliminate vaccine mandates for its citizens, including those for children to attend school.
Current Florida law and the state’s Department of Health require that children who attend day care or public school be immunized for polio, diphtheria, rubeola, rubella, pertussis and other communicable diseases. Dr. Joseph Ladapo, Florida’s surgeon general and a professor of medicine at the University of Florida, has stated that “every last one” of these decades-old vaccine requirements “is wrong and drips with disdain and slavery.”
As experts on the history of American medicine and vaccine law and policy, we took immediate note of Ladapo’s use of the word “slavery.”
There is certainly a complicated history of race and vaccines in the United States. But, in our view, invoking slavery as a way to justify the elimination of vaccines and vaccine mandates will accelerate mistrust and present a major threat to public health, especially given existing racial health disparities. It also erases Black Americans’ key work in centuries of American public health initiatives, including vaccination campaigns.
What’s clear: Vaccines and mandates save human lives
Evidence and data show that vaccines work, as do mandates, in keeping Americans healthy. The World Health Organization reported in a landmark 2024 study that vaccines have saved more than 154 million lives globally in just the past 50 years.
In the United States, vaccines for children are one of the top public health achievements of the 20th century. Rates of eight of the most common vaccine-preventable diseases in school-age children dropped by 97% or more from pre-vaccine levels, preventing an estimated 1,129,000 deaths and resulting in direct savings of US$540 billion and societal savings of $2.7 trillion.
History of vaccine mandates in the United States
Vaccine mandates in the United States date to the Colonial period and have a complex history. George Washington required his troops be inoculated, the predecessor of vaccination, against smallpox during the American Revolution.
To prevent outbreaks of this debilitating, disfiguring and deadly disease, state and local governments implemented smallpox inoculation and vaccination campaigns into the early 1900s. They targeted various groups, including enslaved people, immigrants, people living in tenement and other crowded housing conditions, manual laborers and others, forcibly vaccinating those who could not provide proof of prior vaccination.
Although religious exemptions were not recognized by law until the 1960s, some resisted these vaccination campaigns from the beginning, and 19th-century anti-vaccination societies urged the rollback of state laws requiring vaccination.
By the turn of the 20th century, however, the U.S. Supreme Court also began to intervene in matters of public health and vaccination. The court ultimately upheld vaccine mandates in Jacobson v. Massachusetts in 1905, in an effort to strike a balance between individual rights with the need to protect the public’s health. In Zucht v. King in 1922, the court also ruled in favor of vaccine mandates, this time for school attendance.
Vaccine mandates expanded by the middle of the 20th century to include vaccines for many dangerous childhood diseases, such as polio, measles, rubella and pertussis. When Jonas Salk’s polio vaccine became available, families waited in long lines for hours to receive it, hoping to prevent their children from having to experience paralysis or life in an iron lung.
Scientific studies in the 1970s demonstrated that state declines in measles cases were correlated with enforcement of school vaccine mandates. The federal Childhood Immunization Initiative launched in the late 1970s helped educate the public on the importance of vaccines and encouraged enforcement. All states had mandatory vaccine requirements for public school entry by 1980, and data over the past several decades continues to demonstrate the importance of these laws for public health.
Most parents also continue to support school mandates. A survey conducted in July and August 2025 by The Washington Post and the Kaiser Family Foundation finds that 81% of parents support laws requiring vaccines for school.
Black Americans’ long fight for public health equity
Despite the proven success of vaccines and the importance of vaccine mandates in maintaining high vaccination rates, there is a vocal anti-vaccine minority in the U.S. that has gained traction since the COVID-19 pandemic.
Misinformation proliferates both online and off. Some of the misinformation originates in the historical realities of vaccines and social policy in the United States.
When Ladapo, the Florida surgeon general, invoked the term “slavery” to refer to vaccine mandates, he may have been referring to the history of racism in the medical field, such as the U.S. Public Health Service Untreated Syphilis Study at Tuskegee. The study, which started in 1932 and spanned four decades, involved hundreds of Black men who were recruited without their knowledge or consent so that researchers could study the effects of untreated syphilis. Investigators misled the participants about the nature of the study and actively withheld treatment – including penicillin, which became the standard therapy in the late 1940s – in order to study the effects of untreated syphilis on the men’s bodies.
Today, the study is remembered as one of the most egregious instances of racism and unethical experimentation in American medicine. Its participants had enrolled in the study because it was advertised as a chance to receive expert medical care but, instead, were subjected to lies and painful “treatments.”
National Archives Catalog/Centers for Disease Control and Prevention
Despite these experiences in the medical system, Black Americans have long advocated for better health care, connecting it to the larger struggle for racial equality.
Vaccination is no exception. Despite the fact that they were often the subject of forced innoculation, enslaved people helped to lead the first American public health initiatives around epidemic disease. Historians’ research on smallpox and slavery, for example, has found that inoculation was widely accepted and practiced by West Africans by the early 1700s, and that enslaved people brought the practice to the Colonies.
Although his role is often downplayed, an African man known as Onesimus introduced his enslaver Cotton Mather to inoculation.
Throughout the next century, enslaved people often continued to inoculate each other to prevent smallpox outbreaks, and enslaved and free people of African descent played critical roles in keeping their own communities as healthy as possible in the face of violence, racism and brutality. The modern Civil Rights Movement explicitly drew on this history and centered health equity for Black Americans as one of its key tenets, including working to provide access to vaccines for preventable diseases.
In our view, Ladapo’s reference to vaccines as “slavery” ignores this important and nuanced history, especially Black Americans’ role in the history of preventing communicable disease with vaccines.
benoitb/DigitalVision Vectors via Getty Images
Lessons to learn from Tuskegee
Ladapo’s word choice also runs the risk of perpetuating the rightful mistrust that continues to exist in communities of color about vaccines and the American health system more broadly. Studies show that lingering effects of Tuskegee and other instances of medical racism have had real consequences for the health and vaccination rates of Black Americans.
A large body of evidence shows the existence of persistent health disparities for Black people in the United States compared with their white counterparts, leading to shorter lifespans, higher rates of maternal and infant mortality and higher rates of communicable and chronic diseases, with worse outcomes.
Eliminating vaccine mandates in Florida and expanding exemptions in other states will continue to widen these already existing disparities that stem from past public health wrongs.
There is an opportunity here, however, for health officials, not just in Florida but across the nation, to work together to learn from the past in making American public health better for everyone.
Rather than weakening vaccine mandates, national, state and local public health guidance can focus on expanding access and communicating trustworthy information about vaccines for all Americans. Policymakers can acknowledge the complicated history of vaccines, public health and race, while also recognizing how advancements in science and medicine have given us the opportunity to eradicate many of these diseases in the United States today.
Lauren MacIvor Thompson is an Assistant Professor of History and Interdisciplinary Studies at Kennesaw State University; Stacie Kershner is Deputy Director of the Center for Law, Health & Society at Georgia State University.
Watch it fall says
Republicans don’t care about people. Only money and power. They just kicked 13 million from healthcare and policies like this only help insurance companies by not having to pay for them. People will die from bad policies just like this. It’s unamerican to support the orange terror and his total disregard for the constitution!
Atwp says
Thank you for the story. African Americans need to take care of themselves. The syphillis test on African American men should show us that they, white men are deadly liars. We need to eat right, drink plenty of water, exercise regularly so we can enjoy a long life. This country love to test other prop,e but themselves. That medical guy in Tallahassee is I don’t know what. He is bad for society like most of the Republican leaders. African Americans please take care of yourselves, they will kill us but they will not take care of us. Thank God death come to them too.
Deborah Coffey says
There will be numerous deaths so, let’s call this what it is…murder. Young and old will die, health insurance rates will go through the roof, hospitals will be overburdened if they haven’t already closed under Trump’s Big Beautiful Bill.
What is behind this murderous decision? Is it to sacrifice the lives of hundreds of children to cause the deaths of those of us on Social Security and Medicare? More money for Trump’s and his oligarchs’ pockets? Honestly, I can’t see another reason because the only things Fascists care about are money and power…and, they will kill to keep both.
Doris Marie Brown says
Other vaccines including for poliomyelitis, diphtheria, tetanus, pertussis, measles, mumps and rubella will remain in place unless updated through legislation, according to the state Department of Health.
joe says
Surprising Covid-19 information — I’m over 65, with underlying conditions. I’ve gotten Covid-19 vaccinations previously without needing a doctor’s prescription. Since last Friday, I’ve been trying to find out the latest information on availability in Florida and under what new “standards” the anti-vaccine nuts have imposed.
CDC – as I write this, CDC.gov still has an outdated (one of many) page regarding the vaccine. Dated June6, 2025:
From CDC.gov:
“COVID-19 VACCINE RECOMMENDATIONS
COVID-19 vaccine recommendations have recently been updated for some populations. This page will be updated to align with the updated immunization schedule. Learn more.” – The “Learn more” link takes you to another page Dated May 29, 2025: It contains this information:”
CDC recommends a 2024-2025 COVID-19 vaccine for most adults ages 18 and older. Parents of children ages 6 months to 17 years should discuss the benefits of vaccination with a healthcare provider.
The COVID-19 vaccine helps protect you from severe illness, hospitalization, and death.
It is especially important to get your 2024–2025 COVID-19 vaccine if you are ages 65 and older, are at high risk for severe COVID-19, or have never received a COVID-19 vaccine.
Vaccine protection decreases over time, so it is important to get your 2024–2025 COVID-19 vaccine.” – NOTE: Nothing here about needing a doctor’s prescription.
I called the CDC on Monday to see if there was any updated information as to vaccines, as TWO local pharmacists told me they were “waiting on CDC” for guidance — my question to CDC was “what is it that my pharmacists are waiting for, and when might it be coming”–
To my surprise (and maybe I shouldn’t have been) but when you use the contact number for CDC from their website, you are NOT reaching CDC – using two other numbers got the same result- you are not talking to a CDC representative – you have instead reached “CDCinfo ” – I had to ask several time before the rep told me who they were – they are a “contracted provider” to CDC – ANY questions I asked about Covid-19 were met with these answers: “we are not able to provide info related to Covid-19 through this phone line.” also: “I won’t be able to discuss information related to Covid-19” –She kept referring me back to the outdated cdc.gov page.
So, it is not only misinformation that we face, it NO INFORMATION…..
FLORDIA DOH – I was stunned to find the Florida DOH site now seems to reflect the anti-vaccine view of the Surgeon General:
Prominent on the page is a tab where you can file complaints about vaccine and mask restrictions you are subjected to.
When you click the “Most Viewed Disease” tab, guess which one is NOT on the list.
The “All Diseases” tab has the same disease missing. (It’s Covid-19)
The latest guidance from the Surgeon General is from September 2024.
Knowing his stated intent to eliminate MRNA vaccines, in Florida, we are deep trouble.
Between the ignorance and cruelty coming out of HHS and the White House, we need to trust other sources of information – real doctors and reputable health groups.
It seems that CVS (my usual pharmacy ) has a policy of requiring a doctor’s prescription to apparently guard from legal liability. This chaos of pharmacists, patients, and doctors not knowing what to do is appalling – my doctor’s office said they are “getting inundated all day” with requests for a Covid-19 prescription. Something that used to be routine – getting a tested and safe vaccine is now transformed into a nightmare of uncertainty – all because we have an ignorant, malevolent President who appointed a crackpot conspiracy nut to head our public health system.
PaulT says
Actual science doesn’t appear to be a factor in the Florida Surgeon General’s vaccine decision, or the more recent but equally dubious advice from president Trump on vaccines and OTC drug safety.
In light of the facts I can only conclude that both Gov Ron DeSantis and president Dpmald Trump have rejected years or research and succumbed to conspiracy theories and unproven pseudo science. Alternatively I suppose it’s possible, that both of them are simply trying to capture the anti=vacc segment of the science sceptic voting block for the 2026 mid terms. Because people in power can’t be that stupid, can they?
Joe D says
For Doris Marie Brown:
Yes (at least for the MOMENT) the vaccines for “childhood” diseases will remain AVAILABLE, however, for HERD IMMUNITY (enough of the population is immunized to keep an outbreak from rapidly spreading), enough people have to be vaccinated. In Florida, the vaccination rates among children have DROPPED below the level of HERD IMMUNITY community protection from an outbreak.
The secondary effect is that if vaccinations are not mandated, insurance companies can decide not to pay for them ( injections can cost hundreds of $$ each). Many low income (and middle income) families will not be able to afford the cost, especially if there are multiple children.
As a retired Registered Nurse with a MS in Nursing as a Clinical Nurse Specialist and Certified Nurse Case Manager with 43 years of experience, I find the medical misinformation MADDENING! And more and more people are confused or fulling believing the outright LIES!
I actually caught Measles, and chicken Pox. I got exposed at school in kindergarten , and brought it home and exposed my 1 year younger brother. Luckily neither of us had serious side effects, but some of my classmates weren’t so lucky. POLIO was the fear in the late 50’s and early 60’s. I remember pools being closed for the summer due to epidemics. I also remember standing in line in our Church hall to get the “sugar cube” dose for POLIO when it came out. Some of my classmates were out sick for MONTHS! Some came back with large metal walking braces and forearm crutches! Some didn’t come back AT ALL!!!
Most of my grandchildren are old enough to be at least partially vaccinated…hopefully they will complete their vaccination schedule BEFORE the new outbreaks occur in Florida ( like in the unvaccinated populations in Texas and New York that died, or were disabled from Measles )…and there WILL BE OUTBREAKS!!!
Don’t fool yourselves with this anti vaccine INSANITY!!!
Skibum says
Well, yes… why don’t we all just listen to the wunderkind genius in the WH who seems to know all about EVERYTHING, just ask him! Let’s just nod our heads like ignorant sheeple and follow his brainiac suggestion to grab a syringe and some bleach, and inject that into our bodies to see if his witchcraft potion might cure all that ails us, including the coronavirus.
Who needs medical science and scientific research anyway? Throw out those medical textbooks! End funding for all clinical research studies! Cancel grants to colleges and universities! All that America really needs is a weirdo with an admitted brain worm burrowing around upstairs, making a mish mash of what’s left of cocaine altered brain cells.
Yes, drive around until you find some wayward bear, crush it with your car, stick the carcass in your trunk and let it get real ripe while you try to decide how best to eat the damn thing. Then tell everyone you come in contact with how the food THEY eat will kill them.
Aren’t we all so fortunate to have wackadoodle ignoramuses like drumph and RFK Jr. finally exposing all of our nation’s top medical researchers as conspirators and frauds who have been trying to eradicate the human population from planet earth simply because they don’t like people, isn’t that right?
Even better, other states should elevate medical morons like our own truth and fact reject Ladapo, the lap dog of degenerate DeSantis, so the rest of the states can have the same rise in childhood infectious disease outbreaks as Flori-DUH!
Aren’t they doing a bang up job making America great again?!?!?!
BillC says
For his de facto first day on the job, Ladapo signed an emergency rule that repealed required quarantines for schoolchildren who were exposed to Covid-19.
Ladapo has also co-authored an analysis that determined hydroxychloroquine was effective in treating Covid-19. Less than three months before Ladapo’s analysis was published, the U.S. Food and Drug Administration determined hydroxychloroquine wasn’t safe because it led people to have heart problems. Also, an FDA study determined the medicine wasn’t effective against the virus. Does Ladapo have a brain worm too?
nope says
Great! As a parent, I want full control away from the government. No seat belts, I don’t think we need them and if there is an accident, getting thrown from the car is the best chance of survival for myself and my children. Motorcyclists don’t need helmets and neither do my children when they bike around the neighborhood. Freedom for all! Further more, I don’t think that surgeons need to wear masks when the perform a surgery or gloves, for that matter. Why would they be required to do this and their rights as an individual be taken away? I don’t get it. The government shouldn’t be able to tax me. I don’t care where the money comes from for infrastructure, health, schools, street repairs, etc. come from– not my problem and I shouldn’t have to pay in if I don’t want to. Another thing– teacher certifications, day care schools requiring certificates and clean records should be abolished! Anyone should be able to get one of these jobs if they want it. The other side of the coin– I don’t have to send my kid to public school if I think there are transgressions with hiring processes. No books- you want one, you buy one to have at home. I think everyone gets the gist of what I’m saying….
Laurel says
Nope: I certainly hope you are joking, it’s hard to tell. So many people today are really of the mindset you describe. If you are not joking, heaven forbid, please go ask a doctor why he/she wears a mask during surgery. The washing of hands is not optional, either.
Actually, I agree with some of what you wrote. When I was a kid, our mom’s arm was our seat belt! Now days, kids are padded to the hilt before being let out on a “play date.”
Play date. Geez! Seriously?
But, those examples are not the same as contagions. For parents to sacrifice their children for the support of unscientific misinformation, is irresponsible. Kids are like petri dishes with legs. We were told to go out and play while infected with chicken pox, to get it over with. We did, we infected other kids, we all got chicken pox. Now, because of the lack of a chicken pox vaccine, at the time, and spreading the infection, we have to be concerned about the return of the dormant virus erupting as shingles. Thank goodness there’s a vaccine for that! Other diseases are far less forgiving.
Some think it’s okay to bring the diseases home to Grandma, or to the baby. Is the name of the game culling the poorer, and middle wealth among us, since these vaccines are available to those who can afford it? Or is just ignorance and selfishness at the top of our political theater?
Trump, DeSantis, Lapado and RFK have no business whatsoever, to limit our desire to protect ourselves and our families. I have never seen a dumber administration. They cannot leave soon enough.