On February 20th, Florida Surgeon General Joseph Ladapo reportedly undermined a public health standard controlling measles outbreaks throughout the state. Ladapo sent a short letter to parents amid a measles outbreak that spread through Manatee Bay Elementary School in South Florida, stating they had sole permission to send their children to school unvaccinated.

Ladapo wrote that the Department of Health “is deferring to parents or guardians to make decisions about school attendance.” Ladapo was appointed to head of the agency by Florida Governor Ron DeSantis (R). The move directly conflicts with the advice of the Centers for Disease Control and Prevention (CDC).

Florida’s former surgeon general turned professor at Brown University, Scott Rivkees, said, “This is not a parental rights issue. It’s about protecting classmates, teachers, and community members against measles, a severe and transmittable illness.”

The majority of unvaccinated people will get measles if exposed to the virus. Among the most vulnerable are infants, those with weakened immune systems, those who can’t be vaccinated for medical reasons, and children whose parents opt not to get them vaccinated.

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Since the measles virus quickly spreads on tiny droplets on surfaces and through the air, students sitting in the same classroom or cafeteria as someone infected are considered especially vulnerable to catching the illness. For this reason, the CDC highly advises unvaccinated students to stay home for at least three weeks following exposure. A person infected with the virus can pass it along before developing a cough, rash, fever, or other symptoms. Approximately one in five people end up hospitalized, one in 10 develop severe ear infections that can cause permanent hearing loss, and around one in 1000 die from neurological and respiratory complications.

Miami and Broward pediatrician and president of the Florida chapter of the American Academy of Pediatrics, Thresia Gambon, said, “I don’t know why the health department wouldn’t follow the CDC recommendations. Measles is so contagious. It is very worrisome.”

As a reference, an individual is approximately four times more likely to die from a lightning strike in the United States than a potentially life-threatening allergic reaction to the rubella, mumps, or measles vaccine. Considering the dangers of measles, the vaccine is far safer.

Still, a record number of parents filed for exemptions from school vaccine requirements last year. According to the CDC, childhood immunization rates struck a 10-year low. Beyond Florida, measles cases have been located in 11 additional states, including Arizona, Georgia, Minnesota, and Virginia.

Approximately one-fourth of Florida’s counties have hit the 95% threshold, which considers a community well-protected against outbreaks. Six measles cases have been reported over the past week in Broward County, where around 92% of kindergarten children had received routine immunizations. The other 8% included children (over 1,500) with vaccine exemptions.

Since the start of the outbreak, Manatee Bay Elementary has offered measles vaccines. A person who gets a dose of the vaccine within three days of exposure is much less likely to catch and spread the virus.

Ladapo has directly disregarded CDC recommendations, leaving the choice to the parents on the grounds of a “high immunity rate in the community,” which is contradicted by confirmed data. Ladapo also cited the “burden on families and educational cost of healthy children missing school.”

However, the burden of an outbreak only increases as the virus spreads, requiring additional emergency care, further testing, and broader quarantines. Ladapo’s memo to parents also marks a separation from the standard because state or federal authorities seldom take the lead on containing measles outbreaks, generally leaving the issue in the hands of local health departments.

Data scientist Rebekah Jones said, “The county doesn’t have the power to disagree with the state health department.”

DeSantis appointed Ladapo head of the state health department in 2021 as he incorporated skepticism about COVID-19 vaccines into his political agenda. Jones was not surprised by Ladapo’s letter, stating, “I think this is the predictable outcome of turning fringe, anti-vaccine rhetoric into a defining trait of the Florida government.”

Gambon is highly concerned, saying, “I would like to see the surgeon general promote what is safest for children and for school staff.” She continued, “Since I am sure there are many who might not have as strong immunity as we would hope.” The Florida Health Department wrote in an e-mail, “The surgeon general’s recommendation may change as epidemiological investigations continue.”