Florida is lifting school mandates for some vaccines, including the shot to prevent hepatitis B despite state Department of Health data showing cases have risen sharply over the past two decades.
There were 11 acute cases — or new infections — in Florida children in 2023, the most in a year since 2001.
In 2005, Florida had 597 cases of chronic hepatitis B, the type that can lead to liver cancer and severe disease. By 2023, the latest year for which data are available, that number leapt nearly tenfold to 5,694.
Infectious disease doctors said there is no medical reason to remove a state requirement for hepatitis B vaccines for infants and school-age children.
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"It's a very safe vaccine,” said Scott Weaver, an infectious disease expert at the University of Texas Medical Branch.
Weaver described the decision announced by Florida Surgeon General Dr. Joseph Ladapo this month to start lifting all vaccine mandates ias “very concerning” and a "mistake."
Ladapo likened vaccine mandates to “slavery” and vowed to act swiftly to change rules that require vaccines against hepatitis B, varicella (chickenpox), haemophilus influenza Type b (Hib), and pneumococcal conjugate vaccines. Those could be lifted through a rule-making process in 90 days.
Florida is the first state to initiate such a sweeping change. Other immunizations are written into state statutes and would require legislation to eliminate, including vaccines for polio, diphtheria, rubeola, rubella, pertussis, mumps and tetanus.
Pediatricians weigh in
The Florida chapter of the American Academy of Pediatrics is against altering state immunization requirements for schoolchildren and is lobbying lawmakers to maintain mandates for vaccines against polio, measles and other diseases.
“I don't believe there is a single vaccine that is not important,” said Dr. Rana Alissa, chapter president. “Every vaccine counts, and the reason why people are living longer is because of these vaccines. Children are healthier than any time because of these vaccines.”
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As vaccine hesitancy spreads nationwide, fueled in part by the rise to power of prominent skeptics like Health and Human Services Secretary Robert F. Kennedy Jr., some parents say they are wary of the shot, questioning why infants on their first day should be exposed to an infection that can be spread by sexual contact.
The hepatitis B shot is “not a live, replicating virus, unlike some vaccines, so almost anybody can take it. It can be given to very young babies, and it's very effective,” Weaver explained.
Hepatitis B can also spread via needles and contaminated blood products, and vaccination early in life is the safest way to prevent the spread, he said.
“Sexually transmitted diseases, although we think that we can control them with behavior, it doesn't usually work out that way, and so vaccination is a much safer bet than hoping that your children will remain inactive sexually when they reach that age and not acquire the infection as a teenager or early stage adult,” Weaver said.
'Dangerous and confusing'
Statewide, overall vaccination rates among children entering kindergarten for the entire recommended immunization schedule have dipped to 89%, which is below the 95% threshold needed for herd immunity against a host of contagious diseases.
Alissa lamented the misinformation that parents are hearing and seeing online, coupled with anti-vaccine rhetoric from the state’s top medical officer.
“The conflicting messages here, they're so dangerous. They're so confusing,” she said.
“When you have a lay person listening to this and that, and ‘I said so,’ and ‘he said so,’ and everyone is saying something differently, we're confusing them. You should not confuse the public.”
The health department said vaccines will remain available to Floridians who want them.
"The update does not limit access to vaccines and instead removes the state mandate for the stated vaccines," the agency said in a statement.
"Medical freedoms are the focus, and these vaccines will remain available to families throughout Florida. Parents are encouraged to consult with their health care providers when making health care decisions for their children."
