Florida schools and daycares may soon end requirements for four childhood vaccines, after the state department of health holds a hearing on the matter Thursday.
The idea to relax these rules came from Florida Surgeon General Joseph Ladapo, who has advocated for parental choice and medical freedom, and likened all vaccine mandates to “slavery.”
Earlier this year, Florida legislators balked at a medical freedom bill that would have expanded ways for parents to opt their children out of common shots for schools. National polls show most parents are confident in the safety of vaccines for schoolchildren.
Meanwhile, pediatricians across the country have warned that making immunizations voluntary will lower protection and raise the incidence of preventable diseases and deaths.
Here’s information on the four vaccines in question, and the diseases they prevent, based on data from a University of Florida white paper issued in October 2025, one month after Ladapo initially called for an end to all vaccine mandates.
Ladapo declined WUSF's request for an interview ahead of Thursday's meeting.
According to Dr. Michael Haller, professor in chief of pediatric endocrinology at the University of Florida, the white paper “was put together by a group of physician-scientists, independent of the university. We all happen to be university faculty and employees, but that doesn't represent the views of the institution.”
Haller added: “We felt compelled to put that paper out there because there is so much misinformation being spread throughout the state of Florida and nationally, some of which is being perpetrated by our own Surgeon General, who happens to be a faculty member at the institution (UF), and despite that, our institution has remained silent on much of the misinformation being spread.”
Hepatitis B
Newborns get three doses in their first year. Before the vaccine was introduced, there were 200,000-300,000 acute infections annually in the U.S.
Universal vaccination at birth brought the prevalence rate from 1.9% in 1988-1994 to 0.6% in 1999-2006.
“Hepatitis B, 50 years ago, was a principal reason for liver failure, and that includes cirrhosis or cancer,” said Sten Vermund, dean of the USF College of Public Health. “After the vaccine, we've systematically driven rates down, such that hepatitis B-related liver disease is really only occurring in the elderly who were not able to get vaccinated at all,” he added.
“We are raising an entire generation of children, adolescents, and young adults now that is of at no risk of hepatitis B induced liver cancer. So that to me is a dream come true.”
The UF white paper cited a mathematical model that “predicts that even a 10% decrease in vaccine coverage with the three-dose series can lead to up to a 60% increase in chronic infections among children across their lifetime.”
Pneumococcal conjugate
This shot protects against seven strains of bacteria, which can get into the bloodstream and cause ear infections, pnuemonia and meningitis.
“Before the 7-valent pneumococcal conjugate vaccine (PCV7) was routinely used in the national infant immunization program in the U.S., Streptococcus pneumoniae was endemic in the U.S. and caused over 17,000 cases of severe disease including 13,000 bacteremia and 700 meningitis cases and 200 annual deaths in children under 5 years of age,” according to the UF white paper.
READ MORE: Doctors sound alarm on meningitis cases
After a vaccine came out, there was a 64-93% decline in invasive disease. Florida has seen relatively stable disease rates in recent years, though pediatricians report seeing incidences of Hib more commonly than before as vaccine rates decline.
“They can be fairly benign. We might have pneumococcus hanging out in the back of our throat right now, without our suffering anything harmful, but certain triggers that we don't fully understand can lead to these bacteria being invasive,” said Vermund.
Haemophilus influenzae type B (Hib)
Another common bacteria, found in the nose and throat, that can lead to severe infections, like meningitis is haemophilus influenzae type B (Hib). It is not a type of flu.
Before the Hib vaccine came out in 1987, Hib was “the leading cause of bacterial meningitis and a major contributor to other invasive diseases including epiglottitis, pneumonia, septic arthritis, and cellulitis, in children under the age of 5 years,” said the white paper.
About 1 in 200 young children developed an invasive Hib infection by age 5, including meningitis, pneumonia, epiglottitis, cellulitis, septic arthritis, and bacteremia without a focus. Long-term damage included permanent hearing loss and severe neurologic impairment, with about 4% of cases resulting in death.
“When I was a practicing pediatrician (in the 1980s), these two diseases were the scourge of the pediatric emergency room,” said Vermund, referring to Hib and invasive pneumococcus.
“If we were fortunate to diagnose it, we could do everything right in treating these with antibiotics, and still their pathogenic process was so severe that you may have a child who passes away or who has permanent neurological damage, particularly hearing loss,” he said.
“And meningitis is common with both diseases when it's invasive, and there are all sorts of harmful sequelae, including compromised cognition. So people's intelligence can be compromised.”
Chickenpox (varicella)
Some may recall getting chickenpox as children, and experiencing mostly mild illness and itchy red bumps. But while complications are rare in children, they are more common in the elderly.
“We rely on reducing transmission in children to protect everybody because varicella typically is transmitted in childhood, preschool and early school age, and if we wipe out that transmission cycle, everybody benefits: all of the immunosuppressed children, all the immunosuppressed adults, all of the persons for whom chickenpox could be a very serious disease,” said Vermund.
“Chickenpox is not a very serious disease for most children under five, but the older you are — adolescents, adults, elderly — the more severe the clinical illness is.”
Making the vaccine optional will mean fewer children get the shot, and more older people risk complications from getting sick, Vermund said.
Shot 'risks' overblown
Most importantly, doctors say none of these vaccines are dangerous. But making them optional in the name of medical freedom will lead to more preventable disease and death.
“I've seen horrible things with children, and it's like a gift from God that the vaccines were developed, and the modern pediatrician hasn't seen either of these diseases — never seen invasive pneumococcus or invasive Hib,” said Vermund.
“So why would we invite these two horrible diseases back into our society? It’s a complete mystery.”
As to the risks of the vaccines themselves, Vermund said people who are against the shots “overstate the so-called harms of vaccines, which are really quite minimal,” and he believes many parents are “tragically misled.”
“I could go my whole pediatric practice, and I could have 10 partners going my whole pediatric practice for 40 years and not see a single side effect from any of these vaccines. That's how infrequent it is,” Vermund said.
Predicting what the Department of Health will do after the hearing is tough, but Haller said politics must not influence vaccine decisions.
At UF, Ladapo “still remains a tenured professor, despite doing frankly nothing of substance for the institution that I'm aware of, all the while doing things that are frankly damaging to the public health of Floridians, because he's chosen to use his position to be a political pawn for the state administration,” said Haller.
Relaxing vaccine rules is a policy that is “going to actually hurt people, and the fact that the university has remained entirely silent about that, especially the College of Medicine when we are the flagship university for the state, and supposedly leading in health and science and discovery, has been incredibly frustrating to many of us,” added Haller.
“This is an issue of public health that affects people regardless of what political party or persuasion they are from, and we need to do what's right based on science and what actually promotes public health."
