With a brief memorandum, Florida Surgeon General Joseph Ladapo overhauled public health standards that had long kept measles outbreaks under control.
On Feb. 20, as Measles spread through Manatee Bay Elementary In South Florida, Ladabo sent a letter to parents allowing unvaccinated children to go to school amid the outbreak.
The health department “deferred to parents or guardians to make decisions about school attendance,” wrote Latabo, who was appointed to head the agency by Florida Gov. Ron DeSantis.
Movement of Ladapo Against the advice From the Centers for Disease Control and Prevention.
“This is not a parental rights issue,” said Scott Rivkeys, a former Florida 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 highly contagious disease.”
Who are most people? Not protected by vaccination Measles is caused by infection with the virus. This vulnerable group includes children whose parents did not vaccinate, children too young to vaccinate, those who cannot be vaccinated for medical reasons, and others who are not robust, durable. Immune response For that. According to Rivkey's estimate, one-tenth of a society belongs to the vulnerable category.
The CDC recommends that unvaccinated students stay home from school for three weeks after exposure. Because very contagious Measles virus spreads Students may be exposed to small droplets in the air and surfaces, sitting in the same cafeteria or classroom as an infected person. And a person with measles may pass the infection before developing a fever, cough, rash, or other symptoms of the disease. About 1 in 5 people with measles are hospitalized, and 1 in 10 develop it Ear infection This can lead to permanent hearing loss 1 in 1,000 They die of respiratory and neurological complications.
“I don't know why the health department doesn't follow the CDC recommendations,” said Theresia Kampen, president of the Florida chapter of the American Academy of Pediatrics and a pediatrician who practices in Miami and Broward. Measles outbreak. “Measles is very contagious. It's very worrying.”
Considering the risks of the disease, the vaccine is incredibly safe. About a person Four times A life-threatening allergic reaction to the measles, mumps, and rubella vaccine is the most likely to die from lightning strikes in their lifetime in the United States.
However, last year A Registration number Parents have applied Exemption from school vaccination requirements Across America on religious or philosophical grounds. CDC reports Childhood immunization rates A foot 10 years less.
Except for Florida, Measles cases 11 states have reported this year, including Arizona, Georgia, Minnesota and Virginia.
Only a quarter of Florida counties have reached the 95% threshold in which communities are considered well protected against measles outbreaks, according to a recent report. Data published by the Florida Department of Health in 2022. In Broward County, which reported six measles cases in the past week, about 92% of children in kindergarten received routine vaccinations against measles, chicken pox, polio and other diseases. The remaining 8% includes more than 1,500 children exempt from vaccination by 2022.
Broward's local health department is providing measles vaccines at Manatee Bay Elementary, according to the district's superintendent of schools. If an unvaccinated person gets a dose within three days of contracting the virus, they are much less likely to get measles and spread it to others.
Matias J. Ocner/Miami Herald/Tribune News Service via Getty Images
For this reason, government officials have occasionally mandated vaccinations in emergencies in the past. For example, Deputy Health Commissioner of Philadelphia In 1991, he ordered children to be vaccinated against their parents' wishes during outbreaks at their faith-healing churches. In 2019, when there was a large outbreak of measles among Orthodox Jewish communities in Brooklyn, the New York City Health Commissioner mandated that anyone who lived, worked or attended school in the hardest-hit neighborhoods. Get vaccinated or face fines $1,000. In That commandUnless medically contraindicated, anyone unvaccinated in those areas “creates an unnecessary and avoidable risk of continued infection,” the commissioner wrote.
Ladabo moved in the opposite direction with his letter, deferring to parents because of the “high immunity rate in the community,” conflicting data, and the “burden on families and the cost of education for healthy children who drop out of school.”
Yet the burden of an outbreak only becomes greater when measles spreads, and emergency care, more testing, and more illness and hospitalizations require wider quarantines. Southern Washington is controlling the 2018 outbreak with 72 cases It will cost about $2.3 million, an estimated $76,000 in additional medical costs and $1 million in economic losses due to illness, isolation, and care. If the numbers go up, death will also become a burden. An outbreak occurred in Samoa among a largely unvaccinated population 5,700 cases and 83 deaths Mainly among children.
Ladabo's letter to parents represents a departure from the norm, as local health departments are often at the forefront of controlling measles outbreaks, rather than state or federal authorities. In response to questions from KFF Health News, Broward County's health department deferred to Florida's state health department, which Latabo oversees.
“The county doesn't have the authority to disagree with the state health department,” said data scientist Rebecca Jones, who was fired from her position at the Florida Department of Health in 2020 because of a rift over coronavirus data.
DeSantis, a Republican, appointed Ladapo to head the state health department in late 2021 as DeSantis coordinated skepticism about Covid vaccines. His political platform. In the following months, the Florida Department of Health Deleted information From its home page on COVID vaccines and The District Health Director has been reprimanded He resigned for encouraging his staff to get vaccinated. In January, the Department of Health website published Ladabo's call for a complete halt to vaccination with Covid mRNA vaccines. Scientists call it incredible.
Jones was not surprised to find that Ladapo was a precursor to measles. “I think it's a predictable result of turning fringe, anti-vaccine rhetoric into the defining characteristic of Florida government,” he said. Although his latest decision contradicts CDC advice, the federal agency rarely intervenes in measles outbreaks, leaving the task to states.
In an email to KFF Health News, the Florida Department of Health said it is working with others to identify contacts of people with measles, but details about cases and locations of exposure are confidential. It reiterated Ladabo's decision, saying “the Surgeon General's recommendation may change as epidemiological studies continue.”
For Kampen, the explosion is already disconcerting. “I would like to see the surgeon general publicize what is safe for children and school staff,” she said, “and I believe there are many people who don't have as strong an immune system as we would hope.”
KFF Health NewsFormerly known as Kaiser Health News (KHN), it is a national newsroom that produces in-depth journalism on health issues and is one of the main operating programs. KFF – Independent source of health policy research, polling and journalism.
