Florida's former surgeon general, Dr. Scott Rivkees, is speaking out against a proposal to remove statewide vaccine mandates for schoolchildren, warning of a resurgence of deadly diseases and complications affecting kids and adults.
His successor, Dr. Joseph Ladapo, cited parental rights when announcing the state will work to end the requirements but emphasized all vaccines would remain available for families who chose to get them.
In an editorial in the Tampa Bay Times on Tuesday, Rivkees recalled that the first child he treated as a pediatric intern was a 4-year-old boy with severe brain inflammation due to chickenpox (varicella).
He also pointed out that Ladapo's plan has been "strongly criticized by the medical community within and outside of Florida and by Florida elected officials."
Rivkees is now associate dean for education at the school of public health at Brown University in Rhode Island.
In an interview with WUSF's Kerry Sheridan, Rivkees explains why he believes the state is going backward when it comes to childhood vaccines.
The interview below was lightly edited for clarity.
What made you want to write this?
I think that what's happening in Florida in terms of his [Ladapo] current recommendations is worrisome, not just for children, but for all people living in the state of Florida. It actually has implications beyond Florida.
One of the things we know is that vaccines are just an amazing public health success, and anything that undermines vaccination is going to have an impact on children and actually on the community at large.
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I've cared for many other children who suffered — some of whom died — from diseases that are now vaccine-preventable, and to think that we can wind the hands of the clock back in time, that we're going to now start seeing children suffer from chickenpox, haemophilus influenza, hepatitis B, pneumococcal disease. It really shouldn't be that way.
You point out that the Florida Department of Health should do a projection of what the impacts of this decision would be, and they haven't.
The Florida Department of Health is a great department. They have great epidemiology; they can certainly make these types of projections.
But we know what cases were in the pre-vaccination era. In the United States, there were 500,000 cases of measles a year before vaccines were introduced. There were more than 4 million cases a year of chickenpox, 20,000 cases haemophilus influenza. In Florida, we contribute about 7 to 8 percent of those cases. So information is out there.
"So it's to protect everybody, young and old, individuals who are healthy, individuals who may have underlying medical conditions. We are dependent on each other to keep each other safe and healthy."
Even just a couple months ago, there was an excellent study that came out at Stanford University looking at if vaccination rates, just focusing on measles, go down by 10% nationally, we'll be talking about more than 11 million cases of measles over the next 20 to 25 years. And in Florida, this means that there could be more than 1 million new cases of measles as well if vaccination rates just drop 10% from current levels of about 92%.
You mentioned in your editorial that you see leaders ignoring these principles for the sake of political ideology. Are you saying that Dr. Ladapo is doing that?
Dr. Ladapo has made some very different stances from the rest of the public health community. For example, one of the first things that he announced was that healthy children should not get vaccinated against COVID, even though the medical community was in agreement with that.
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During the pandemic, 2,000 children died from COVID while I was surgeon general. I reviewed every one of those sad death certificates, and most of these children did not have underlying medical conditions.
So this viewpoint was not adopted by any other state. And then last year, he announced that no individuals in Florida should have a messenger RNA vaccine, young or old, without telling older individuals, who are mostly at risk for COVID, what to do. No other state has adopted those guidelines. So the viewpoints that he has put forth are not in keeping with mainstream medicine.
I've heard Dr. Ladapo say, in his view, Florida is "leading the way." Do you see it that way?
He's leading the way, but nobody else is following. Again, in terms of the recommendation that healthy kids not get vaccinated, no other state adopted that.
Then he said young adult males should not get vaccinated against COVID. Same with the mRNA vaccines. And another thing that was very unconventional, when there was a measles outbreak in Broward County, he said it was up to the parents to decide whether their nonvaccinated, potentially exposed and contagious children could go back to school, which bears the risk of having measles spread further. And no other state or department of health has adopted those types of unconventional approaches for outbreak control.
The argument that some of the people who are against vaccines make is, "Well it's my choice." What do you say to that?
I understand the personal choice and personal freedom argument, but vaccines need to have two things that work.
First, parents need to vaccinate their children, and for that child to be protected, you're also dependent on other parents vaccinating their child as well. This is why every state in this country has vaccine mandates. This is something that society has decided, and the Supreme Court has decided this as well.
One of the reasons why it's important to have such broad vaccination leads to the concept we call herd immunity or community protection. Not all vaccinated children will end up being protected after vaccination, and some individuals may be immunocompromised, they may be treated for cancer, where their immune system is down. This could be children in school or people in the public.
So it's to protect everybody, young and old, individuals who are healthy, individuals who may have underlying medical conditions. We are dependent on each other to keep each other safe and healthy.
What do you think can be done to turn this around?
Parents need to reflect on the fact that when they vaccinate their child, they're not just protecting their child, they're protecting other children as well. We're in a community. We're in a society. We need to look out for each other. Let's not go to a situation where everybody's just looking out for themselves.
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