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Florida’s Disney World has so far escaped large measles outbreaks, like the one California’s Disneyland grappled with a decade ago. That outbreak spread rapidly because some schools in Southern California had far less vaccination coverage than required for herd immunity. More than 300 people were sickened in the U.S. and Canada.

However, Florida’s vaccination rates have dropped in recent years. And that’s bound to worsen as the state’s surgeon general, Joseph Ladapo, enacts a decree ending school requirements for childhood vaccinations. 

Ladapo holds more power over the state’s centralized public health system than his counterparts in other states, where county health departments act with greater autonomy. Under his leadership, Florida health departments posted misinformation on Covid vaccines last year and issued advice contradicting the public health consensus — namely, that unvaccinated students exposed to measles need not quarantine at home. 

Around 90% of people unvaccinated against measles will be infected if exposed. Roughly 1 in 5 people with measles can end up hospitalized, and 1 in 10 develop ear infections that can lead to permanent hearing loss. 

Florida researchers and doctors have been critical of Ladapo’s shutdown of school vaccine requirements. But many have declined to speak out against it, according to KFF Health News senior correspondent Arthur Allen. Doug Barrett, formerly the chief of pediatrics at the University of Florida, told Allen that university administrators have muzzled infectious disease experts. 

Florida is the first state to revoke school vaccine requirements, although several states have made exemptions easier to obtain in the past few years and parents have increasingly used them. As a result, kindergartner vaccine rates are at a 10-year low.

Other countries are seeing falling vaccination rates, too, as misinformation and a backlash against vaccine requirements rise. Some countries have also been hurt by a prolonged lapse in vaccination programs at the peak of the Covid pandemic. 

Canada may lose its status as a measles-free country because the virus has spread continuously there for a year. A division of the World Health Organization will review the data in November and decide. The United States may not be far behind, with more measles cases this year than in the past three decades.

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