The surgeon general in Florida is facing backlash for his actions regarding a measles outbreak at an elementary school. He has informed parents of unvaccinated children that it is up to them whether or not their children attend school, going against federal guidelines that require their exclusion.

Dr. Joseph Ladapo, a well-known figure for his vocal doubt of the effectiveness of the COVID-19 vaccine, wrote a letter to parents of Manatee Bay Elementary School in Fort Lauderdale this week. The letter was prompted by six students at the school testing positive for the highly transmissible and potentially fatal virus. While outbreaks like this are uncommon in the US, there has been a significant increase in reported cases from 58 in 2023 to 35 so far this year.

The message states that in the event of a measles outbreak at a school, it is typically advised for unvaccinated students who have not previously contracted the disease to stay at home for three weeks due to the high probability of them becoming infected.

However, the letter states that the state currently has no plans to make this recommendation mandatory. According to the Broward County school district, 33 out of 1,067 students at Manatee Bay have not received at least one dose of the two-dose measles vaccine. This vaccine also provides protection against mumps and rubella and remains highly effective against measles even after only one dose. The school is located in Weston, a wealthy suburb with a median household income of over $120,000 per year.

Because the community has a high level of immunity and families face financial and educational challenges when their healthy children miss school, the state health department is allowing parents or guardians to decide whether or not their children should attend school. This decision was stated by Ladapo, who was chosen by Republican Governor Ron DeSantis in September 2021 due to their shared stance against COVID-19 vaccine and mask mandates as well as school closures.

The language he uses conflicts with the guidelines set by the Centers for Disease Control and Prevention, which advise school administrators to exclude unvaccinated children for a period of three weeks. It should be noted that states are not obligated to adhere to these recommendations.

The decision to not prohibit unvaccinated children is receiving backlash from physicians in Florida and across the nation, including the American Academy of Pediatrics.

On Friday, Dr. Rana Alissa, the vice president of the academy in Florida, stated that the state should adhere to the CDC guidelines in order to protect our children’s safety. She expressed concern that allowing unvaccinated children to attend during the outbreak not only puts them at risk, but also endangers those with weakened immune systems who may contract it from them later on.

According to the speaker, in order to control an outbreak, it is necessary to adhere to public health and safety guidelines rather than allowing individuals to make their own decisions. She believes that allowing choice is what led to the current situation.

According to Jodie Guest, an expert in disease control at Emory University’s Rollins School of Public Health, the guidelines provided by the CDC have been developed over many years of scientific research. However, there is misinformation being spread about the safety of the measles vaccine. The CDC states that in very uncommon cases, the vaccine may cause seizures that are not permanent or life-threatening.

She stated that there is a widespread problem of false information in the science community.

A phone call requesting a response to the critique was not answered by Ladapo’s office on Friday.

The health department has the authority to make decisions regarding the mandatory exclusion of unvaccinated students, according to the school district. John Sullivan, a spokesperson, did not disclose whether the six sick children were unvaccinated due to privacy reasons.

Florida legislation mandates that students receive vaccinations for measles and other infectious diseases, however, exemptions are permitted by a medical professional or by parents who object based on religious grounds. Officials are prohibited from requesting further details about these beliefs.

The measles virus can be spread through exhalation, coughing, and sneezing by infected individuals, and it can remain in the air and on surfaces for up to two hours, infecting multiple people. Contagion can occur up to four days before symptoms such as a rash, fever, cough, runny nose, and watery eyes appear in an infected person.

According to the CDC, individuals who have received the vaccine are unlikely to contract the illness. In the rare case that they do, their symptoms are milder and they are less likely to spread the disease to others.

Excluding individuals who have not received vaccinations, the group most vulnerable to the infection consists of babies who have not yet been able to receive the vaccine, individuals with weakened immune systems due to illnesses like cancer and HIV, and pregnant women whose unborn babies may be negatively impacted.

According to the CDC, although many individuals who contract measles usually make a full recovery, an unvaccinated person who catches the disease has a 20% likelihood of requiring hospitalization.

Approximately 5% of children who are infected will develop pneumonia, while 1 in every 1,000 may experience brain swelling resulting in deafness or intellectual disability. According to the CDC, between 1 and 3 out of every 1,000 unvaccinated infected children will succumb to the disease.

In 1963, prior to the implementation of measles vaccinations, over 400,000 people in the United States were infected with the disease each year. However, thanks to the vaccine, the number of cases decreased significantly to 47,000 in 1970 and 13,000 in 1980. Although there was a slight increase to 27,000 cases in 1990, by the year 2000, there were less than 100 reported infections.

However, there was a significant increase to 1,200 cases in 2019, followed by a decrease due to the COVID-19 lockdowns in 2020 and 2021.

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Devi Shastri, a reporter for AP Public Health in Milwaukee, contributed to the information in this report.

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