Proposed vaccine legislation has all eyes on Florida

Florida legislators will soon begin debating several bills that propose to alter vaccination practices in the state. If eventually signed into law, Florida would emerge as the most aggressive proponent of abandoning long-standing immunization practices and policies.

In Florida, Gov. Ron DeSantis and Florida Department of Health surgeon general Joseph Ladapo, announced a plan in September to repeal some vaccine requirements for entrance to Florida schools. Some bills supporting that plan have already been introduced in the Florida legislature, including:

• House Bill 917, called the “Health Care Medical Freedom Act, would prohibit a physician from refusing to take a patient who does not wish to be vaccinated. The bill would also require health care providers to inform parents regarding the “unique risks, benefits, safety and efficacy of each vaccine” included in a vaccination schedule. Finally, the bill would allow parents an exemption simply called “conscience” to bypass the requirements. Currently, parents can request exemptions based on religious practices.
• House Bill 339 and Senate Bill 408 would allow individuals to sue vaccine manufacturers if harmed by vaccines advertised within the state.

The legislation comes amid a backdrop of national upheaval regarding vaccines. On Jan. 5, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. announced major changes to the childhood vaccination schedule, which many public health and medical experts say will weaken protections for children and will result in thousands of cases of illness and hospitalizations in the future.

The recommendations reduce the number of diseases targeted by vaccination from 17 to 11. Shots to protect children against hepatitis A, hepatitis B, meningococcal disease, rotavirus, influenza and respiratory syncytial virus (RSV) are no longer recommended.

DeSantis’ plan for Florida would be similar, dropping four mandated vaccines: varicella (chickenpox), hepatitis B, pneumococcal bacteria and Haemophilus influenzae type B (HiB). Currently, children cannot attend school in Florida without proof of these four immunizations plus measles, mumps and rubella; diphtheria and polio.  

The sponsor of HB 917, Rep. Jeff Holcomb, R-Spring Hill, said the legislation was needed to restore “medical freedom” in Florida. The childhood vaccination schedule includes too many shots and combinations of shots that can harm children, he said.

“Today’s children are seeing an unprecedented amount of childhood illnesses from: learning issues, tics, allergies, asthma, eczema, autoimmune diseases, ADHD, autism and SIDS,” Holcomb said. “The evidence is clear; we should give parents the rights they deserve to determine if or when they should give childhood vaccines.”

Holcomb told the Observer he believes there is strong support for the legislation.

Medical organizations oppose changes

Most major medication organizations say the childhood vaccination is safe and prevents thousands of deaths and injuries annually from the diseases the vaccines are designed to prevent. Last week, the American Academy of Pediatrics and five other prominent U.S. medical groups sued the federal government, challenging the recent changes to the childhood vaccine schedule.

“Children’s health depends on vaccine recommendations based on rigorous, transparent science,” AAP president Andrew D. Racine said in a statement. “Unfortunately, recent decisions by federal officials have abandoned this standard, causing unnecessary confusion for families, compromising access to lifesaving vaccines and weakening community protection.”

Kennedy is a long-time critic of childhood vaccination claiming, inaccurately, that some childhood vaccines cause autism. In addition to overhauling the childhood vaccine schedule, Kennedy dismantled the nonpartisan and independent vaccine advisory board, replacing most of its members with people who are self-identified anti-vaxxers or who have expressed criticism of vaccination practices.

Both the federal and state actions are adding to deep confusion among parents, says Dr. Rana Alissa, president of the Florida chapter of the American Academy of Pediatrics. She called the federal government’s revisions “ridiculous.”

“It’s dangerous and it’s irresponsible,” said Alissa, a board-certified pediatrician with a practice in Jacksonville. “They’re messing around with a vaccine schedule that has been working for decades. This is going to risk bringing back several diseases that have been almost eradicated ... The number of shots, the mixing of vaccines together, the combination of how many vaccines per visit, it’s all been studied extremely carefully. It has been working.”

Alissa said the proponents of weakening the vaccine schedule claim to be champions of “parental choice.” But that philosophy abandons the concept of relying on expert medical advice.

“The ultimate decision has always been with parents,” she said. “We’ve never given a shot without parental consent. It has always been shared decision-making. They are just trying to confuse everyone.”

The American Medical Association strongly opposes Florida’s plan to alter vaccine mandates, including those required for school attendance,” Dr. Sandra Adamson Fryhofer, an AMA trustee, said in a statement released in September, following the announcement of DeSantis’s proposed vaccine changes in Florida. “This unprecedented rollback would undermine decades of public health progress and place children and communities at increased risk for diseases such as measles, mumps, polio, and chickenpox, resulting in serious illness, disability, and even death. While there is still time, we urge Florida to reconsider this change to help prevent a rise of infectious disease outbreaks that put health and lives at risk.”

Vaccination rates dropping

Rates of childhood vaccination are already dropping, Alissa said. Last year, vaccination coverage among U.S. kindergartners decreased for all reported vaccines, according to the Centers for Disease Control and Prevention.

Scientific evidence shows that a large majority of children need to be vaccinated to protect against the spread of infectious disease — what is called “herd immunity.” For a highly infectious disease such as measles, for example, herd immunity is reached with a vaccination rate of 95% or higher, according to the AMA. Loss of herd immunity could impact the population, including medically fragile individuals, people with compromised immune systems and cancer patients who cannot be vaccinated.

“We are already below the recommended numbers,” for herd immunity, Alissa said. Lawmakers “are making it worse and more dangerous and riskier. We are already seeing parents refusing vaccines.”

Already a dip in vaccination for measles has led to the highest outbreak of cases in the United States since the disease was declared eliminated in 2000. Other diseases also will reemerge, Alissa predicted. Rotavirus, for example, caused about 70,000 hospitalizations annually prior to the widely celebrated 2006 approval of a modern vaccine to prevent the disease. Rotavirus is a nasty disease primarily affecting infants and young children that causes severe stomach pain, diarrhea, vomiting and fever, lasting three to eight days.

Climate of fear

The Florida legislation will not just impact children, Alissa said. Many adults, particularly senior citizens, benefit from annual flu and COVID shots as well as shingles and pneumococcal vaccines. A Florida bill that threatens the advertising of such vaccines would likely diminish vaccination across all age groups.

The bill is symbolic and only adds to the climate of confusion, she said, because “anyone can already sue for a vaccine injury.”

Several major health care providers in North Florida refused to comment on the proposed legislation in Florida when contacted by the Observer. People are afraid, Alissa said.

“There is real retaliation here,” she said. “It’s scary. It’s a vindictive administration.”

However, she suggested most legislators will turn back efforts to weaken the vaccination schedule. As a major tourist destination, increased outbreaks of infectious disease could have major economic consequences for the state. Amusement parks, such as Disney World, draw millions of tourists from around the world and have been the sites of previous outbreaks.  In 2014, a measles outbreak that sickened 150 people was traced to an infected individual who visited Disneyland in Anaheim, California.

“I feel a little optimistic that Florida politicians [support] vaccines,” she said. “I am hoping nothing crazy is going to happen.”