Florida's surgeon general wants to end school mandates for four vaccines, in the name of medical freedom. One vaccine that could become optional prevents a dangerous form of meningitis, which is already becoming more common and killing children in Florida, doctors said during a state workshop Friday.
It's called haemophilus influenzae type B, or hib. Caused by bacteria, it can spread by coughing or sneezing.
"I want everyone to know how serious matters are," Eehab Kenawy, a pediatrician in Panama City, said during the Department of Health's public workshop.
"Just in the past six months, we've had two patients in the ICU with hib. One child unfortunately succumbed at four months of age. No vaccines. One month ago, I was on call, and another patient also came into the ICU, a two-and-a-half-year-old, never vaccinated, hib again. Abscesses in the brain, seizures, brain dead. Quote, unquote, mother's words: 'please give my child every vaccine you can.'"
During nearly three hours of public comment, a number of doctors, nurses, and teachers spoke in favor of keeping mandates in place. Many speakers also applauded the state for moving to lift mandates, saying parents should be able to choose whether to vaccinate their children.
"Almost no one at that meeting, unless they're my age or above, and I'm almost 70, has seen some of the conditions that immunizations now routinely prevent," D. Paul Robinson, a pediatrician in Tallahassee who has been treating children for more than 40 years, said on the eve of the meeting.
"If you've never seen, for example, haemophilus influenza meningitis, you don't have any idea what it looks like. It's just a condition on paper. Those of us who are older, we've seen it. We've seen the damage it does."
When Robinson spoke for his two minutes at the meeting, he recalled how early in his career, spinal taps were far more common for sick children, and as many as 20 percent of children he treated with hib died from sepsis or severe infections of the brain and spinal cord.
"Hib didn't cause mild illness. It caused children to die," he said. "And many survivors were left with deafness, paralysis or lifelong neurologic injury."
A vaccine was introduced in the late 1980s, and since then hib has become rare. But cases have started rising again in recent years.
Data from the Florida Department of Health shows the rate of haemophilus influenzae illnesses – which is not a form of the flu despite its name – among children under 4 nearly tripled from 2020-2023, before dropping slightly in 2024, the most recent year with data available.
The number of cases statewide among children was 207 in 2020, rising to 460 in 2023, and dipping to 403 in 2024, according to this chart.
Friday's workshop was a first step toward lifting requirements for children to receive four vaccines before entering daycares and schools: haemophilus influenzae b, varicella (chickenpox), pneumococcal conjugate and hepatitis B.
The idea was announced by Florida Surgeon General Joseph Ladapo in September. He said he would like to see all vaccine mandates end, likening them to slavery.
Some speakers, like Larry Downs, Jr., said they applaud the state surgeon general's stance.
"This is about freedom. The default setting should be freedom, not these corporate chemical vaccine injections," Downs said.
Other groups expressed their opposition to any change in vaccine rules, citing civil rights and religious protections.
"The proposal to eliminate vaccine requirements in the state of Florida is not just a policy change, it is a direct threat to public health equity and civil rights, and today, the NAACP clearly stands and clearly states that we oppose it," said Lewis Jennings, with the NAACP Okaloosa chapter.
Current law in Florida allows parents to opt out of vaccines for their children via medical or religious exemption.
One speaker, Susan Sweetin, who leads marketing for the National Vaccine Information Center, said her son was "vaccine injured," and that such exemptions are difficult to obtain.
"This idea of freedom, this idea of choice, is not existent, and it's an illusion. It is not the role of the government to mandate a procedure that can cause injury and death, period. We shouldn't have to ask the government for permission to not do a medical intervention," Sweetin said.
One handout from the Department of Health at Friday's workshop suggested expanding exemptions. The current language says "immunizations are in conflict with my religious tenets or practices." A new draft document would add the following phrase: "which may include a sincerely held moral or ethical belief."
Joseph Harmon with the Florida Conference of Catholic Bishops said he disagreed.
"We urge the Department of Health to utilize the current language, rather than adopt the new rule, which seems to be an improper expansion of what's allowed by the statute," Harmon said.
One speaker, Mary Wynn, said the idea of lifting mandates is not allowed by law, and pointed to a line in Florida statutes, which said the health department "shall ensure that all children in this state are immunized against vaccine-preventable diseases."
Near the end of the meeting, Simone Chriss, a civil rights attorney with Southern Legal Counsel, asked if the state had "consulted national medical experts on this rule development, such as the American Academy of Pediatrics or the American Medical Association."
The answer was no.
"Thank you so much for your question. The rule language is grounded in policy based on considerations that favor parental rights and medical freedom," a Florida Department of Health spokeswoman said in response.
The health department is "still in the process of looking at" epidemiologic modeling to estimate increases in hospitalization and death following the loss of herd immunity, she added.
Another requirement for the state is to show the estimated regulatory cost of the changes, which has not been done yet.
It is "a requirement in the Florida statutes for rulemaking and will be done at the appropriate time," said Amanda Bush with the general counsel's office.
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