Florida Defies CDC in Measles Outbreak, Telling Parents It’s Fine to Send Unvaccinated Kids to School

Yves here. Even though has Lambert featured the appalling further collapse in public health standards, via Florida greenlighting measles spread through its Surgeon General greenlighting infected kids attending school, it’s such a bad development in terms of where the US is as a society that it merits highlighting via this post.

This is where you wind up with decades of indoctrination of libertarianism and neoliberalism, where “freedom” is anarchy, a rejection of the ability of the state to impose restrictions, even in the name of public safety.

Having said that, measles as we know is highly contagious, kills, and can do lasting damage. I hope someone can come up with a legal theory to sue Florida into the ground for this destructive act, but it would be difficult to establish that an infection occurred at or via a school. And Florida could then turn around and argue the parents were liable for not vaccinating. But babies below six months cannot be vaccinated. Will there be enough infant deaths to generate sufficient outrage to roll this decision back?

In the meantime, more cheery sightings on the likely consequences:

To point out the obvious, measles denialism will be difficult:

The article below recaps the situation, but annoyingly depicts measles as spread via droplets, when it is the paradigmatic airborne disease. But it does describe how Florida is poorly protected against measles outbreaks, and that getting vaccinated against measles even after exposure can prevent infection.

By Amy Maxmen. Originally published at KFF Health News

With a brief memo, Florida Surgeon General Joseph Ladapo has subverted a public health standard that’s long kept measles outbreaks under control.

On Feb. 20, as measles spread through Manatee Bay Elementary in South Florida, Ladapo sent parents a letter granting them permission to send unvaccinated children to school amid the outbreak.

The Department of Health “is deferring to parents or guardians to make decisions about school attendance,” wrote Ladapo, who was appointed to head the agency by Florida Gov. Ron DeSantis, whose name is listed above Ladapo’s in the letterhead.

Ladapo’s move contradicts advice from the Centers for Disease Control and Prevention.

“This is not a parental rights issue,” said Scott Rivkees, Florida’s former surgeon general who is now a professor at Brown University. “It’s about protecting fellow classmates, teachers, and members of the community against measles, which is a very serious and very transmissible illness.”

Most people who aren’t protected by a vaccine will get measles if they’re exposed to the virus. This vulnerable group includes children whose parents don’t get them vaccinated, infants too young for the vaccine, those who can’t be vaccinated for medical reasons, and others who don’t mount a strong, lasting immune response to it. Rivkees estimates that about a tenth of people in a community fall into the vulnerable category.

The CDC advises that unvaccinated students stay home from school for three weeks after exposure. Because the highly contagious measles virus spreads on tiny droplets through the air and on surfaces, students are considered exposed simply by sitting in the same cafeteria or classroom as someone infected. And a person with measles can pass along an infection before they develop a fever, cough, rash, or other signs of the illness. About 1 in 5 people with measles end up hospitalized, 1 in 10 develop ear infections that can lead to permanent hearing loss, and about 1 in 1,000 die from respiratory and neurological complications.

“I don’t know why the health department wouldn’t follow the CDC recommendations,” said Thresia Gambon, president of the Florida chapter of the American Academy of Pediatrics and a pediatrician who practices in Miami and Broward, the county affected by the current measles outbreak. “Measles is so contagious. It is very worrisome.”

Considering the dangers of the disease, the vaccine is incredibly safe. A person is about four times as likely to die from being struck by lightning during their lifetime in the United States as to have a potentially life-threatening allergic reaction to the measles, mumps, and rubella vaccine.

Nonetheless, last year a record number of parents filed for exemptions from school vaccine requirements on religious or philosophical grounds across the United States. The CDC reported that childhood immunization rates hit a 10-year low.

In addition to Florida, measles cases have been reported in 11 other states this year, including Arizona, Georgia, Minnesota, and Virginia.

Only about a quarter of Florida’s counties had reached the 95% threshold at which communities are considered well protected against measles outbreaks, according to the most recent data posted by the Florida Department of Health in 2022. In Broward County, where six cases of measles have been reported over the past week, about 92% of children in kindergarten had received routine immunizations against measles, chickenpox, polio, and other diseases. The remaining 8% included more than 1,500 kids who had vaccine exemptions, as of 2022.

Broward’s local health department has been offering measles vaccines at Manatee Bay Elementary since the outbreak began, according to the county school superintendent. If an unvaccinated person gets a dose within three days of exposure to the virus, they’re far less likely to get measles and spread it to others.

For this reason, government officials have occasionally mandated vaccines in emergencies in the past. For example, Philadelphia’s deputy health commissioner in 1991 ordered children to get vaccinated against their parents’ wishes during outbreaks traced to their faith-healing churches. And during a large measles outbreak among Orthodox Jewish communities in Brooklyn in 2019, the New York City health commissioner mandated that anyone who lived, worked, or went to school in hard-hit neighborhoods get vaccinated or face a fine of $1,000. In that ordinance, the commissioner wrote that the presence of anyone lacking the vaccine in those areas, unless it was medically contraindicated, “creates an unnecessary and avoidable risk of continuing the outbreak.”

Ladapo moved in the opposite direction with his letter, deferring to parents because of the “high immunity rate in the community,” which data contradicts, and because of the “burden on families and educational cost of healthy children missing school.”

Yet the burden of an outbreak only grows larger as cases of measles spread, requiring more emergency care, more testing, and broader quarantines as illness and hospitalizations mount. Curbing a 2018 outbreak in southern Washington with 72 cases cost about $2.3 million, in addition to $76,000 in medical costs, and an estimated $1 million in economic losses due to illness, quarantine, and caregiving. If numbers soar, death becomes a burden, too. An outbreak among a largely unvaccinated population in Samoa caused more than 5,700 cases and 83 deaths, mainly among children.

Ladapo’s letter to parents also marks a departure from the norm because local health departments tend to take the lead on containing measles outbreaks, rather than state or federal authorities. In response to queries from KFF Health News, Broward County’s health department deferred to Florida’s state health department, which Ladapo oversees.

“The county doesn’t have the power to disagree with the state health department,” said Rebekah Jones, a data scientist who was removed from her post at the Florida health department in 2020, over a rift regarding coronavirus data.

DeSantis, a Republican, appointed Ladapo as head of the state health department in late 2021, as DeSantis integrated skepticism about covid vaccines into his political platform. In the months that followed, Florida’s health department removed information on covid vaccines from its homepage, and reprimanded a county health director for encouraging his staff to get the vaccines, leading to his resignation. In January, the health department website posted Ladapo’s call to halt vaccination with covid mRNA vaccines entirely, based on notions that scientists call implausible.

Jones was not surprised to see Ladapo pivot to measles. “I think this is the predictable outcome of turning fringe, anti-vaccine rhetoric into a defining trait of the Florida government,” she said. Although his latest decision runs contrary to CDC advice, the federal agency rarely intervenes in measles outbreaks, entrusting the task to states.

In an email to KFF Health News, the Florida health department said it was working with others to identify the contacts of people with measles, but that details on cases and places of exposure were confidential. It repeated Ladapo’s decision, adding, “The surgeon general’s recommendation may change as epidemiological investigations continue.”

For Gambon, the outbreak is already disconcerting. “I would like to see the surgeon general promote what is safest for children and for school staff,” she said, “since I am sure there are many who might not have as strong immunity as we would hope.”

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34 comments

  1. The Rev Kev

    Letting measles spread which can wipe your immunity memory while Covid is still pin-balling its way around the country? Sounds a legit strategy. The way that things are going with public health in the US, I think that it is only a matter of time until the health departments of the countries of the Global Majority will start issuing travel health notices for those citizens wanting to visit America advising them of the rampaging diseases that are being let run free with special notice about Florida. Your kids wanna go to Walt Disney World in Orlando? Tell them tough bikkies.

  2. Samuel Conner

    Perhaps this is tinfoil hat territory, but the thought occurs that passively/permissively promoting the spread of disease in public schools could have the effect of undermining public trust in them as places that are safe to send one’s children to. I have the impression that public education has, for some of the right, been a target of at least some on the right.

    1. Michael Fiorillo

      Your sense of things is correct: charter schools, vouchers for religious schools (in some states), accompanying the undermining of public schools and expansion of private entities receiving tax dollars, has been going on for two decades, and is a bi-partisan project.

  3. jackiebass63

    If you choose to not vaccinate your children you may be doing harm to others. Which diseases that are contagious it is very easy to infect others. People need to think about how their actions can hurt others.

  4. Rip Van Winkle

    The unforgettable Honeymooners ‘Blabbermouth’ episode had a subplot where Ralph caught the measles from a kid on the stickball team in the building. So then Alice had to stay with Ralph’s mother-in-law anyway.

    1. Klaus

      I grew up in the same kind of building (as “the Honeymooners”) I remember one of the neighbor ladies caught measles from her kid and ended up retarded and in walking on crutches the rest of life

  5. Kilgore Trout

    This news breaks in time for school vacation for states in New England at least. What could go wrong?

  6. t

    Hat tip to RFK! He he has a whole book about this – secrets “they” don’t want you to know! In summary – vaccines dangerous scam, measles no big deal, send money now.

    1. Objective Ace

      Hat tip to the CDC for falsely comparing traditional vaccines to mRNA “vaccines”. (And being flat out wrong about the effectiveness of them)

      The CDC deserves a whole lot more blame then RFK, and unlike RFK, its their job to get the science right. If they had, people wouldnt be seeking alternative voices such as RFK

    2. marku52

      At this point, if the CDC advocates something, I’m inclined to believe the opposite. Good job, CDC.
      “You’ve vaccinated, now you can throw away your masks”

      Simply watching the excellent contact tracing out of S’Pore, I knew that was a lie. Why didn’t they?

  7. Bsn

    The quote from Dr. Pham: “I can’t stress enough how downplaying COVID has emboldened the far right.” is absurd. Downplaying Covid has emboldened anyone, left or right, with both lobes of a brain that function. This whole story reminds me of the boy who cried wolf parable. When you lose trust as the CDC has, people won’t trust them even when (once in a while) they are right.

    1. Grayce

      Wasn’t the reputation of the CDC shattered on purpose before any of their flaws were spotlighted? And who asked the CDC to take shortcuts at “warp speed”? Just when it seemed safe to become a despot, darn, a disease of global proportions showed up. Why not deny its existence? Then you win either way. If the economy goes bad, blame Covid. If the economy goes well, take credit.

  8. Jeremy Grimm

    As I recall, the German measles can cause serious birth defects. I am not sure about the other strains of measles. Encouraging the spread of measles while at the same time getting an abortion has been made highly ‘problematic’ seems a formula for some very long-term and expensive problems for the future — not to underplay the health dangers mentioned in this post.

  9. BrooklinBridge

    While no excuse for Florida’s criminal negligence in advice re. the measles, nevertheless, the public needs some sort of flag or compass they can use for when the CDC gets it right. Fomites and droplets?, WRONG, measles? on the money or much closer to it.

    As to the CDC and the well being of the public vs. corporate profit, that’s easier to figure…, devil take the hindmost.

  10. Grayce

    The freedom to swing your arm ends at the tip of MY nose. You can’t actually hit me while practicing freedom. Now think–we all share the air. You don’t own it. I don’t own it. Your freedom to infect the air ends where my kid’s breath begins. What is wrong with the adults in Florida?

  11. Heather

    This angers me so much. When my now 38 year old son was 6 months old he got the measles. The measles vaccine isn’t given until the baby is a year, or at least it was like that back then. Anyway, he now has a 40% hearing loss in one ear. So he must have gotten it from an unvaccinated person, probably a child. These parents who won’t vaccinate never think about how their actions affect other children and the harm, including death, that can be done. I do not understand that public health doctor in Florida, does he really think this is the way to go? Or is he just trying to please his boss, De Santis? I truly don’t get it. Let him stay up for days, holding a crying baby with a high fever and itching spots.

    1. CA

      This angers me so much. When my now 38 year old son…

      [ All my sympathy and hopes. This is why the problem is so, so serious. ]

        1. CA

          He actually became an RN, which he loves!

          [ Important and I think completely reasonable and even expected for the experience brought forth compassion. Such compassion however is evidently not easily brought forth. I need to think about this and welcome assistance. ]

  12. Laura in So Cal

    Just letting everyone know that the measles vaccine can wear off and/or not “take” so if you are older and very worried about it, you should have your “titers” checked. They now give 2 doses of the MMR 6 weeks apart, but if you got your vaccine more than 40 years ago, you probably only got one dose.

    In my case, I was vaccinated for measles as a toddler (1967) and in about 1977, there was a big push to have all the kids get another dose, so I did. When I wanted to live in a college dorm in 1983, they wanted proof of 2 doses which we couldn’t find so I got the MMR. In 2002. I told my Doctor that we were thinking about a baby so he suggested we run my “titers.” I was positive for Mumps and Chicken pox (I had both diseases in childhood) BUT for Measles and Rubella…Nothing. It was if I had never been vaccinated. So I got the MMR again. I did react to it with a low fever for several days so something “took”.

    https://www.cbc.ca/news/health/measles-undervaccinated-1.5094362

  13. LawnDart

    One less reason for employees to call-off due to a sick-kid. Predatory animals preying on the weak and vulnerable is the American Way.

  14. Futility

    Another not mentioned reason to get the measles vaccine is the risk of later developing SSPE (Subacute sclerosing panencephalitis). It only develops after an infection with measles (it is estimated that 2 in 10000 people who get measles develop later SSPE, but it can be as high as 1 in 600 for unvaccinated infants under 15 months). It is rare BUT it is almost 100% deadly. There is no known cure or therapy. The measles virus lays dormant (it is present but no replication of live measles virus occurs, only parts of the virus are replicated) after the initial infection passed. The person appears to be completely healthy again. Only years (!) later (average 7 years) a sudden deterioration of the mind sets in with neurological complications, seizures and changes of personality which progresses inexorably as the virus starts to replicate ( but still without forming infectious virus particles) leading to a progressive inflammation of the brain which ultimately leads to its complete destruction. There is no cure it almost always results in death. (There are very seldom cases of sudden remission but depending on how far the disease already progressed, the victims are severely disabled).
    Imagine the anguish of parents losing their child to SSPE. The only way to prevent this is to never get measles, which a vaccination ensures. In Asia SSPE is still a problem, also in US/Europe cases happen sometimes.
    The advice of Florida’s Surgeon General is absolutely irresponsible.

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