Florida's move to end vaccine mandates may deepen skepticism in Black communities, health experts warn
By Nicquel Terry Ellis, CNN
(CNN) — Kiva Williams lives in Tampa, Florida, but she’s worried the state is going to turn into the “wild, wild West.”
Florida officials announced their intent to end all vaccine mandates this month, which would make it the first state to terminate the well-established and constitutionally upheld practice of requiring certain vaccines for schoolchildren.
“I’m a parent who cares about health and lessening overall sickness,” Williams said.
The mom of three said she has always taken her kids to get their vaccinations – not only to comply with the state’s school requirements but because she also feels at peace knowing the vaccines can prevent her kids – and their classmates – from getting seriously ill from diseases such as measles, mumps, polio and hepatitis B.
Measles, one of the world’s most contagious infectious diseases, can cause serious complications – such as blindness, pneumonia or encephalitis, swelling of the brain – and even turn deadly, especially in children younger than 5. It can also kill years down the line. The worst form of the polio virus causes nerve injury that can lead to paralysis, difficulty breathing and death. Hepatitis B is an illness linked to liver disease and cancer.
The state’s move has left Williams worried that some parents — particularly in Black families, who historically face distrust in medicine and hurdles to health care access – will opt out of getting their children vaccinated, leading to an increased risk of exposure to illness at Florida schools.
Health advocates fear this could lead to higher rates of illness among children, which could worsen the health care disparities that already afflict the Black community.
Vaccines also “provide substantial health and economic benefits and promote health equity,” the CDC says.
Removing vaccine mandates despite research showing they work could send mixed messages to the Black community, which is already generally skeptical of the health care system due to the nation’s history of racism in medical research, said Dr. Nelson Adams, an obstetrician-gynecologist in Miami and a board member for the Health Foundation of South Florida, an organization that aims to improve health outcomes in underserved areas.
“The trust issue is compounded when the messaging is not clear, it’s inconsistent and the messengers are folks who have positions of authority,” Adams said.
Vaccine hesitancy in the Black community intensified during the Covid-19 pandemic, and many trusted leaders launched campaigns and efforts to build confidence in the vaccine that rolled out at the end of 2020. Civil rights leaders criticized the federal government at the time for failing to prioritize equitable access in communities of color.
But vaccine hesitancy among Black Americans also has roots going back decades further due to the nation’s history of racism in medical research.
Adams pointed to the Tuskegee experiments from 1932 to 1972, which recruited 600 Black men — 399 who had syphilis and 201 who did not — and tracked the disease’s progression by not treating the men as they died or experienced severe health issues. Black people who were enslaved were also historically used by doctors to test medications and surgeries that often caused health complications or death.
Differing views
Florida Surgeon General Dr. Joseph Ladapo announced earlier this month that the state health department would immediately move to end all non-statutory vaccine mandates. State lawmakers will then look into developing a legislative package that ends any remaining mandates, Florida Gov. Ron DeSantis said.
Every vaccine mandate “is wrong and drips with disdain and slavery,” Ladapo said, adding that they should be a personal choice.
“People have a right to make their own decisions, informed decisions,” Ladapo said. “What you put into your body is because of your relationship with your body and your God. I don’t have that right. Government does not have that right.”
Adams said it is “appalling” that Florida would roll back vaccine mandates.
“These vaccines are a must, and this is a step backward after years and years of us making incremental steps in the right direction,” Adams said. “We are mitigating morbidity in children and the elderly and saving lives in children and the elderly.”
Ladapo’s potent derision of vaccine mandates sparked a near-instant deluge of reaction and vigorous disagreement, including from infectious disease experts.
Dr. Zachary Rubin, a double board-certified pediatrician who specializes in immunology and allergy treatment, said in a Substack post that Ladapo’s words are “a calculated move in the ongoing politicization of public health.”
“The reality is that vaccines are not shackles, they are shields. Vaccines have eradicated smallpox, nearly eliminated polio in most of the world, and saved millions of lives annually. To suggest otherwise isn’t just irresponsible; it’s dangerous,” he wrote.
President Donald Trump told reporters he supported vaccines when asked about Florida’s move to cancel the mandates.
“I think you have to be very careful when you say that some people don’t have to be vaccinated,” Trump said. “You have vaccines that work, they just pure and simple work. They’re not controversial at all, and I think those vaccines should be used; otherwise, some people are going to catch it, and they endanger other people.”
Vaccines save lives, experts say
Dr. Roger Mitchell, president of the National Medical Association, called it “dangerous” to turn vaccines into a political issue when science has proved them to be lifesaving.
He said removing the vaccine mandates “gives power to the hesitancy” that many Black Americans may already be feeling toward vaccines and the health care system. Black people face more barriers to health care due to racism, lack of access to quality health care in their communities and are more likely to lack health insurance than their White counterparts.
Making vaccines a choice could mean some Black families are less likely to engage with the health care system or talk to their physicians about other health concerns, Mitchell said.
“The evidence is overwhelming that vaccination is protective particularly in our pediatric, and our elderly and more vulnerable populations,” Mitchell said. “It’s helpful for those that are disenfranchised and disinherited and don’t have access to care. These things are helpful, and they save lives.”
Civil rights leaders agreed that removing vaccine requirements could have negative consequences for Black Americans.
“Rolling back vaccine mandates in Florida threatens to deepen the health disparities already impacting Black communities,” NAACP President and CEO Derrick Johnson said in a statement to CNN. “At a time when vaccine hesitancy and barriers to healthcare persist, removing safeguards such as vaccine mandates only puts Black Floridians at greater risk.”
Dr. Jodie Guest, a professor and the senior vice chair of epidemiology at Emory University’s Rollins School of Public Health, said she worries that without state mandates in place, there may be more barriers for families to get vaccines.
For example, she said, parents may need to get a prescription to get their child a vaccine, as opposed to being able to simply walk into a pharmacy.
There is also the risk of health insurance companies charging for vaccines that were previously covered when there was a state mandate, Guest said.
“When additional barriers are put in place, it disadvantages already disadvantaged communities,” Guest said.
Guest said she encourages families to speak with their physician if they feel torn about whether to get their child vaccinated.
“We really do have a lot of data to support how safe and effective these vaccines are in keeping our kids healthy.”
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