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Instead of following what he acknowledged was the “normal” recommendation that parents keep unvaccinated children home for up to 21 days (the incubation period for measles), Ladapo said the state health department “You are handing over decision-making about school attendance to parents or guardians.”
Ladapo’s controversial move follows a pattern of going against public health regulations, particularly when it comes to vaccines. Last month, he called for stopping the use of mRNA vaccines against the coronavirus, in a move condemned by the public health community.
Ben Hoffman, president of the American Academy of Pediatrics, said Florida’s guidelines contradict long-standing and widely accepted public health guidelines for measles, which can lead to serious complications, including death.
“It goes against everything I’ve heard and everything I’ve read,” Hoffman said. “It goes against our policy. It goes against what [Centers for Disease Control and Prevention] “I would recommend.”
Measles outbreaks have been increasing in recent years. So far in 2024, at least 26 cases in at least 12 states Cases have been reported to the CDC, about twice as many as this time last year. In addition to the six confirmed cases at the Florida school, cases Cases have been reported in Arizona, California, Georgia, Maryland, Minnesota, Missouri, New Jersey, New York, Ohio, Pennsylvania and Virginia.
Experts say the outbreaks are linked to the growing number of parents seeking exemptions from childhood vaccines in recent years following political backlash to coronavirus pandemic mandates and rampant misinformation about vaccine safety.
In January, the CDC issued a warning to health providers to be alert for more cases of measles. Infected people are contagious from four days before a rash develops and up to four days afterward.
Because measles virus particles can remain in the air and on surfaces for up to two hours after an infected person leaves the area, up to 90 percent of people without immunity will get measles if exposed. People who have been infected or have received the full two doses of the MMR vaccine are 98 percent protected and are very unlikely to contract the disease. That That’s why public health officials often advocate for vaccination amid outbreaks.
“The reason there is a measles outbreak in Florida schools is because many parents have not protected their children with the safe and effective measles vaccine,” said John P. Moore, professor of microbiology and immunology at the Weill Cornell Medical College. “And why is that? It’s because the anti-vaccine sentiment in Florida comes from the top of the public health food chain: Joseph Ladapo.”
When asked to comment, the Florida health department responded with a link to Ladapo’s letter.
Ladapo’s unwillingness to use public health tools echoes the move by conservative and libertarian forces to weaken public health’s ability to contain diseases such as the highly contagious measles. In a measles outbreak in Ohio that began in late 2022, most 85 children infected They were old enough to receive the vaccines, but their parents decided not to, officials said. the state legislature in 2021 had stripped health officials of the ability to order someone suspected of having an infectious disease to be quarantined.
Ladapo’s letter to parents comes at a time of heightened concern about the public health consequences of anti-vaccine sentiment, a long-standing problem that has led to declines in childhood immunization rates in areas across the United States. The percentage of kindergartners whose parents opted out of receiving at least one state-required childhood vaccine rose to the highest level yet during the 2022-2023 school year (3 percent), according to federal data released last year.
Paul Offit, a pediatric infectious diseases expert at Children’s Hospital of Philadelphia, said Ladapo’s failure to encourage vaccination puts children at risk.
“Are you trying to prove that measles is not a contagious disease when the data is clear that it is the most contagious vaccine-preventable disease, much more contagious than influenza or Covid?” Offit wrote in an email.
The measles virus is extremely contagious and infections spread quickly. Young children are especially vulnerable because the first dose is not given until the child is 12 to 15 months old. The CDC recommends two doses of the MMR vaccine, with the second dose between ages 4 and 6.
A drop below 95 percent of measles vaccination coverage can compromise herd immunity and allow the virus to spread more quickly. Vaccination coverage in the state of Florida is 90.6 percent, but statewide vaccination coverage does not identify areas where there may be lower coverage.
The outbreak will explode exponentially and become a much larger community threat, if not vaccinated People exposed to the virus do not follow public health recommendations and do not go to school during the potentially contagious period, said Patsy Stinchfield, president of the National Foundation for Infectious Diseases. and nurse practitioner in Minneapolis. She has been involved in controlling three measles outbreaks, including the 2017 outbreak in Minnesota that affected 75 people, most of them unvaccinated and mostly children.
About 1 in 5 unvaccinated people in the United States who get measles are hospitalized. According to the Centers for Disease Control and Prevention. Up to 1 in 20 children develop pneumonia, the most common cause of death from measles in young children. About 1 in 1,000 children with measles will develop inflammation of the brain that can cause seizures and leave the child deaf or intellectually disabled. Among unvaccinated babies who contract measles, 1 in 600 may develop a fatal neurological complication that can lie dormant for years.
Manatee Bay Elementary School, about 20 miles west of Fort Lauderdale, has six confirmed cases of measles, school officials said this week. Of the school’s 1,067 students, 33 have not received the MMR vaccine, Broward County Schools Superintendent Peter B. Licata said Wednesday during a school board meeting. A school district official said the district has held “four vaccination opportunities,” including two at school and two at other locations in the community.
The first case was reported Friday in a third-grade child. who had no history of traveling abroad, Florida health officials said.
School officials referred questions to the Broward County school district, which said it is following state health department guidelines.