In a radical, unscientific, and potentially deadly departure, Florida moves to end school vaccine requirements 

“Longstanding.”

That’s how Immunize.org, a nonprofit focused on disseminating vaccine information, characterizes the requirements in all 50 states for children in daycare or school to get the diphtheria, tetanus, and pertussis vaccine (DTaP). Same for the measles, mumps, and rubella (MMR) vaccine (with the exception of Iowa, which requires only measles and rubella). For a long time now, school districts and parents have trusted these vaccines, and others, to keep children safe from harmful and potentially deadly diseases. And though anti-vaccine activists have been seeking to weaken these mandates, sometimes successfully, for years, no state has simply abandoned vaccine requirements. But that may be about to change.

Florida Surgeon General Joseph Ladapo announced Wednesday that his state would work to end all vaccine mandates. “Every last one of them is wrong and drips with disdain and slavery,” Ladapo told a crowd in Tampa.

Ending requirements means diseases that are now rare in the United States could gain a toehold once again. And these illnesses aren’t the sniffles. Polio can paralyze people who get it and can sometimes lead to death. It was a feared disease in the United States, and the iron lung breathing machine became a symbol of the mid-20^th century—until a polio vaccine became available.

Modern polio vaccines protect almost all children who receive them. Diphtheria, a bacterial disease, causes a coating to develop in the throat that eventually causes breathing difficulties. Once called “the strangling angel,” it can lead to death in one in 10 cases, even with treatment. Luckily, diphtheria vaccines are 95 percent effective. Similarly, the measles vaccine is 97 percent effective.

Childhood vaccines are safe and effective. The Centers for Disease Control and Prevention (CDC) monitors for adverse events after vaccination. Though Ladapo called the COVID-19 vaccines, credited with saving millions of lives during the pandemic, “poison,” he didn’t grapple with efficacy or safety statistics in his talk, and instead asserted that vaccination should be entirely voluntary on religious and personal liberty grounds. “Who am I as a government, or anyone else, or who am I as a man standing here now to tell you what you should put in your body,” Ladapo said. “Your body is a gift from God. What you put into your body is because of your relationship with your body and your god. I don’t have that right. The government does not have that right.”

In the diverse democracy that is the United States, however, the government does in fact have the right to balance personal liberty with public health and safety. The Supreme Court has recognized that states can impose vaccine mandates since 1905, when it held that Cambridge, Massachusetts, could require smallpox vaccination. “[T]he liberty secured by the Constitution of the United States to every person within its jurisdiction does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint,” The Court’s summary of Jacobson v. Massachusetts reads.

Ladapo’s announcement isn’t occurring in a vacuum. At the federal level, Health and Human Services Secretary Robert F. Kennedy Jr. has downplayed the effectiveness of vaccines; during the Texas measles outbreak this year, he recommended alternative therapies to treat the disease. Kennedy, a long-time anti-vaccine activist, has been seeking to change federal vaccine recommendations, which could affect their availability and whether insurance will cover their cost. Ladapo has made waves in public health circles before, such last year, when he declined to order unvaccinated children to remain home during a school measles outbreak, breaking from standard procedure.

Many experts decried Ladapo’s announcement. “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,” Sandra Adamson Fryhofer said on behalf of the American Medical Association. Michael Osterholm, of the Center for Infectious Disease Research and Policy at the University of Minnesota, told Reuters, “Every parent of a child who dies or who is hospitalized with a vaccine-preventable disease will know exactly why.”

Although Ladapo said people who want vaccines, should get them (“God bless you. I hope you make an informed choice,” he told the crowd), whether they will be able to do so in the current climate is an open question. Moreover, many people can’t or don’t have time to get well-informed before making important choices, whether at the auto mechanic’s shop or the doctor’s office. They rely on expertise. They rely on people like Ladapo to be immersed in the latest literature and to tell them what they should do, based on scientific study.

But there’s also a moral question that Ladapo’s announcement raises: Outbreaks of infectious diseases can kill people, particularly children. Using proven vaccines—vaccines that have been used safely for decades in many cases—has been shown in scores of studies to prevent illness and save lives.

So how many dead kids is the freedom not to be vaccinated worth?