St. Paul, Minnesota. State capitol. Stand up for science rally. University of Minnesota researchers, scientists and other supporters protested against President Donald Trump’s proposed scientific research funding cuts. (Photo by: Michael Siluk/UCG/Universal Images Group via Getty Images)
UCG/Universal Images Group via Getty Images
As children head back to school this year, parents are hearing conflicting advice, particularly about immunizations. Florida’s Surgeon General, Joseph Ladapo, created a stir this week suggesting the state eliminate all school vaccine requirements. Mehmet Oz, the celebrity doctor who oversees Medicaid and Medicare, echoed that desire. And Robert F. Kennedy, Jr. has been steadily attacking vaccines with unscientific and debunked statements about them causing harm. He has also fired 17 expert members of the Vaccine Advisory Committee and replaced them with people with questionable credentials. And despite his promises of continued access, he has just declared new rules for who can receive COVID-19 vaccines, excluding healthy people under the age of 65, even if they want them.
Dropping school vaccine requirements flies in the face of decades of public health recommendations and specific evidence-based guidance from the Centers for Disease Control and the American Academy of Pediatrics.
Measles Is Spreading And Is Dangerous
As of Sept. 2, 2025, there have been a total of 1,431 confirmed measles cases reported in the U.S., with three deaths, two of them in unvaccinated children.
Note that because of good vaccination levels, measles had been eliminated from the U.S. in 2000, and now we have a resurgence, centered in Texas.
Measles is the most highly contagious infection. It is spread through tiny droplets in the air and lingers for up to two hours. If exposed to an infected person, 90% of unvaccinated people will become infected. Transmission can readily happen in a school or a pediatrician’s office.
Children with measles often become sick with high fevers, cough, runny nose and conjunctivitis, and about 1 in 5 need to be hospitalized. Pneumonia occurs in 1 in 20, encephalitis (brain swelling) in 1/1000, and deaths in 1-3/1000. A late complication, occurring in 1 in 600, is subacute sclerosing panencephalitis, a fatal brain inflammation.
Measles also wipes out immune memory, making children more susceptible to other infections because the affected B cells “forget” how to fight infections. The kids may also have to be revaccinated against different diseases. This immunosuppression may last from months to three years.
I can’t imagine anyone who wants children to die or be permanently disabled from an infection that is so easily preventable with an immunization.
What Happens If An Unvaccinated Person Is Exposed To Measles? A Warning To Parents
The incubation period—time from exposure to symptoms—is 7 to 14 days. Another 3-5 days go by before a rash develops. The person is infectious for another 4 days.
If an unvaccinated person is exposed to measles, they have to quarantine for 21 days after exposure. That means no school for the child and no work for an unvaccinated adult.
How many parents can afford to take 3 weeks off work to care for an ill child?
How many unvaccinated adults can afford to take 3 weeks off work if they been exposed to measles?
Besides the personal cost of stress and lost wages, there is a societal cost for any infectious outbreak.
Costs Of Measles Outbreaks
A review of measles outbreaks showed that the median cost per case was $32,805, with an additional $4000 per day of investigation. The cost of lost productivity (due to illness, home isolation, quarantine, or informal caregiving) was $47,479 per case or $814 per contact.
There are billions of dollars in savings to society for routine childhood vaccinations, in addition to the millions of hospitalizations and deaths averted.
There is also a huge strain on public health departments, which are already overburdened and short-staffed from budget cuts. Measles outbreaks have necessitated providing post-exposure prophylaxis, public outreach, setting up a “toll-free measles information hotline, subpoenaing flight records, and daily screening of all hospital staff for rash and fever.” The added personnel time is reallocated from other programs, resulting in holes in those services.
With 20% of children infected with measles requiring hospitalization, how will medical centers maintain adequate staffing? Many healthcare workers are young adults with school-aged children. A previous study earlier in the COVID-19/influenza pandemic found higher absenteeism due to caring for sick children and dealing with school closures.
Further Dividing The Country
There are striking differences in vaccine acceptance and approaches between Red and Blue states, with Florida and Texas leaning toward “medical freedom” to be free from mandates. [That inherently goes against another person’s desire to be free from unnecessary infection, disability, or death from unvaccinated people. Vaccines are not 100% effective—you need herd immunity to protect you and the community). More liberal states are considering forming compacts and creating their own regulations that require vaccines to protect their communities.
Ladapo’s proposal is raising other questions. Kathy Browning, former president of the Florida Association of School Nurses, asked, “If the state decides they’re no longer going to require mandatory vaccinations, are they no longer going to require the mandatory reporting of diagnoses?”
Will Florida eliminate quarantine for such a highly infectious disease? Last year, Ladapo did that, saying, the state’s Department of Health “is deferring to parents or guardians to make decisions about school attendance” because of the “burden on families and the educational cost of healthy children missing school” and the “high immunity rate in the community.”
Another question arises whether private schools can have different rules, requiring vaccination for their students, while public schools won’t have that option.
The Texas measles outbreak served as a warning shot in the new vaccine wars, pitting different parts of the country against each other, with a focus on maximizing individual freedoms versus the common good. With all of these unintended consequences, wouldn’t it be better if we all were vaccinated?
