Florida Department of Health Surgeon-General Dr. Joseph Ladapo speaks during a Patient Freedom news conference in March. Dr. Ladapo has called vaccine mandates 'immoral.'Chris O'Meara/The Associated Press
Florida’s controversial Surgeon-General Joseph Ladapo says the state will abolish vaccine mandates, a cornerstone of public health that has helped all but eliminate once-common childhood illnesses.
“Who am I to tell you what your child should put in their body?” he said last week. “Your body is a gift from God.”
Currently, all 50 U.S. states have mandates – lists of vaccines that children must receive before attending school or daycare. But Florida’s move could have a domino effect, especially in Republican states.
It also emboldens the so-called “health freedom” movement and the “Make America Healthy Again” program championed by U.S. Health Secretary Robert F. Kennedy Jr., which are both fuelling growing disdain for vaccines in the U.S.
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But it is an odd notion of freedom that holds that individual choice trumps the collective benefits of protecting children’s health. And it is odder still to think that exposing children to measles, mumps, rubella, chickenpox, hepatitis B and all other manner of nasty bugs will make them healthier.
Yet Dr. Ladapo called vaccine mandates “immoral,” claiming that “every last one of them drips with disdain and slavery.”
It is egregious to equate vaccine mandates with slavery and the Holocaust, as anti-vaccination advocates have done, but over-the-top claims are a hallmark of the movement.
What is truly disdainful is failing to acknowledge the massive benefits of vaccination – not only for children’s health, but for the economy.
The World Health Organization estimates that childhood vaccination has prevented 154 million deaths over the past five years. Before it was eviscerated, the U.S. Centers for Disease Control and Prevention published research showing that, in the decade between 1994 and 2003, childhood vaccination prevented 508 million cases of childhood illness and 1.13 million deaths in the U.S. alone. Those averted illnesses saved US$540-billion in direct health care costs and US$2.7-trillion in economic losses, because when children are sick, their parents miss work.
Preventing illness yields a much greater return on investment than treating an illness once someone is sick. That is the guiding principle of public health: Harm reduction.
Vaccine mandates have existed since the 1850s, put in place to limit the spread of smallpox. Requiring vaccines before school attendance became commonplace in the late 1950s after the development of the polio vaccine, and mandates grew more expansive as safe and effective shots came on the market in the 1970s and 1980s.
But vaccine skepticism is growing, driven by lingering anger over COVID-era restrictions and by disinformation and lies propagated by anti-vaxxers like Dr. Ladapo.
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Personal-freedom zealots argue that mandates are coercive and undermine civil liberties; Dr. Ladapo has claimed that falling vaccination rates are “reflections of God’s light against the darkness of tyranny of oppression.” But rights are not absolute, and individuals don’t live in a bubble. People have obligations to others in a society.
As the American Civil Liberties Union argues: “Far from compromising civil liberties, vaccine mandates actually further civil liberties. They protect the most vulnerable among us, including people with disabilities and fragile immune systems, children too young to be vaccinated and communities of color hit hard by disease.”
People have a right to make choices, but within limits. In a democratic society, we are routinely compelled to do things we would not otherwise do under the threat of punishment: pay taxes, heed speed limits, show up at work on time. Or, as the colloquialism holds: “Your right to swing your fist ends where my nose begins.”
While the fight against vaccine mandates is raging in the U.S., it’s interesting to note that mandates are rare in Canada. Only two jurisdictions – Ontario and New Brunswick – have legislated mandatory vaccine requirements for attendance at schools and daycares, but they allow medical, religious and philosophical exemptions. We make vaccine recommendations (which, for no good reason vary by province and territory) and expect parents to do the right thing for their own child and others.
Ideally, mandates should not be necessary. But not everyone is a good citizen and, increasingly, a small minority is aggressively anti-social in its opposition to reasonable public health measures.
If anything, Canada should be expanding vaccine mandates to make clear our obligations to our children and to each other.
We need to state unequivocally, in legislation and otherwise, that vaccines do far more good than harm.
The absence of vaccine mandates does not create freedom, it creates unnecessary risks. And it can have only one result: more sick and dead children.
No thank you.