As Florida Schools Admit Unvaccinated Students, Working Families May Feel the Worst Consequences: Analysis

More unvaccinated or undervaccinated children may soon start attending class in Florida. 

On Dec. 3, the state will end many of the vaccine mandates required to enroll in public school. The state’s surgeon general, Joseph Ladapo, announced the plan, implemented in conjunction with Florida Gov. Ron DeSantis, in September 2025. 

Vaccines that protect against hepatitis B, chickenpox, and pneumonia will no longer be required for K-12 students in Florida. Protection against haemophilus influenza Type B, a bacteria that can cause meningitis and pneumonia, will also become optional for students. Vaccines for polio, diphtheria, tetanus, whooping cough, measles, mumps, and rubella are still required for now.

The most immediate consequence of Florida’s new policy is expected to be a statewide decrease in vaccinations during early childhood, which is when most Americans get the bulk of their shots. But the effects will be felt well beyond the classroom. 

Why vaccinating young children protects everyone

Academic research shows that strict vaccine mandates for school enrollment increase overall childhood inoculation rates. That, in turn, improves community protection against infectious disease. 

Children—with their underdeveloped immune systems and physical proximity to others—are major germ spreaders. By preventing some illnesses among young kids, early childhood vaccination also keeps family members, teachers, and others healthier. 

That reality may impact some more than others, as critics of Florida’s new policy have pointed out. Evidence shows that children who live in rural areas, are low-income, or whose families lack health insurance are less likely to get vaccinated, even when vaccination is obligatory. 

Working parents without the time or means to take their children to get vaccinated may skip the shots that are no longer required Alok Patel, a pediatrician at Stanford Children’s Health, told ABC News. 

“If you have parents who have barriers to getting those vaccines … and then all of a sudden, they’re told you don’t need to get them, sometimes the pathway of least resistance is not getting your kid vaccinated,” Patel said.

Florida offers free vaccines to children 18 and under who are uninsured, underinsured, Medicaid-eligible, Medicaid-enrolled, American Indian, or Alaska Native. But their caretakers may have to pay up to $24.01 per vaccine in administration fees, and could still be charged for other care related to the visit.

A CDC report released in 2024 found that vaccinating children born between 1994 and 2023 prevented 508 million infections, 32 million hospitalizations, and 1.1 million deaths. The result was $540 billion in direct medical and nonmedical savings, and $2.7 trillion in associated societal savings. 

Vaccination, in other words, may save money in copayments, medicine purchases, and days off work for illness or child care.

Some experts warn that the state’s decision could also increase vaccine hesitancy in Black communities. Black Americans have documented historical justification for mistrust in the medical establishment following centuries of racism and unethical medical research, such as the Tuskegee Syphilis Study. 

Declaring once-essential vaccines to be optional may add to their overall skepticism of the health establishment, Dr. Nelson Adams, an OB-GYN in Miami and a board member for the nonprofit Health Foundation of South Florida, told CNN in September, following Ladapo’s announcement.

“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.

Deadly diseases can spread fast

History shows that any decrease in vaccination rates, among any demographic group, will quickly result in an increase in preventable infections. 

Children, babies who are too young for immunization, and individuals who are immunocompromised or otherwise unable to be vaccinated will be most vulnerable as preventable diseases spread.  

As a result, vaccine-preventable diseases will likely rise in Florida in the coming months and years—specifically measles, which is now exploding worldwide after being nearly eradicated. The U.S. is currently experiencing its largest measles outbreak since 1992 and is in danger of losing its status as having eradicated the disease.

Measles is a highly-infectious respiratory disease that typically causes high fever, cough, and rash, though it can lead to pneumonia, blindness, and brain damage. While most people’s symptoms improve, 1 in 5 unvaccinated people in the U.S. who contract it will be hospitalized. Roughly 1-to-3 of every 1,000 people who contract the disease will die, according to the National Foundation for Infectious Diseases.

Florida had 11 confirmed measles cases in 2024 and seven so far in 2025.

Nursing homes and hospitals are acutely at risk when infectious diseases are allowed to spread.

Florida is home to nearly 5 million residents aged 65 or older. According to the Florida Health Care Association, there are approximately 71,000 people being cared for at the 691 licensed nursing homes in the state. 

Florida’s long-term care facilities were hit hard by COVID, with staff vaccination rates consistently falling below the industry standard of 75 percent. In August 2021—eight months after the vaccine was first offered to older Americans, Florida was tied with Alaska for the nation’s highest rate of death in nursing home residents. 

If vaccination rates for measles fall below herd immunity thresholds of 95 percent, this population and others will again be highly exposed to a deadly illness.

Increased health disparities

Florida Surgeon General Ladapo, a vaccine skeptic, framed the state’s rollback of public health protections as a matter of bodily autonomy, at one point comparing vaccine mandates to human bondage.

“Every last one of them is wrong and drips with disdain and slavery,” Ladapo, who is Black, said at a Sept. 3 press conference.

But recent national polling shows that nearly 4 in 5 Americans support requiring vaccination for children—including 68 percent of Republicans. Florida’s abrupt policy change, enacted despite having no basis in science, has drawn criticism even from members of Ladapo’s own party.

“Florida already has a good system that allows families to opt out based on religious and personal beliefs, which balances our children’s health and parents’ rights,” U.S. Sen. Rick Scott, a Republican whose funding cuts to many state public health initiatives as Florida’s governor from 2011 to 2019 made him a foe of public health proponents, said in a statement.

Florida, like all 50 U.S. states, already allows medical exemptions from required student vaccinations. It also allows parents to exempt their children from inoculation on religious grounds. 

In the 2024-2025 school year, Florida was among 16 states where more than 5 percent of students were unvaccinated. It already falls below the federal government’s 2030 target of 95 percent MMR (measles, mumps, and rubella) immunization, with just 89 percent of kindergartners receiving routine immunizations for 2024-2025.

If Florida classrooms become incubators of disease, working-class families could face a tough decision: Do we send our child to school with unvaccinated and undervaccinated peers? 

If the child is vaccinated, mingling with children who are not fully vaccinated may pose an acceptable risk. But what if the child—or one of their parents—is immunocompromised? 

Upper-income families have more options. To avoid disease exposure, some will withdraw their children from the public education system, as private schools can set their own vaccine policies.

And many of these families will opt to use school vouchers to offset their new tuition costs. 

Prior to 2022, voucher programs—which Republicans have pushed since the 1980s as a way for parents to choose the best schools for their children—were usually limited to low-income families. In recent years, however, some states—including Florida—have expanded their programs to include all students, regardless of income. Florida expanded its voucher program in 2023, and 44 percent of new applicants came from households that make $120,000 or more annually.

Poor and working class families can use vouchers too, but they must still cover costs that the vouchers do not. In Florida, for example, the average voucher was $8,833 for the 2024-2025 school year, while recent estimates put the average cost of private school tuition at about $14,000.

As a result, it’s likely that the families who decide to take their children out of public schools to reduce their disease exposure, whether using vouchers or paying out of pocket, will be affluent. This sort of exodus of upper-income parents has negative outcomes for public schools, which educate 90 percent of students nationwide, as well as for the community, and the education system as a whole.

Spinoff effects

And when diseases break out in Florida following the end of mandates, they will not stay within state borders.

Florida’s tourism industry, which brought a record 143 million people to the state in 2024, will exacerbate this ripple effect. Travelers infected with measles in Florida could appear healthy for up to two weeks before showing symptoms of the disease, and they may spread it to many others during that period.

Additionally, other states with anti-vaccine leadership—for example, Louisiana and Texas—could soon follow suit, removing their own vaccine mandates and creating a larger pool of susceptible unvaccinated and undervaccinated people nationwide. 

The fallout of Florida’s anti-vaccine policy will have far-reaching consequences, harming households even if they don’t have young children, raising healthcare costs, and increasing health disparities nationwide. 

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