On September 3, 2025, Florida Governor announced plans to become the first state to eliminate vaccine mandates for residents, including those required for children attending school. Current Florida law mandates that children receive vaccinations against diseases such as polio, diphtheria, and measles. Dr. Joseph Ladapo, Florida’s surgeon general and a professor at the University of Florida, stated that these vaccine requirements “drip with disdain and slavery.” This controversial assertion has reignited discussions about the intersection of public health policy, race, and history in America.
Public health experts have expressed significant concern over Ladapo’s remarks. They argue that invoking slavery in the context of vaccine mandates risks perpetuating distrust in vaccines and could exacerbate existing health disparities among racial and ethnic communities. Vaccination campaigns have historically played a crucial role in American public health, and the dismissal of mandates may threaten the progress achieved.
The World Health Organization reported in a landmark 2024 study that vaccines have saved over 154 million lives globally in the past 50 years. In the United States, childhood vaccinations are considered one of the top public health achievements of the 20th century. Vaccines have led to a dramatic decline in the incidence of vaccine-preventable diseases, with rates of eight common diseases dropping by over 97% from pre-vaccine levels. This decline has prevented an estimated 1,129,000 deaths and resulted in direct savings of US$540 billion.
Vaccine mandates in the U.S. date back to colonial times and have evolved through various historical contexts. George Washington mandated smallpox inoculation for his troops during the American Revolution to combat the disease. By the early 1900s, state and local governments implemented vaccination campaigns targeting high-risk groups, including enslaved individuals and immigrants. Vaccination efforts often faced resistance, yet they led to significant public health advancements.
The U.S. Supreme Court upheld vaccine mandates in the early 20th century, balancing individual rights with public health needs. The rulings in Jacobson v. Massachusetts in 1905 and Zucht v. King in 1922 reinforced this position, allowing for mandates in school settings. By 1980, all states had established mandatory vaccination requirements for school entry.
Despite the proven efficacy of vaccines, a vocal anti-vaccine minority has gained prominence, particularly following the COVID-19 pandemic. Misinformation regarding vaccines and public health policies has proliferated, often rooted in historical injustices such as the Tuskegee Study. Conducted from 1932 to 1972, this unethical study involved hundreds of Black men who were misled about their treatment for syphilis, highlighting the legacy of medical racism in America.
The historical context of vaccines and race reveals a complicated narrative. Enslaved people in America played a critical role in the development of public health initiatives, including vaccinations. Historical accounts indicate that inoculation practices were introduced to the Colonies by individuals like Onesimus, an enslaved man who educated his owner, Cotton Mather, about the practice. Enslaved and free individuals of African descent actively contributed to health initiatives within their communities, often in the face of systemic racism and discrimination.
Ladapo’s reference to slavery in relation to vaccine mandates overlooks this nuanced history. His statements may further entrench mistrust among communities of color regarding vaccines, as studies show that the lingering effects of past medical injustices contribute to health disparities today. Black Americans experience shorter lifespans, higher rates of maternal and infant mortality, and increased incidences of communicable diseases compared to their white counterparts.
Eliminating vaccine mandates in Florida could exacerbate these existing disparities and hinder public health efforts. However, there remains an opportunity for health officials to learn from the past. Rather than weakening vaccine requirements, a focus on expanding access and providing reliable information about vaccines is essential.
Policymakers can acknowledge the complex history of vaccines, public health, and race while promoting the benefits of vaccination. By addressing historical injustices and fostering trust in the healthcare system, officials can work towards improving public health outcomes for all Americans.
