Hiltzik: Florida faces a measles epidemic under Joseph Ladapo - Los Angeles Times
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Column: As measles spreads, ‘herd stupidity’ grips Florida’s government

Dr. Joseph Ladapo
Florida Surgeon General Joseph Ladapo secured his position as the most dangerous quack in America with his response to a measles outbreak in his state.
(Brendan Farrington / Associated Press)
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As of this writing, the measles outbreak in Florida is up to nine cases, including the first one recorded outside the epicenter in Broward County, in the vicinity of Fort Lauderdale.

Nine cases may not seem like a lot, but it’s enough to alarm epidemiologists. They point out that measles is among the most contagious viruses known to humankind, which means that the cases identified thus far are likely to be the tip of the iceberg.

Who’s unconcerned? The chief public health official of the state of Florida, that’s who. He’s Joseph Ladapo, whom I earlier identified as “the most dangerous quack in America.”

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That was before the measles outbreak, when Ladapo was known chiefly for opposing COVID vaccination despite incontrovertible evidence that it saves lives.

1 in 5 will be hospitalized, 1 in 20 will develop pneumonia (the most common way measles kills young kids), 1 in 1,000 will develop encephalitis (infection of the brain, sometimes causing permanent brain damage), and 1-3 in 1,000 will die.

— Epidemiologist Katelyn Jetelina on measles

Ladapo has now cemented his position at the top of the list of public officials hazardous to your health. He did so with a letter issued Feb. 20 to parents with children at the elementary school suffering the outbreak.

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The letter noted that it is “normally recommended” that children stay home until the end of the infectious period, which he pegged at March 7.

But he added: “Due to the high immunity rate in the community, as well as the burden on families and educational cost of healthy children missing school,” his agency would let parents or guardians make their own decisions about sending their kids to school.

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The letter was also notable for what it did not say. It did not recommend that parents of nonimmunized children get them vaccinated immediately.

Ladapo was installed as surgeon general by Republican Gov. Ron DeSantis, largely because he mouthed the same propaganda opposing anti-COVID measures, including the vaccines, as the governor. DeSantis hasn’t spoken in public about the measles outbreak, but make no mistake: He deserves equal blame for the consequences.

Florida Surgeon Gen. Dr. Joseph A. Ladapo is advising people to avoid the most effective COVID vaccines, just as a surge in disease cases gets worse.

Jan. 9, 2024

To say that Ladapo’s advisory left physicians and epidemiologists aghast would be a massive understatement. Allowing unimmunized children to go to school where they could be exposed to measles contradicts every responsible recommendation from medical science.

Ladapo tried to justify the decision to let unimmunized children exposed to measles go to school by asserting that the vaccination rate is high enough.

But as epidemiologist Katelyn Jetelina observed on her blog, Your Local Epidemiologist, while the vaccination rate in Florida is just over 90%, that’s “not high enough — because measles is so contagious, the threshold for herd immunity against measles is 95%. This means there are pockets in the school, other schools, and a community that measles could burn through.”

A bar chart shows measles cases
Measles is already on the march in the U.S. in 2024. Case numbers are current to Feb. 22.
(Centers for Disease Control and Prevention)
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To put it another way, Ladapo’s appeal to the principle of “herd immunity” is outweighed by the herd stupidity of the anti-vaccination movement that he is a part of.

She also points out that “unvaccinated kids can still get protection from a vaccine within 72 hours of exposure.” That generally reduces the severity of symptoms. But Ladapo didn’t point that out.

Ladapo also minimized the consequences of measles infection. The rate of measles in the U.S. has been so low in recent years that the severity of the disease for the unimmunized can be deadly. Ladapo advised parents to be on the lookout for “a rash that often develops on the face and neck before spreading to the rest of the body as well as “high fever, which can reach 105°F, cough, runny nose, and red, watery eyes.”

Is that sufficient warning? No. The Centers for Disease Control and Prevention reports that among the unimmunized, 9 out of 10 people exposed will get infected.

Jetelina adds that among the unimmunized, “1 in 5 will be hospitalized, 1 in 20 will develop pneumonia (the most common way measles kills young kids), 1 in 1,000 will develop encephalitis (infection of the brain, sometimes causing permanent brain damage), and 1-3 in 1,000 will die.”

DeSantis and his crackpot surgeon general attack COVID vaccination with misinformation, cherry-picked data and lies. They’re a menace to public health as long as they have jobs.

Sept. 15, 2023

Also, measles can “cause ‘immune amnesia,’ where the immune system loses its ability to fight other viruses that people were previously immune to.”

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In other words, measles is not something to view casually. The CDC has identified 35 cases nationwide this year so far. That’s more than half the total of cases in all of 2023, registered after less than two months of 2024. This figure is certain to rise as public health officials such as Ladapo fail to do their jobs.

The measles vaccine — MMR, which includes immunity for mumps and rubella — has been a prime target of the anti-vaccination cabal ever since the British physician Andrew Wakefield published a fraudulent and long-debunked report in 1998 linking it to autism. Wakefield lost his medical license in Britain as a result, but his work has remained a blot on public health ever since.

Ladapo has made common cause with the anti-vaccine movement over COVID vaccines. Doubts about the MMR shots may have infected his judgment in the measles outbreak.

His inadequate response to the outbreak finally has some Floridians and the state’s media taking note of the danger his policies represent to the health and well-being of Florida’s children and others. But given the virulence of measles, it may be too late.

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