Donald Trumpthe promise to shake up public health policy across the United States by installing Robert F Kennedy Jr as Secretary of Health » resonates in Florida, where experts say the nation can learn from its own experience from a vaccination-denying state surgeon with unorthodox scientific views.
Like Kennedy’s relationship with the new president, Dr. Joseph Ladapo was championed and closely linked to a powerful right-wing political leader – Ron DeSantis, the Republican governor of Florida.
Since Ladapo was sworn in in February 2022, he has been at the heart of several controversies. Some notably advised parents to send unvaccinated children to school during a measles epidemic, personally manipulate a study to try to show that Covid-19 vaccines pose a greater health risk than them and to urge municipalities to remove fluoride from drinking water despite the proven benefits for dental health.
Her marginal opinionsand public guidance, often in direct contradiction to that of the federal Centers for Disease Control and Prevention (CDC), parallels that of Kennedy, an equally polarizing figure who peddled numerous conspiracy theories including the discredited link between vaccines and autism, promoted raw milk and disparaged the pharmaceutical industry.
Florida’s experience could soon become that of the entire United States, experts fearif Kennedy is confirmed by the Senate and allowed to translate some of his most extreme beliefs into federal public health policy.
“During the pandemic, this wave of anti-expert, anti-public health sentiment grew, the flames fueled by politics, and the response to the pandemic became highly politicized in a way that no response to a pandemic had never happened before. It certainly struck a chord with many people in this country,” said Dr. Scott Rivkees, Ladapo’s predecessor as Florida surgeon general who was sidelined then replaced by DeSantis for his pro-mask and pro-vaccine position which clashed with that of the governor.
“Regarding the views expressed by my successor, Dr. Ladapo and RFK Jr, there is a sentiment in the United States that believes what they say and believes that there should be more personal freedom and less role for the government to tell people what they need to do to protect themselves and others.
“This has made things difficult in the health sector and in the public health sector, as many of the safeguards that keep individuals safe and healthy and protect communities are now threatened and challenged. »
In the aftermath of the November election, DeSantis, whose failed presidential campaign plan was essentially “Making America in Florida“, was promotion of Ladapo for the role of health secretary. The president-elect ultimately opted for Kennedy, but Washington Post report The fact that Ladapo was on the shortlist suggests that Trump had observed and admired his maverick tenure as Florida’s surgeon general, and is seeking to replicate it nationally.
Rivkees said the approach was concerning, but he remained optimistic.
“Some of the new messages – anti-vaccination, anti-health and education, things like that – will end up having detrimental consequences in terms of public protection, but there are a lot of dynamics behind what has been put in place for the public health that should allow us to weather the current storm,” he said.
“We have hundreds of thousands of practitioners across the United States who continue to promote vaccinations and healthy lifestyles, who meet with families every day and talk about what they need to do to protect themselves.
“They may not be as overt in terms of public health vaccination campaigns, for example, but will continue to ensure that individuals get vaccinated in a more discreet way, without necessarily stirring up political controversy.”
Florida’s statistics, however, show that it could be an uphill battle if Ladapo’s anti-vaccine message is amplified nationally, which seems certain. Another Florida doctor who has questioned vaccine safety, David Weldon, has been appointed by Trump to lead the CDC.
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Weldon shares many of the views of Ladapo, who modified a study to make the Covid vaccine more harmful to young men and did common false statements on vaccinations in general, including that Covid mRNA boosters alter human DNA and can potentially cause cancer.
Vaccination rates for kindergarten children in Florida, already declining since 2016, fell precipitously following Ladapo’s appointment in 2021, from 93.3% to 88.1% last year, according to the CDC. Vaccination rates at a Broward County elementary school that experienced a measles outbreak in February 2024 was 89.31%officials said.
“We’re going to start seeing localized outbreaks of vaccine-preventable diseases and public health is going to have to change to be able to deal with these outbreaks that we’ve never seen before,” Rivkees said.
Not all experts see the worst case scenario in a federal health department with similar values and attitudes to the Ladapo state agency. Jay Wolfson, distinguished professor of public health, medicine and pharmacy at the University of South Florida Morsani School of Medicine, said the U.S. constitutional system leaves most health policy decisions anyway to the States, and that some of Kennedy’s “difficult” positions would carry little weight. .
“Supreme Court Justice Louis Brandeis said: ‘It is one of the happy incidents of the federal system that a single courageous State can, if its citizens choose, serve as a laboratory; and try new social and economic experiments without risk to the rest of the country,” Wolfson said.
“The things that Florida has done may or may not be helpful to other states and the rest of the country, and we have a lot to learn from them. And while some of Mr. Kennedy’s ideas on fluoridation and vaccination are certainly thought-provoking, he has some very interesting and positive public health things in mind, regarding food additives, chronic diseases like diabetes , heart disease, hypertension and obesity, and the need to tackle these as epidemics.
Wolfson pointed out that DeSantis “has relied heavily on Dr. Ladapo, and some of us have expressed concerns about some of his research.”
“But on the national level, Kennedy will not be the only force,” he said.
“Trump will hear what Mr. Kennedy has to say, but I think he will find a balance with the people who will bring good science, good medicine and good policy (to the National Institutes of Health), and soften the rough edges of Kennedy’s political views.