Blog – The Elimination of Mandated Vaccines in Florida Means an Elimination of Global Immunity
On September 3rd, 2025, the state of Florida announced plans to eliminate all mandated vaccines, including those required for public schools. This isn’t just a local policy shift–it’s a global public health concern with serious ethical implications. So, what does this mean for the future of healthcare?
Historically, when a baby is born, they begin their vaccination schedule. This schedule ensures protection from preventable diseases and that care is given at the appropriate time. However, without these mandates, parents may choose to forgo vaccine protection, thereby putting their own child, and inadvertently the global population, at risk.
Parental Decision-Making and Best Interest Standard: Parents have the ethical and legal authority to make healthcare decisions for their child, which is grounded in the obligation to act in the child’s best interest – known as the Best Interest Standard (BIS) in clinical ethics. The BIS requires that all healthcare decisions promote the pediatric patient’s health, safety and well-being. As young pediatric patients frequently lack the capacity to make informed decisions regarding their care, we rely on parents and/or surrogates to make those life-altering decisions. By refusing vaccines, are parents acting in the best interest of their child? Their child becomes more susceptible to illnesses and diseases that were previously prevented by vaccination.
Global Impact: Florida is undoubtedly a central global tourist hub, home to Disney World and other vacation destinations. An unvaccinated population increases the risk of disease transmission, not just within Florida, but to every tourist who visits and returns to their home state or country. It is difficult to ethically support and defend a healthcare decision that does not solely affect one patient or one family. Instead, the decision to be unvaccinated has monumental medical implications for a global population, differing from personal healthcare decisions regarding reproductive care.
A common misconception about vaccines is that vaccination guarantees immunity to the disease. So, those who are deciding not to vaccinate their children may believe that they are solely impacting their own child. However, that is not how vaccines work. Vaccines are unfortunately not 100% effective; instead, they work so efficiently by creating “herd immunity.” When a population has a widespread vaccination rate, the disease is less likely to spread and allows those who are unable to be vaccinated (for reasons other than choice), to be protected.
For example, measles requires a 94% vaccination to reach herd immunity. That means, 94% of the global population ought to be vaccinated against measles to prevent an outbreak from occurring. So, if states like Florida opt out, that threshold is compromised, and global outbreaks become more likely.
Duty and Public Health: From a public health ethics perspective, this brings forward the principle of duty. When individuals refuse vaccines, they compromise collective safety, especially for those who cannot protect themselves. Does society share an ethical duty and responsibility to protect one another? That’s what vaccination is. It is society’s collective agreement to safeguard each other’s well-being and our moral imperative in helping to reduce societal harm. Vaccination isn’t just a personal decision; it’s a social duty.
At what point does parental autonomy and decision-making cross into public endangerment? When refusing a vaccine puts the child and the community at risk, the ethical balance shifts. Ethically speaking, autonomy is not absolute. It must be balanced against competing principles: the child’s best interest, the duty to prevent harm, and the health of the public. Removing vaccine mandates in a state as populous and globally connected as Florida is more than a policy decision–it’s an ethical failure that places individual belief over scientific consensus, autonomy over duty, and personal freedom over public responsibility.
It is imperative that, with the elimination of the mandate, parents do their research and consult experts. The World Health Organization (WHO) has reported that vaccine hesitancy is one of the top threats to global health. So, it is vital that decision-makers recognize that ethical healthcare decisions require more than personal conviction; they demand accountability to the child, the community, and the global population.
Brianne Helfrich, PhD is a Pediatric Ethicist.
Mariah Chobany, PhD is a Clinical Ethicist at Sanford Health.
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