On October 16, 2025, Florida’s Surgeon General Dr. Joseph Ladapo made headlines by declaring that vaccine mandates are both unethical and unnecessary, igniting a new round of debate over public health policy in the United States. Ladapo’s remarks, delivered at a public event in Miami with Governor Ron DeSantis at his side, have set off a wave of political and scientific discussion that cuts to the heart of how Americans approach childhood immunizations—and whether the U.S. can maintain high vaccination rates without legal requirements.
Ladapo cited countries like Sweden, Norway, Denmark, the United Kingdom, and Canada as examples where, he argued, high vaccination rates are achieved without the use of mandates. “You can still have high vaccination numbers, just like the other countries who don’t do any mandates like Sweden, Norway, Denmark, the [United Kingdom], most of Canada,” Ladapo said, as reported by the Associated Press. “No mandates, really comparable vaccine uptake.”
On the surface, the numbers seem to back him up. According to 2024 data from UNICEF and the World Health Organization, 94 percent of one-year-olds in the United States received all three doses of the DTaP vaccine, which protects against diphtheria, tetanus, and pertussis. Canada and the UK each reported 92 percent, while Denmark, Norway, and Sweden all hovered around 96-97 percent. These figures suggest that high vaccination rates are possible without mandates—but experts caution that the story is far more complicated than statistics alone suggest.
Florida’s current state law requires students from daycare through 12th grade in both public and private schools to receive specific immunizations, though families can opt out for religious or medical reasons. Despite these requirements, about 11 percent of Florida kindergarteners are not immunized, according to recent data. With Governor DeSantis’s support, Ladapo is pushing to eliminate these school vaccine mandates, aligning Florida with a growing movement among some states to prioritize individual choice over public health mandates.
The debate is not unique to Florida. In April 2025, Idaho made headlines by passing the Medical Freedom Act, which bans vaccine mandates for schools, employers, and other entities. Leslie Manookian, president of the Health Freedom Defense Fund and an author of the Idaho law, told ProPublica, “The most basic and fundamental of human rights is the right to direct our own medical treatment—and to codify that in law in every state.” She added, “Breaking that barrier in Idaho proves that it can be done, that Americans understand the importance of this, and the humanity of it, and that it should be done in other states.”
Florida’s announcement in September that it would begin phasing out school-mandated vaccines marked another major step. At a press conference, Dr. Ladapo did not mince words, likening vaccine mandates to slavery. “Every last one of them is wrong and drips with disdain and slavery,” he said. “Who am I as a government or anyone else, or who am I as a man standing here now to tell you what to do with your body?”
Not everyone in the Republican Party is on board with these sweeping changes. Senator Thom Tillis called Florida’s ban on school vaccine mandates a “horrible idea,” while Senator Shelley Moore Capito emphasized, “Vaccinations have proven to be—the basic ones—helpful in preventing the spread of measles, polio and other things. My children are vaccinated, my grandchildren are vaccinated. I don’t agree with that.”
Meanwhile, at the national level, the debate has reached the highest echelons of public health leadership. On October 29, 2025, Dr. Martin Kulldorff, who leads the Centers for Disease Control and Prevention’s vaccine advisory panel, told Politico that school vaccine mandates are “not necessary.” He argued that the CDC’s Advisory Committee on Immunization Practices (ACIP) should focus on recommendations for what is best for children, not on enforcing mandates. “I don’t think we should be involved at all in mandating any vaccines,” Kulldorff said, adding, “ACIP is an independent committee of independent scientists. We don’t work for the government.”
Kulldorff, who was nominated by Health and Human Services Secretary Robert F. Kennedy Jr.—a figure well-known for his anti-vaccine activism—emphasized his independence and distanced himself from Kennedy’s views. He pointed to Sweden as a successful example of a country with high vaccination coverage but no school mandates, noting, “People are very confident in the vaccine schedule they have in Sweden. There are no mandates in schools. So I think mandates are not necessary.”
But many experts warn that the U.S. is not Sweden, Denmark, or Canada. As Dr. Megan Berman of the University of Texas Medical Branch’s Sealy Institute for Vaccine Sciences told The Atlantic, universal healthcare and routine access to preventive care in those countries make vaccines both more accessible and more accepted. “In the US, our healthcare system is more fragmented, and access to care can depend on insurance or cost,” Berman said. Anders Hviid, an epidemiologist at Statens Serum Institut in Copenhagen, added that Danish citizens’ strong trust in government is a key factor—something that is notably lower in the United States. In fact, as of 2024, fewer than one in three Americans over age 15 reported confidence in the national government, the lowest among the countries Ladapo mentioned, according to the Organisation for Economic Co-operation and Development.
Dr. Richard Rupp, also of the University of Texas Medical Branch, explained, “The effectiveness of recommendations depends on faith in the government and scientific body that is making the recommendations.” Without mandates, he and others argue, the U.S. would need to lean heavily on education, access, and public trust to maintain high vaccination rates—a tall order in a country marked by fragmented healthcare and deep political polarization.
There is also concern about the role of top health officials. Samantha Vanderslott, leader of the Oxford Vaccine Group’s Vaccines and Society Unit, pointed out that the U.S. is an outlier in having a health secretary with a history of vaccine skepticism. “It is unusual for someone with Kennedy’s background to hold a position where he has the power to spread misinformation, encourage vaccine hesitancy and reduce mainstream vaccine research funding and access,” she said. This, she argued, could make it even harder to maintain vaccination rates if mandates are removed.
Ultimately, experts agree that simply copying policies from abroad may not work in the U.S. context. As Matt Hitchings, a biostatistics professor at the University of Florida, put it, “If I said that people in the UK drink more tea than in the US and have lower rates of certain cancers, would that be convincing evidence that drinking tea reduces cancer risk?” The analogy underscores the complexity of public health policy and the dangers of oversimplifying international comparisons.
As the debate continues, one thing is clear: the future of vaccine mandates in the United States is far from settled. With states like Idaho and Florida leading the charge to roll back requirements, and prominent public health officials questioning their necessity, the coming years will test whether American society can sustain high vaccination rates on trust, education, and access alone—or whether mandates remain a necessary tool for protecting public health.
