Mississippi, Florida, and the Coming Vaccine Apocalypse

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Consider Mississippi. According to a memo from the state's Department of Health in March of this year, "There have been no reported cases of measles in Mississippi since 1992." This was relevant, of course, because at that point the country had seen more than 200 cases of the world's most contagious infectious disease spreading primarily in Texas but in a dozen or so other states as well.

Since then, the number of measles cases across the country has risen to 1,431, the most since the disease was eliminated — meaning the absence of continuous spread for more than 12 months — in 2000; the most, in fact, since 1992. Though Texas's outbreaks still dominate, almost all states have now had at least some exposure. It is not alone in this, but Mississippi has remained pristine:

At this point in a year of big outbreaks, Mississippi's avoidance of even a single case is at least somewhat due to luck. But not entirely: for a long time, the state was one of only a few that did not allow exemptions of any kind to school vaccination requirements. If your kid went to school there, they would need to be up to date on the various immunizations that represent without question one of humanity's greatest public health achievements. (Three of the other five states without religious exemptions, for the record, are also at zero cases of measles this year — Maine, Connecticut, and West Virginia.)

The result of the was one of the highest rates of childhood vaccination in the country. For example, according to CDC data, in the 2019-2020 school year Mississippi kindergartners had coverage rates above 99 percent for the measles/mumps/rubella, diptheria/tetanus/pertussis, polio, hepatitis B, and varicella vaccines. Just considering a couple of its neighbors, that same year in Louisiana those rates ranged from around 93 percent to around 96 percent; in Alabama they were in the mid-80s.

The people of Mississippi have long faced plenty of health issues. It has among the country's highest obesity rates, the highest heart disease mortality rates, and more; its overall life expectancy is more than half a decade less than the country's average. But it had that childhood infectious illness thing nailed. Until it didn't.

In 2023, a judge ruled that Mississippi had to start allowing religious exemptions to school vaccine requirements, joining almost every other state in the country. As a result, the tiny rate of exempt children in the state — there are some medical conditions that exempted kids before the law change — has jumped, from something like 0.1 percent up to 1.2 percent for this past school year.

The overall coverage rate in the state remains high — but not as high, at 97.6 percent for the five vaccines for last school year. That number will probably keep dropping, perhaps down toward the 95-percent level experts say is needed for measles herd immunity, and that perfect, 30-plus-year measles record will almost certainly drop with it.

Which brings us to Florida. On Wednesday, Governor Ron DeSantis stood with state surgeon general Dr. Joseph Ladapo to announce that the state will become the first in the country to dispense with all vaccine mandates, including those previously in place for kids entering school. Ladapo, a truly remarkable crank even in a country whose leadership positions are teeming with them, said that every vaccine mandate "is wrong and drips with disdain and slavery." He — again, the surgeon general of a state — added: "Who am I to tell you what your child should put in their body?"

Experts and non-conspiracy-addled people were, obviously, appalled. Florida's childhood vaccination rates were already low, in the 89 percent rate at last count; the total rate of exemptions there has jumped from 1.5 percent in 2011-2012 to 5.1 percent for 2024-2025. And now, assuming this policy change moves ahead, the number of unvaccinated kids will leap even higher — though without the mandates, we basically won't know about it.

Meanwhile, on Thursday, a day after Florida's announcement, Anti-Vaxxer in Chief and overcooked tannery product Robert F. Kennedy Jr. faced the Senate Finance Committee, where Democrats called him a "charlatan" and demanded he resign over and over and even some Republicans seemed to be growing fed up with his collective moves to remove immunization access and weaken the country's public health. They — RFK, Ladapo, judges in Mississippi, the rest — they're coming for all of it.

Before the switch in 2023, Mississippi spent decades with some of the best immunization rates in the country because of a 1979 case where the state Supreme Court banned the use of religious exemptions. As a judge wrote then:

"The protection of the great body of school children attending the public schools in Mississippi against the horrors of crippling and death resulting from poliomyelitis or smallpox or from one of the other diseases against which means of immunization are known and have long been practiced successfully, demand that children who have not been immunized should be excluded from the school community until immunization has been accomplished.... To the extent that it may conflict with the religious beliefs of a parent, however sincerely entertained, the interests of the school children must prevail.

To misunderstand this concept is to misunderstand not only how vaccination works but how — literally — society works.