What happens when a vaccine skeptic leads health policy? Ask Florida

President-elect Trump says he's going to let Robert F. Kennedy Jr. "go wild on health." That has many pediatricians nervous, because of RFK Jr.'s anti-vaccine rhetoric. When another vaccine skeptic, Joseph Ladapo, became surgeon general in Florida, some doctors there say vaccine hesitancy got worse.

"It's because people in power, like our surgeon general, as an example, are pushing this anti-vax message," says Dr. Jeffrey Goldhagen, a professor of pediatrics at the University of Florida College of Medicine and president of the International Society for Social Pediatrics and Child Health. Vaccine hesitancy has been growing in Florida. The routine childhood vaccination rate for kindergartners is now at 90.6%. That's the lowest rate in more than a decade — and it's well below the threshold needed for herd immunity against highly contagious diseases like measles.

Dr. Lisa Gwynn, a pediatrician in Miami-Dade county, says she spends a lot of her time countering vaccine misinformation. "Probably 50% of our job now in pediatrics is explaining to parents the importance of vaccinating their children," she says. Earlier this year, Gwynn saw the consequences of not getting routine childhood vaccinations first hand.

"We just had a measles outbreak right around the corner of the elementary school that my daughter went to," in nearby Broward County, she says. "There were five kids who contracted measles and they were not immunized." When a measles outbreak occurs, the Centers for Disease Control and Prevention advises parents to keep unvaccinated children at home after exposure, to stop the disease from spreading. But Florida Surgeon General Joseph Ladapo's advice was quite different: He told parents of unvaccinated children that it was up to them to decide whether to send their children to school or keep them home.