ORLANDO, Fla. — As Florida seeks to end vaccine mandates, a behind-the-scenes debate in the medical community has been thrust into the public spotlight: Should doctors see young patients whose parents do not want them to get shots?

The decision has long rested with physicians, who say they weigh the needs of children who have no control over their families’ health care choices against their responsibility to protect their most vulnerable patients — including newborns — from potential exposure to highly contagious, preventable diseases. Many pediatricians opt to require vaccines, even posting such policies on their practice’s websites.

But doctors no longer will make the call if Florida leaders have their way. Gov. Ron DeSantis and Surgeon General Joseph Ladapo said on Sept. 3 they want to end vaccine requirements in public and private spaces, including doctors’ offices.

That announcement alarmed some Central Florida pediatricians, who view requiring vaccines for diseases such as measles, polio and whooping cough as critical public health measures even as the COVID-19 pandemic made parents increasingly distrustful of vaccines and government mandates.

Dr. Pamela Trout said she asks parents who refuse to vaccinate their children to look elsewhere for their health care because she feels she needs to protect children who are too young to get the shots or can’t get them for medical reasons. That means keeping unvaccinated kids out of her waiting room.

“It’s not fair to my other patients,” said the Winter Park doctor.

But DeSantis has decried this stance as a form of “discrimination” he wants to stop.

“That is limiting people’s freedom to do what they think is right for their kids by having these restrictions,” DeSantis said during a press conference last week.

Not all vaccines required by the state may make sense, DeSantis added, citing Hepatitis B, which is often transmitted through activities like sex and needle-sharing, as an infection he did not think young children would be likely to contract.

Under current state law, doctors can turn away patients who refuse vaccines, but legislators could change that, said Lars Noah, a law professor at the University of Florida whose areas of focus include public health.

And they may have ethical reasons for doing so, he said. “To say, ‘you do it my way or I’m not going to see you anymore,’ is fairly coercive,” Noah said. “Some of these patients may not have a whole lot of choices.”

Posts from parents searching for pediatricians who take a flexible stance on vaccines are common on local social media pages.

“I have multiple children but my youngest isn’t vaccinated yet and I’m not sure when or if I want to but I don’t want to constantly be pushed every time I take my baby to the doctor,” one mother wrote on Facebook recently.

Ladapo said last week the Florida Department of Health will end state rules that mandate certain vaccines first and then work with DeSantis and the Legislature to eliminate the rest of the required shots. It’s unclear whether lawmakers would support such a change or pass a new law requiring doctors to treat unvaccinated patients.

Earlier this year, legislators failed to pass a law that would have prohibited healthcare providers and facilities from declining to treat patients based solely on vaccination status. Some lawmakers worried that the provision exposed physicians to medical malpractice lawsuits.

During the pandemic, Florida forbade businesses from asking for proof of COVID-19 vaccination from their customers and employers from requiring their workers to get the shots. That prohibition was narrowly focused on the COVID-19 vaccines, but Noah said it shows lawmakers can stomp out vaccine mandates and could extend such a ban to health care settings.

“Doctors are subject to all kinds of intrusive state mandates these days,” Noah said. “This one strikes me as one of the least controversial that you could pick.”

But local pediatricians say lawmakers need to consider that some patients can’t get the shots for medical reasons and depend on the immunity of others to protect them.

“The most vulnerable kids, the ones who can’t be vaccinated, are the ones at highest risk,” said Dr. Jaime Candelori, who is based in Maitland. “As a pediatrician, as a parent, I would not send them to a school knowing not all the kids are vaccinated.”

Candelori said she works with parents who are hesitant about shots but willing to discuss the benefits, but suggests that families who are adamantly opposed to vaccines pick a different doctor.

“If parents don’t trust you to say vaccines are safe, and they’re the best method we have in preventing serious illness in kids, how can you have a relationship?” Candelori said.

Jessica Tillmann, a Seminole County mother of four, believes parents have the “fundamental right” to decide whether their children receive shots. Tillmann said she decided not to vaccinate her two youngest children after her second oldest had an adverse reaction after receiving a shot.

She obtained a religious exemption for her unvaccinated children, who attend a private school. Her family has been “kicked out” of several doctors’ practices because of her stance on vaccines, she said.

“I think it’s almost disturbing a pediatrician would kick out a parent for asking questions about an invasive procedure,” said Tillmann, the chair of Seminole’s Moms for Liberty chapter, a conservative parents group that formed during the pandemic. “If that is their true concern, then I would suggest that they make time in their schedule to see those patients when they know they won’t be around other patients.”

Many parents, like Tillmann, are already declining the shots. Florida, which offers parents easy-to-get religious exemptions from its current vaccine rules, saw a 20-year low in the kindergarten vaccination rate during the 2024-25 school year.

Last school year, less than 89% of Florida kindergarteners were fully immunized. That rate is well below the 95% level, sometimes referred to as herd immunity, which makes it unlikely that a single infection will spark a disease cluster or outbreak.

The lower vaccination rate alarms experts, who note there was a measles outbreak at a Broward County elementary school last year, where 33 students lacked at least one required shot, and that two unvaccinated Texas school-age children died from measles a few months later.

If the mandates go away entirely, even fewer parents will vaccinate their kids, said Dr. David Carr, a pediatrician whose practice is just south of downtown Orlando.

Carr said he sees children whose parents refuse vaccines because many of his patients are covered by Medicaid insurance plans and the rules of that program generally forbid doctors from withholding care based on their vaccination status.

But as a physician for nearly four decades, Carr described vaccines as “one of the biggest medical marvels of modern history.”

Today’s parents haven’t seen most of the diseases that shots are intended to prevent and many don’t realize how seriously ill their children could become if they’re not protected, he said.

Carr said he fears diseases like diphtheria, a respiratory infection that’s particularly dangerous for young children and older adults, could make a comeback if vaccination rates dip too low. Because Central Florida draws tourists from around the world, this area is particularly vulnerable to an outbreak, he said.

“I think the vaccine program in the United States has been so successful it’s become a victim of its own success,” he said.

The American Medical Association said last week it “strongly opposes” Florida’s plan to end all vaccine mandates. “This unprecedented rollback would undermine decades of public health progress,” it said in a statement, and put children at risk of serious illness.

However, the organization previously has urged doctors not to turn away patients who decline shots. During the pandemic, it acknowledged that many doctors were frustrated with patients who forwent the COVID-19 vaccines but said they should see them anyway.

But Trout doesn’t budge on shots. She said she knows many of her peers will make exceptions, adding she’s “one of the stricter pediatricians in town.”

“I require all vaccines on schedule and if they choose not to, I just tell them, ‘It’s been great treating you and I would love to continue, but this is my policy and I would just ask you to find a practice that’s comfortable with kids that aren’t fully vaccinated being in their office,” she said.

If Florida laws change, Trout said, her office policies “will be what is best for my patients.”

She added she thinks some parents resist vaccines because of notions about personal freedom or feelings that they should only look out for their own families.

“I don’t even think people are willing to consider the community or the greater good,” Trout said.

-------------

©2025 Orlando Sentinel. Visit at orlandosentinel.com. Distributed by Tribune Content Agency, LLC.