Understanding the Impact of Slavery and Racism in Vaccine Mandate Discourse

On September 3, 2025, Florida announced plans to become the first state to eliminate vaccine mandates for its residents, including those required for children to attend school. While current laws in Florida, overseen by the Department of Health, mandate immunizations for various communicable diseases such as polio, measles, rubella, and pertussis, Florida’s Surgeon General Dr. Joseph Ladapo has argued that these requirements are flawed and likened them to “slavery.”

As experts in American medical history and vaccine policy, we found it necessary to scrutinize this analogy. The history of race and vaccination in the United States is complex, but invoking slavery to oppose vaccine mandates can worsen public mistrust and threaten ongoing efforts to address racial health disparities. Black Americans historically played essential roles in public health initiatives, including vaccination campaigns, despite facing systemic racism and unethical practices.

The use of the term “slavery” in this context risks oversimplifying history and dismissing the contributions of Black Americans to health equity. Historically, enslaved individuals actively participated in early vaccination efforts, such as inoculation practices brought from West Africa, which were crucial in controlling smallpox outbreaks. Enslaved people and Black communities have long fought for equitable access to healthcare and have been central to combating infectious diseases.

Vaccine mandates have a long-standing history in the U.S., dating back to colonial times, with legal affirmations in the early 20th century following landmark Supreme Court rulings like Jacobson v. Massachusetts and Zucht v. King. These mandates helped eliminate deadly diseases such as polio, measles, and mumps, saving countless lives. Public support for these mandates remains high, with recent surveys indicating that most parents endorse vaccination requirements for school attendance.

However, the legacy of unethical medical experiments, such as the Tuskegee Syphilis Study, continues to cast shadows over trust in healthcare institutions among Black Americans. These historic abuses, along with ongoing disparities in health outcomes—such as higher infant mortality and lower life expectancy—highlight the persistent impact of systemic racism.

Ladapo’s comparison of vaccine mandates to slavery overlooks this nuanced history and risks fueling mistrust. Instead, public health initiatives should prioritize expanding vaccine access, transparent communication, and acknowledging past injustices while emphasizing the scientific successes that have dramatically reduced the burden of infectious diseases.

By learning from history and working collaboratively, health authorities can strengthen efforts to ensure equitable healthcare and improve vaccine confidence across all communities, without resorting to harmful and misleading allegories.