Cayman’s top doctor warns of public health threat ‘to the north’

Cayman’s Chief Medical Officer, Dr. Nick Gent, has declared a public health warning over Florida’s move to dismantle vaccine mandates, cautioning that the decision could have direct consequences for Cayman and the wider Caribbean.

Speaking on Compass TV’s Forefront talk show, Gent said he is deeply concerned about the knock-on effect of Florida’s controversial policy shift – announced on 3 Sept. by Florida Governor Ron DeSantis and Surgeon General Joseph Ladapo – that would make many childhood vaccines optional.

“There is a threat to the north of us, and if that manifests itself, there will be increasing outbreaks and [illnesses] arriving on planes and getting into our community,” Gent said.

He expressed concern that if states like Florida remove vaccines from their recommended immunisation programmes, the shots will no longer be free of charge. “If people start to pay for those vaccines, immunisation rates will fall,” he cautioned.

In Cayman, vaccines are not mandatory for school entry. Gent noted that the high uptake among parents is largely because of the strong safety record and accessibility of vaccines. But he warned that any decline in coverage in Florida could have direct consequences.

It would mean that “the chances of incursion into the Cayman Islands rises and rises and rises,” he said.

Florida is Cayman’s closest US gateway. So far this year, more than 12,000 Cayman residents have travelled there as a first US port of entry, accounting for nearly three-quarters of all Cayman-US travel. The state also serves as a key stopover hub for visitors coming to Cayman. According to Reuters, Florida welcomed a record 143 million international and domestic tourists in 2024.

Cayman’s proximity to Florida, Gent said, makes the state’s policy shift a real threat to the local community.

“Now more than ever, parents in the Cayman Islands need to make sure their children are absolutely up to date on all their immunisations,” he warned.

The public health context

Florida’s rollback will begin with removing school requirements for hepatitis B and chickenpox vaccines. Eliminating mandates for others – including measles, polio and pertussis – would require legislative approval.

In a CNN interview, Ladapo admitted his office had conducted no analysis on how ending vaccine mandates might affect outbreaks of diseases, such as measles, polio or whooping cough. Pressed by host Jake Tapper, Ladapo dismissed the need for modelling, framing the issue instead as one of parental rights.

Critics, including Dr. Tina Tan, president of the Infectious Diseases Society of America, warned that the move could mislead parents who are responsible for making vaccination decisions for their children.

“The problem is that now you are opening the door for vaccine-hesitant parents and antivaxxers to continue to increase,'” said Tan in an article she authored in Contemporary Pediatrics.

“This is really devastating news, because what is going to happen is you are going to see multiple outbreaks of vaccine-preventable diseases that are now going to spread very quickly, not only in Florida, but all over the US and then internationally.”

Gent stressed that parents asking their healthcare provider about the risks and benefits of vaccines is not problematic. The barriers that prevent families from accessing vaccines in the first place are a far greater concern.

“When we look at where immunisation rates are low, it usually has nothing to do with parents being sceptical about vaccines,” he said. “It’s because obstacles have been put in their way.”

The real public-health challenge, he explained, comes when parents can’t easily get the information they need, are required to book an appointment instead of simply walking into a clinic, or if they have to pay for vaccines because they are not mandatory.