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People hold signs as several hundred anti-mandate demonstrators rally outside the Capitol during a special legislative session considering bills targeting COVID-19 vaccine mandates on Nov. 16, 2021, in Tallahassee, Fla.Rebecca Blackwell/The Associated Press

A prominent public-health official in Florida has been pulled from his position after advocating vaccines for his own staff, as the political divide deepens in the U.S. over the role of government in pandemic response.

Earlier this month, Dr. Raul Pino sent an e-mail to staff at the Orange County Department of Health, where he was health director in the fifth-largest county in the state. It is “pathetic,” he said, that less than half the county’s public-health workers were vaccinated. Only 13 per cent had received booster shots.

“I am sorry but in the absence of reasonable and real reasons it is irresponsible not to be vaccinated,” Dr. Pino wrote.

Within two weeks, he had been placed on administrative leave and his future employment made subject to investigation by a state whose Governor, Ron DeSantis, has been among the most powerful critics of vaccine requirements in the country’s political establishment.

In Florida, “the decision to get vaccinated is a personal medical choice that should be made free from coercion and mandates from employers,” the state’s department of health said in a statement. Laws passed by the state last year prevent public employers from mandating vaccines and place heavy restrictions on any such mandates by private companies.

Dr. Pino’s situation – incomprehensible to observers outside the U.S. – comes as legislators across the U.S. are proposing hundreds of new bills tackling vaccines and employment.

“The biggest divide in this country right now, outside of abortion, is mandates,” said Jay Wolfson, a scholar of health law and policy at the University of South Florida.

Researchers at the Kaiser Family Foundation, or KFF, have tracked 23 states with some kind of vaccine mandate, and 13 with some form of mandate prohibition. “These prohibitions take many forms,” said Jennifer Tolbert, a health policy expert at KFF, and range from fettering local government vaccine requirements to blanket bans that outlaw demanding inoculation anywhere, including at schools and hospitals.

The number of fully vaccinated Americans has now reached 210 million, while the tally of adults with no vaccines whatsoever has fallen to 35 million from 90 million in mid-2021.

But with the U.S. still enduring its biggest spike in COVID-19 cases, the political clashes over vaccines are far from over. Across the U.S., legislators have put forward 336 state and federal bills for this year dealing with vaccines and employment.

Those bills are “fairly tilted towards bans, or at least providing exceptions” for religious and other reasons, said Amber Thyson, director of health policy at MultiState, a government relations company that tracks pandemic policies.

While it is surprising to see the removal of someone such as Dr. Pino, she said, it is “not shocking with just how political conversations surrounding COVID – including vaccinations, mask policies etc. are in the U.S.”

In Florida, the rule is “very express. The state policy is, you don’t actively as a state agency court or require or insinuate that vaccinations are required,” Prof. Wolfson said.

“You may not agree with that statute, but you’re an employee of the organization and you know what the rules are. He violated the rule.”

Dr. Pino did not respond to requests for comment.

Critics of Mr. DeSantis, who has refused to say whether he received a booster shot, accuse him of seeking to politicize the pandemic and position himself for a presidential campaign in 2024.

“It’s raw politics,” said Dick Batchelor, a former Democratic state legislator who is now a government strategist.

“He is going to basically dictate what the good politics are for the right wing of the party, notwithstanding what the health consequences might be.” It is difficult, Mr. Batchelor said, to square the Hippocratic Oath with the removal of a public-health official advocating vaccines.

In a state of the state address last week, Mr. DeSantis declared Florida “the freest state in these United States” and decried any denial of freedoms on medical grounds.

“We reject the biomedical security state that curtails liberty, ruins livelihoods and divides society. And we will protect the rights of individuals to live their lives free from the yoke of restrictions and mandates,” he said.

The rules in Florida, however, directly contradict a federal U.S. mandate requiring vaccination for health care workers at hospitals and other care facilities that receive Medicare and Medicaid funding. The Supreme Court last week upheld that mandate, leaving health care executives and officials to navigate a legislative minefield between the federal and Florida state requirements that is nearly impossible to navigate safely.

Violate the state ban, and an employer could be fined up to US$50,000 a violation.

Violate the federal mandate, and a hospital could jeopardize millions in critical funding.

A study in mid-September showed that 30 per cent of U.S. health care workers had not been fully vaccinated.

Across Florida, hospitals have struggled to respond, with some saying they would stand by vaccine requirements for staff, while others relegate the decision to further study.

“It’s going to be tested in court,” Prof. Wolfson said.

“In the meantime, nobody wants to anger the Governor – and nobody wants to anger the federal government.”

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