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Vaccine Preventable Diseases (VPD)

Florida Health

Disease Control

The COVID-19 pandemic is affecting health care seeking behavior, which may be impacting the diagnosis and reporting of hepatitis A, pertussis, and varicella cases that are shown in this report. For more information on the COVID-19 pandemic in Florida, please visit

Vaccine Preventable Disease Surveillance Report September 2021

Hepatitis A

A graph showing Hepatitis A activity has fluctuated each month fromOcotber 2020 – Septeber 2021. In September 9 cases were reported.
  • Hepatitis A activity increased from last month and was below the previous 5-year average.
  • 9 cases were reported in September.
  • Since 2018, 97% of cases were not up-to-date on hepatitis A vaccinations.
  • The Hepatitis outbreak in Florida was declared over as of August 31, 2021


A graph showing Pertussis activity has fluctuated each month from Ocotber 2020 – September 2021. In September 3 cases were reported.
  • Pertussis activityincreased from last month and was below the previous 5-year average.
  • 3 cases were reported in September.
  • Compared to April 2019 - September 2019, there was an 89% decrease in reported cases in the past 6 months.
  • In the past 6 months, the average incidence rate for <1 year old was 39 times lower compared to April 2019 - September 2019.


A graph showing Varicella activity has fluctuated each month from October 2020 – September 2021. In August 29 cases were reported.
  • Varicella activity decreased from last month and was below the previous 5-year average.
  • 29 cases were reported in September.
  • Incidence was highest among infants <1 year old.
  • 41% of cases were not up to date on varicella vaccinations or had unknown vaccination status.

For all vaccine-preventable diseases, timely and complete vaccination is the best way to prevent infection. Although vaccinated individuals can still become infected with diseases like pertussis or varicella, in general, those who have received at least 1 dose of vaccine have less severe outcomes than those who have never been vaccinated for the disease.

A map showing the proportion of children ages 4–18 years with religious exemptions by county as of September 31, 2021. Counties with a proportion of 0.6%–1.9% are: Hardee Gadsden Liberty Hendry Calhoun Taylor Jackson Bradford Hamilton Dixie Glades DeSoto Washington Putnam Madison Okeechobee Franklin Counties with a proportion of 2.0%–3.3% are: Levy Lafayette Baker Holmes Jefferson Union Wakulla Gilchrist Miami-Dade Leon Nassau  Gulf Sumter Polk Hillsborough Highlands Bay Counties with a proportion of 3.4%–4.7% are: Suwannee Lake Clay Orange Duval Citrus St Lucie Escambia Indian River Marion Manatee Palm Beach Alachua Pasco Broward Charlotte Santa-Rosa Counties with a proportion of 4.8%–8.9% are: Volusia Osceola Seminole Lee Brevard Columbia Hernando Collier Pinellas Martin Okaloosa Monroe St Johns Flagler Walton Sarasota

Unvaccinated children are at increased risk of vaccine-preventable diseases like measles, pertussis, and varicella. Communities with a higher proportion of religious exemptions (REs) to vaccination are at increased risk of vaccine-preventable disease transmission.

The proportion of children age 4–18 years with new REs are increasing each month. Statewide, the estimated prevalence of REs among children age 4–18 years old is 4.1% with individual counties ranging from 0.6 – 9.0%. In September 2020, the statewide prevalence was 3.6%, and the prevalence has gradually increased each month since.

To learn more about REs at the local level, please visit

All REs are required to be entered into Florida SHOTS (State Health Online Tracking System), Florida’s statewide immunization registry. The map above includes REs registered in Florida SHOTS through September 31, 2021.


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