Florida may become the first state in the nation to remove some vaccination requirements for children to attend school, which has alarmed doctors and many parents’ groups.

The state health department is proposing that children will no longer need vaccination against Haemophilus influenzae type b, hepatitis B, varicella, and pneumococcal disease. The state also said it would broaden exemptions to include “moral or ethical beliefs” against vaccines. The proposal is now open for a 21-day public comment period.

If adopted, the proposal would translate to “increasing the risk that these preventable illnesses spread in our schools and communities,” said Rana Alissa, MD, president of the Florida Chapter of the American Academy of Pediatrics, in a statement to Medscape Medical News. “Pediatricians have been clear that widespread childhood immunization helps keep children healthy and protects those who are most vulnerable,” said Alissa.

Danielle Carter, MD, president of the Florida Academy of Family Physicians, said in the statement that quick policy changes “can create confusion for parents about what their children actually need.” But she added, “[c]hanging a school requirement does not change the clinical evidence physicians use to recommend vaccination, and neither does it change the need to protect newborns, cancer patients, and others who may be more vulnerable to serious illness.”

Doctors will continue to make evidence-based vaccine recommendations, said Carter.

Kas Miller, a parent in Tampa and director of Florida Families for Vaccines, said in the statement that she expected many residents to submit comments in favor of keeping vaccine requirements and to request a public hearing. “We hope the Department listens and preserves the safeguards that have protected Florida children for generations,” said Miller.

“Parents deserve a meaningful voice in decisions this significant, and we hope the state preserves the protections that have served Florida families for generations,” said Jude Bruno, president of the Florida PTA, in the statement provided to Medscape Medical News.

Florida Vaccine Coverage Declines, Exemptions Rise

The four vaccines were selected by the state because they are the only childhood immunizations that are governed by regulation, not statute. The move comes almost a year after Florida Surgeon General Joseph Ladapo, MD, announced at a press briefing that he would seek to end all school-based vaccine requirements.

If the proposed rule is adopted, state law would still require students to be vaccinated for poliomyelitis, diphtheria, rubeola, rubella, pertussis, mumps, and tetanus.

State legislative efforts to reduce or eliminate vaccine mandates have failed to gain traction, even as vaccination coverage is dropping statewide and the percentage of parents seeking exemptions has increased.

According to the CDC, only 88.9% of Florida kindergartners were considered up to date on varicella vaccination in the 2025-2026 school year. Vaccination for varicella has steadily declined since the 2020-2021 school year when 93.3% of kindergartners had been immunized. Vaccination for hepatitis B has also declined since 2020 and now stands at 88.9%.

Exemptions have also been climbing since 2020 in Florida, which has previously allowed parents to object to vaccination based on religious beliefs. In the 2025-2026 school year, 5.5% of kindergartners had a nonmedical exemption, whereas only 0.3% had a medical exemption, according to the CDC.

Cathy Mayfield, Founder of Run for Lawson and a Tallahassee parent who lost her 18-year-old daughter, Lawson, to meningitis in 2009, said in a statement to Medscape Medical News that she was “deeply troubled” by the broadening of exemptions to include moral or ethical beliefs. “It means more children could be left unprotected from diseases we know how to prevent,” she said.

Floridians Generally Support Mandates

Multiple polls have shown that state residents, especially parents, are in favor of keeping school-based vaccine mandates.

In a January poll conducted for Florida Families for Vaccines, 79% of voters supported Florida’s school vaccine requirements; that included voters across the political spectrum. More than two thirds (65%) said they opposed eliminating the immunization requirements.

The findings were similar in a KFF-Washington Post survey conducted in the fall of 2025. Among all, 82% of Florida-based respondents said public schools should require vaccines for measles and polio, with some exceptions.

“Parents overwhelmingly support routine vaccination and want clear, evidence-based guidance they can trust,” said Jennifer Herricks, PhD, advocacy director of American Families for Vaccines, in a statement to Medscape Medical News.

“As Florida moves forward with this rulemaking, that broader consensus should not be ignored,” she said.

The experts cited in this article had no relevant disclosures.

Alicia Ault is a Saint Petersburg, Florida-based freelance journalist whose work has appeared in many health and science publications, including Smithsonian.com. You can find her on X @aliciaault and on Bluesky @aliciaault.bsky.social.