Federal health officials are rolling back a long-standing requirement that states track and report childhood vaccination rates for children covered by Medicaid and the Children’s Health Insurance Program.
In a Dec. 30 guidance letter, the Centers for Medicare and Medicaid Services said states will no longer be required to submit several pediatric and prenatal immunization measures as part of mandatory quality reporting, beginning with 2026 data.
The reporting had been used by CMS to assess the quality of care provided to children in publicly funded insurance programs.
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Medicaid and CHIP together cover roughly 40% of children nationwide. Medicaid serves low-income families, pregnant women and people with disabilities, while CHIP provides coverage for children whose family income exceeds Medicaid eligibility limits.
Florida administers one of the nation’s largest Medicaid programs, covering millions of residents, including a substantial share of children.
Public health experts say eliminating mandatory immunization reporting could make it more difficult to monitor vaccination trends among low-income families in a state that has experienced periodic outbreaks of vaccine-preventable diseases.
CMS said states may continue to submit immunization data voluntarily while the agency works to redesign how vaccine-related care is measured. Voluntary reporting, the agency said, would allow CMS to maintain long-term data while it explores alternative approaches.
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Rather than focusing on vaccination rates alone, CMS said future measures may emphasize whether parents and families were informed about vaccine choices, safety, potential side effects and alternative vaccination schedules. The agency also said it plans to examine how religious exemptions could be reflected in future data.
The change comes amid broader efforts by Health and Human Services Secretary Robert F. Kennedy Jr. and the Trump administration to scale back federal involvement in vaccine policy.
On Monday, federal health officials made sweeping changes to childhood vaccine guidance, with the Centers for Disease Control and Prevention reducing the number of diseases for which it recommends routine vaccinations from 18 to 11. The move drew concern from pediatricians and major medical groups.
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The CDC also revised its guidance in December on hepatitis B vaccination, no longer recommending the shot for all newborns and instead limiting it to infants whose mothers test positive for hepatitis B or whose infection status is unknown.
Unlike the federal changes, which focus on guidance and reporting, Florida Surgeon General Dr. Joseph Ladapo is moving to eliminate all 11 vaccination requirements tied to school entry. Ladapo has likened the vaccines to "slavery" and said the plan comes in the name of medical freedom.
Four can be addressed through the state health department, which Ladapo heads: Hib, varicella (chickenpox), pneumococcal conjugate and hepatitis B. The others are part of state law.
Doctors and public health advocates have warned that easing vaccine requirements could reverse decades of progress against serious childhood illnesses. State data show reported Hib cases among children under 4 nearly tripled from 2020 to 2023 before declining slightly last year, a trend pediatricians say reflects the consequences of falling vaccination rates.
