Last September, Florida's Surgeon General Dr. Joseph Ladapo said he wanted to end all vaccine mandates in the state.
It would be the first and only state to do so.
So what's changed since then?
On a policy level, nothing. But parents are confused, local pediatricians are seeing vaccine hesitancy growing and vaccine exemption rates are the highest they've been in a decade.
Vaccines are still mandated throughout Florida without any changes to the vaccine schedule since that announcement. Florida students must still get the standard vaccines before attending schools — public, private, charter, doesn't matter.
School mandates ensure protection against 11 vaccine-preventable diseases before entering kindergarten: diphtheria, tetanus, pertussis (DTaP); polio; measles, mumps and rubella (MMR); haemophilus influenzae type B (Hib); hepatitis B (Hep B); varicella (chickenpox); and pneumococcal.
"We've historically had vaccination rates close to herd immunity, and this is largely due to the school vaccination programs," according to Dr. Mary Jo Trepka, an infectious disease epidemiologist at Florida International University's Robert Stempel College of Public Health and Social Work.
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Rates for herd immunity — the protection a community has against an infectious disease when enough people are immune by vaccination or surviving the disease — vary by disease.
For measles or whooping cough, it's around 95%, and for others like polio it's around 80%, according to Trepka.
Nationally, measles cases are surging, with more cases in the first half of this year than all of 2025. Through Aug. 1, the Florida Department of Health has reported 155 cases, compared with seven last year.
Nearly all of Florida is below the 95% immunization rate — the threshold for establishing herd immunity — for measles.
How does that happen if vaccine mandates are in place?
Medical exemptions
Well, there are few ways around mandates. For example, kids that are homeschooled are not subject to them. Others can get what's called an exemption.
There are two types of exemptions in Florida: medical or religious. This year, there was an attempt in the Legislature to pass a bill that would introduce a new type based on parents' conscience. Sixteen states allow this type of exemption.
The Medical Freedom Act, filed in the state House and Senate, that would have expanded access to vaccine exemptions. The proposal passed in the Senate, but it wasn't discussed in the House.
Sen. Clay Yarborough then filed a similar bill during April's special legislative session, but that died as well. The House discussed only redistricting and was dismissed.
"Generally, the more religious exemptions, the fewer students with completed Certificates of Immunization," according to the Senate bill's analysis and fiscal impact statement.
Across Florida, 88.9% of kindergarteners completed their vaccinations before the start of the 2025-26 school year. That dropped from 93.3% in 2020. At the same time, religious exemption rates increased from 2.7% in 2020 to 4.6% in 2023.
Two-mandate processes
Some vaccines are mandated by Florida law and others by the state Department of Health. The statutes mandate DTaP, MMR and polio. The health department mandates Hib, Hep B, chickenpox and pneumococcal.
Ending all vaccine mandates, as Ladapo called for, would require:
- Removing those required by law through the state House and Senate.
- Removing the others through the health department's rule-making process.
Ladapo, who leads the health department, may be able to repeal mandates on vaccines regulated by that agency more easily, but it would still require a lengthy procedure and paperwork yet filed.
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The department has taken a few steps toward this goal, however.
In December 2025, it hosted a public meeting in Panama City Beach to discuss possible changes to mandates. Data about the rates of vaccine-preventable diseases is also less readily available on its website. Several months before Ladapo's announcement, the department stopped sharing vital information about disease tracking. In May 2025, it stopped publishing its monthly Vaccine-Preventable Disease Surveillance Report.
The health department did not respond to several requests for comment for this article. While much of this data is still available by searching manually on www.flhealthcharts.gov, it is no longer compiled and published as a report as many other states and county-level health departments do.
National trend
These state level changes follow a national trend – the federal Center for Disease Control and Prevention's newly appointed Advisory Committee on Immunization Practices (ACIP) voted to end the universal newborn Hepatitis B dose and reduce the number of childhood vaccines.
However, the American Academy of Pediatrics and other professional medical groups have sued the Department of Health and Human Services over changes to the ACIP, putting a pause on any adjustments to the vaccine schedule for now.
The pediatrics group continues to endorse the standard vaccine schedule, and many Florida pediatrician offices state their own vaccine prerequisites to become a patient in their practices.
Part of a House bill that was not discussed during this legislative session also introduced a clause that would mandate that pediatricians accept patients who chose not to vaccinate.
While this year's session is over, the conversation isn't, according to Dr. Rana Alissa, the president of the Florida chapter of the American Academy of Pediatrics.
" Florida is not the only state, but it was going to be ground zero to change these rules," she said.
The AAP is continuing to monitor any future meetings or announcements, and though none are scheduled, she encourages anyone who has strong feelings about the future of the state's vaccine policy to contact their legislators.
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