Florida's surgeon general wanted to repeal vaccine mandates. They remain, but hesitancy is growing
By Roshan N. Bransden
August 10, 2026 at 6:00 AM EDT
Last September, Florida’s Surgeon General Dr. Joseph Ladapo said he wanted to end all vaccine mandates in the state of Florida.
It would be the first and only state in the country 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 vaccine mandates ensure protection against eleven vaccine-preventable diseases before entering kindergarten. They are: diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, haemophilus influenzae type b, hepatitis 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 FIU’s Robert Stempel College of Public Health and Social Work.
READ MORE: Ladapo issues new Florida guidance on children's psychiatric medications
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 Dr. Trepka.
Nationally, measles cases are surging, with this year seeing more cases in the first half than all of 2025. This year so far the Florida Department of Health has reported 155 cases, compared to just seven cases reported last year.
Nearly all of Florida is below the 95% immunization rate – below the threshold for establishing herd immunity for measles.
Palm Beach is at 88.3%, Broward at 84.7%, and Miami-Dade at 90.8%, according to a Florida Senate bill analysis and fiscal impact statement.
How does that happen if vaccine mandates are in place?
Medical exemptions
Well, there are few ways around mandates. Kids that are homeschooled are not subject to this mandate, for example. Others can also get what’s called an exemption.
There are two types of exemptions allowed in the state of Florida — a medical or a religious exemption. This year, there was an attempt to pass a bill that would introduce a new type of exemption based on a parent’s conscience. Sixteen states in the US currently allow this type of exemption.
There was a proposed bill, the Medical Freedom Act, filed in the House and in the Senate that would have expanded access to vaccine exemptions.
The proposal passed in the Senate, but it wasn't discussed in the House. Senator Clay Yarborough then filed a similar bill during April's special legislative session. However, that version died as well, so it won't take effect this year. During the special session, only redistricting was discussed and the House was dismissed.
“Generally, the more religious exemptions, the fewer students with completed Certificates of Immunization,” according to that same Florida Senate bill’s analysis and fiscal impact statement.
(1168x1158, AR: 1.008635578583765)
For the 2025-2026 school year across Florida, 88.9% of kindergarteners completed their vaccinations before the start of the school year. This number has steadily dropped from 93.3% in 2020. At the same time, religious exemption rates have increased from 2.7% in 2020 to 4.6% in 2023.
Two mandate processes
In the state of Florida some vaccines are mandated by laws written into the Florida Statutes and others by the Florida Department of Health (DOH).
The Florida Statutes mandates: DTaP, MMR and Polio. The DOH mandates: Hib, Hep B, chickenpox and pneumococcal.
In order to do what Ladapo called for last summer and end all vaccine mandates it would require two separate processes: 1) going through the House and the Senate to change the state law for those regulated by the Statutes and 2) going through the DOH rule making process for the others.
Ladapo directly heads the DOH and may be able to repeal mandates on vaccines regulated by that body more easily, but it still requires a lengthy rule-making process and paperwork the department has yet to file, according to previous reporting.
The department has taken a few steps toward this goal, however. In December 2025, the DOH hosted one public meeting in Panama City Beach to discuss possible changes to vaccine mandates.Data about the rates of vaccine preventable diseases is also less readily available on their website. Several months before Ladapo’s announcement the department stopped sharing vital information about disease tracking. In May, it stopped publishing its monthly Vaccine-Preventable Disease Surveillance Report.
The DOH did not respond to several requests for comment. 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 routinely do.
National trend
These state level changes follow a national trend – the Center for Disease Control’s newly appointed Advisory Committee on Immunization Practices (ACIP) voted to end the universal newborn Hepatitis B birth 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 changes to the vaccine schedule for now.
Dr. Rana Alissa, the president of the Florida chapter of the American Academy of Pediatrics (480x640, AR: 0.75)
The American Academy of Pediatrics continues to endorse the standard vaccine schedule and many South Florida pediatrician offices instate their own vaccine mandates of patients in order to become a patient in their practice.
Part of a House bill that was not discussed during this legislative session also introduced a clause that would mandate pediatricians accept patients who chose not to vaccinate.
This law is not currently in place.While this year's legislative 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 so far, she encourages anyone who has strong feelings about the future of the state’s vaccine policy to contact their legislators.
“On your way to work, call your legislator. Leave a voicemail if they don't answer. Request meeting with them. Send them an email,” she said. “There are so many ways of doing so if you cannot physically show up to Senate hearings and to your legislator's offices.”
It would be the first and only state in the country 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 vaccine mandates ensure protection against eleven vaccine-preventable diseases before entering kindergarten. They are: diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, haemophilus influenzae type b, hepatitis 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 FIU’s Robert Stempel College of Public Health and Social Work.
READ MORE: Ladapo issues new Florida guidance on children's psychiatric medications
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 Dr. Trepka.
Nationally, measles cases are surging, with this year seeing more cases in the first half than all of 2025. This year so far the Florida Department of Health has reported 155 cases, compared to just seven cases reported last year.
Nearly all of Florida is below the 95% immunization rate – below the threshold for establishing herd immunity for measles.
Palm Beach is at 88.3%, Broward at 84.7%, and Miami-Dade at 90.8%, according to a Florida Senate bill analysis and fiscal impact statement.
How does that happen if vaccine mandates are in place?
Medical exemptions
Well, there are few ways around mandates. Kids that are homeschooled are not subject to this mandate, for example. Others can also get what’s called an exemption.
There are two types of exemptions allowed in the state of Florida — a medical or a religious exemption. This year, there was an attempt to pass a bill that would introduce a new type of exemption based on a parent’s conscience. Sixteen states in the US currently allow this type of exemption.
There was a proposed bill, the Medical Freedom Act, filed in the House and in the Senate that would have expanded access to vaccine exemptions.
The proposal passed in the Senate, but it wasn't discussed in the House. Senator Clay Yarborough then filed a similar bill during April's special legislative session. However, that version died as well, so it won't take effect this year. During the special session, only redistricting was discussed and the House was dismissed.
“Generally, the more religious exemptions, the fewer students with completed Certificates of Immunization,” according to that same Florida Senate bill’s analysis and fiscal impact statement.
(1168x1158, AR: 1.008635578583765)
For the 2025-2026 school year across Florida, 88.9% of kindergarteners completed their vaccinations before the start of the school year. This number has steadily dropped from 93.3% in 2020. At the same time, religious exemption rates have increased from 2.7% in 2020 to 4.6% in 2023.
Two mandate processes
In the state of Florida some vaccines are mandated by laws written into the Florida Statutes and others by the Florida Department of Health (DOH).
The Florida Statutes mandates: DTaP, MMR and Polio. The DOH mandates: Hib, Hep B, chickenpox and pneumococcal.
In order to do what Ladapo called for last summer and end all vaccine mandates it would require two separate processes: 1) going through the House and the Senate to change the state law for those regulated by the Statutes and 2) going through the DOH rule making process for the others.
Ladapo directly heads the DOH and may be able to repeal mandates on vaccines regulated by that body more easily, but it still requires a lengthy rule-making process and paperwork the department has yet to file, according to previous reporting.
The department has taken a few steps toward this goal, however. In December 2025, the DOH hosted one public meeting in Panama City Beach to discuss possible changes to vaccine mandates.Data about the rates of vaccine preventable diseases is also less readily available on their website. Several months before Ladapo’s announcement the department stopped sharing vital information about disease tracking. In May, it stopped publishing its monthly Vaccine-Preventable Disease Surveillance Report.
The DOH did not respond to several requests for comment. 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 routinely do.
National trend
These state level changes follow a national trend – the Center for Disease Control’s newly appointed Advisory Committee on Immunization Practices (ACIP) voted to end the universal newborn Hepatitis B birth 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 changes to the vaccine schedule for now.
Dr. Rana Alissa, the president of the Florida chapter of the American Academy of Pediatrics (480x640, AR: 0.75)
The American Academy of Pediatrics continues to endorse the standard vaccine schedule and many South Florida pediatrician offices instate their own vaccine mandates of patients in order to become a patient in their practice.
Part of a House bill that was not discussed during this legislative session also introduced a clause that would mandate pediatricians accept patients who chose not to vaccinate.
This law is not currently in place.While this year's legislative 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 so far, she encourages anyone who has strong feelings about the future of the state’s vaccine policy to contact their legislators.
“On your way to work, call your legislator. Leave a voicemail if they don't answer. Request meeting with them. Send them an email,” she said. “There are so many ways of doing so if you cannot physically show up to Senate hearings and to your legislator's offices.”