TALLAHASSEE, Fla. — Florida is, after a year of anticipation, moving forward with a plan to remove four required school-entry vaccines.

The Department of Health filed its proposed rule change Monday as part of Surgeon General Joseph Ladapo’s plan to remove all Florida vaccine mandates.

Under the proposal, Florida children would no longer have to get shots for chickenpox, Hepatitis B, Haemophilus influenzae type b, or Hib, and pneumococcal disease. (Parents could still choose to immunize their children, and pediatricians’ groups recommend the vaccines.)

Three of those vaccines were recently backed by President Donald Trump.

Trump, in his August executive order calling for changes to the childhood vaccine schedule, recommended that all children be immunized for chickenpox, Hib and pneumococcal disease, along with other diseases like measles, mumps and polio.

The Florida Department of Health did not return requests for comment.

Ladapo has asserted himself as one of the country’s most outspoken vaccine skeptics, going beyond what some of his fellow Republicans have been comfortable with. When Ladapo in 2025 announced his plan to remove all vaccine mandates, Trump partly rebuffed it by saying that some vaccines “just pure and simple work.”

Trump’s health secretary, Robert F. Kennedy Jr., who helped launch the “Make America Healthy Again” movement, has also said parents should vaccinate their children against measles. Cases have been spiking in hot spots nationwide as more parents have opted their children out.

Ladapo has been less authoritative about encouraging vaccines as safe. He has primarily focused on the ideas of bodily autonomy and parental rights as reasons to make vaccines optional.

Last month, Ladapo said that the measles vaccine was “effective” but stopped short of encouraging it, according to Orlando’s News 6.

Trump and his administration have also encouraged states to make it easier for parents to exempt their children from vaccine requirements. If states don’t allow parents to use a religious exemption or medical opt-out, his administration has threatened legal action.

Parents have increasingly made use of Florida’s religious exemption. In 2019, about 94% of Florida kindergarten students had vaccines. In 2026, that number dropped to 89%, a level that could increase disease transmission.

The state, as part of its rule change, would expand that exemption, allowing parents to opt their children out of vaccines based on a “sincerely held moral or ethical belief.”

The Department’s proposal is not yet final. Children attending school must, for now, be vaccinated against the four diseases in question.

Other vaccine requirements, such as for measles, polio and mumps, are in state statute and would require the Legislature’s sign-off to be repealed. Lawmakers this year never took up Ladapo’s call to remove those mandates.

The Department of Health started its rule-making process in September 2025 and held a workshop to hear from the public last December.

It isn’t clear why it then waited months to take the next step forward.

Ladapo’s tenure as surgeon general could end with Gov. Ron DeSantis leaving office. Ladapo has said, though, that he would be “honored to continue serving” under U.S. Rep. Byron Donalds, the Republican nominee for governor.

Donalds told the conservative outlet Florida’s Voice last week that he is grateful for Ladapo’s work but that winning the election has to come before any personnel discussions.

On Sunday, Donalds discussed vaccine policy on the “Face the Nation” news show. He expressed support for removing vaccine mandates that had been put in place by state rule but said he’d need to study the idea of removing other immunization requirements from state law. Donalds also blamed measles outbreaks on illegal immigration.

Florida had 155 reported cases of measles this year, a number far higher than any single year in the past decade. The bulk of the cases this year have been in Collier County, which Donalds represents. More than 50 were identified on the campus of Ave Maria University, a private Catholic school.

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