The Florida Department of Health on August 24, 2026, filed a Notice of Proposed Rule that would remove varicella (chickenpox), hepatitis B, Haemophilus influenzae type b (Hib), and pneumococcal conjugate vaccines from the list of immunizations required for public and private school attendance. The proposed rule, signed by State Surgeon General Joseph Ladapo on August 20, also expands the state's religious exemption form to include moral and ethical beliefs.
Under current Florida law, vaccines that are required by state statute — measles, mumps, and rubella (MMR), polio, diphtheria, and tetanus — would remain mandatory. Only the four vaccines that exist in agency rule rather than in statute are targeted for removal, meaning the Department of Health can act without legislative approval. A 21-day public comment period follows the notice's publication.
The proposed changes in detail
The Notice of Proposed Rule for Rule 64D-3.046 states that it removes from requirements immunizations that are not required by section 1003.22 of Florida Statutes. That section already lists the vaccines the state mandates, and the four being dropped are not among them. The department began this rulemaking process with a Notice of Development of Rulemaking published in the Florida Administrative Register on September 10, 2025, and held a public workshop on December 12, 2025, in Panama City Beach attended by about 90 people.
The proposed rule also updates the Religious Exemption form, designated DH 681, to provide for the inclusion of moral and ethical beliefs. Under current Florida immunization guidelines, exemptions for personal or philosophical reasons are not permitted under Florida law, and religious exemptions are issued only for a child not immunized because of his or her family's religious tenets or practices.
Additionally, the rule updates provisions for opting out of the Florida SHOTS immunization registry, allowing parents, guardians, and college and university applicants aged 18 to 23 to decline participation in the state vaccine database.
Rationale and next steps
At the December 2025 workshop, DOH division director Emma Spencer described the policy as grounded in considerations that favor parental rights and medical freedom. If a hearing is requested within 21 days of the notice publication, one will be scheduled and announced in the Florida Administrative Register. The contact person for the proposed rule is Thomas Bendle, Bureau Chief of the Bureau of Epidemiology.
How this compares to national practice
The CDC's Public Health Law Program documented in 2019 that four common childhood vaccines — DTaP, MMR, polio, and varicella — are required for kindergarten entry in almost every state, and that all states require vaccination as a condition for school attendance. Many states also require hepatitis B; Alaska, for example, requires hepatitis A and hepatitis B for kindergarten entry. Florida's proposal would make it the first state to remove multiple CDC-recommended vaccines from school-entry requirements through administrative rulemaking, diverging from the near-universal national practice.
Florida's previous rule revisions in 2016 and 2017 were conducted to implement the revised CDC Advisory Committee on Immunization Practice recommendations, meaning prior state rulemaking aligned with federal guidance rather than narrowing requirements.
Research evidence on the targeted vaccines
The CDC's Advisory Committee on Immunization Practices recommends all four vaccines targeted for removal as part of the routine childhood immunization schedule for ages 0 to 18 years. The CDC recommends a 3-dose series of hepatitis B vaccine starting at birth, a 3-to-4 dose series of Hib vaccine starting at age 2 months, a 4-dose series of pneumococcal conjugate vaccine (PCV15 or PCV20) starting at age 2 months, and a 2-dose series of varicella vaccine starting at age 12 to 15 months.
The CDC notes that state laws establish vaccination requirements for school children and often apply not only to children attending public schools but also to those attending private, parochial, and other types of schools. The CDC does not directly mandate vaccines for school attendance; that authority rests with individual states.