State-Level Vaccine Mandate Policies Shift as Advocacy Efforts Expand

Recent actions in several U.S. states have changed the landscape of school vaccine requirements, with new policies and advocacy efforts emerging in 2025.

Florida’s Surgeon General Joseph Ladapo announced in September 2025 that the state would move to eliminate all childhood vaccine mandates for school and daycare attendance. This announcement followed earlier developments in Idaho, where a law passed in April 2025 removed most immunization requirements for K-12 schools and banned vaccine mandates for businesses.

Other states have also seen changes. In January 2025, West Virginia’s governor issued an executive order permitting religious exemptions to school vaccine mandates, but the state Board of Education did not implement the order. Meanwhile, California, Oregon, and Washington established the West Coast Health Alliance in September 2025 to coordinate vaccine guidance independently from the CDC.

Advocates connected to Health Secretary Robert F. Kennedy Jr. have supported state-level legislation in several states, including Florida, West Virginia, South Carolina, California, Connecticut, Maine, and New York, aiming to loosen or eliminate school vaccine requirements. In the same period, Kennedy Jr. dismantled the CDC’s Advisory Committee on Immunization Practices and appointed new members to the committee.

What the numbers show

• Idaho became the first state to remove most school vaccine requirements in April 2025
• As of 2025, all states except Idaho require immunizations for school entry
• Forty-five states and Washington, DC allow religious exemptions, while 16 states permit philosophical exemptions

Florida’s policy announcement in September 2025 was described in media reports as energizing anti-mandate activists in other states. Some activists referred to the move as a catalyst for similar legislative efforts in additional states.

The formation of the West Coast Health Alliance marked a shift among California, Oregon, and Washington to develop vaccine guidance separate from federal recommendations. This alliance was established in September 2025 as part of broader efforts to address vaccine policy at the state level.

Public health experts have stated that removing school vaccine mandates could result in increased outbreaks of diseases that vaccines are designed to prevent. These statements have been made in response to the recent policy changes and legislative proposals in multiple states.

Industry reaction

Public health experts have expressed concerns regarding the potential impact of eliminating school vaccine mandates, specifically noting the risk of increased disease outbreaks. These reactions have followed the policy shifts in states such as Florida and Idaho, as well as the restructuring of the CDC’s immunization advisory committee.

Media coverage has documented that Florida’s decision to end childhood vaccine mandates has been cited by activists in other states as a motivating factor for pursuing similar changes. The policy developments have prompted responses from both public health institutions and advocacy groups.

* This article is based on publicly available information at the time of writing.