As Gov. Ron DeSantis’s administration moves toward making Florida the first state to eliminate school vaccine mandates, significant concern is growing among doctors, parents, and public health workers regarding the safety of children and other vulnerable individuals who might be at risk during a disease outbreak.

They worry that diseases, which have been controlled for decades through vaccination, could resurface if insufficient numbers of people in Florida are immunized. Here’s what to consider:

DeSantis calls this ‘medical freedom’

Although states usually align with federal vaccine recommendations, state health departments set school mandates. Florida’s Surgeon General, Dr. Joseph Ladapo, announced on Wednesday that the Health Department plans to remove these mandates, arguing that they are “immoral” interferences that limit parents’ ability to make health decisions for their children.

“We’re going to end it,” Ladapo said, without providing details or a timeline.

The Health Department did not immediately answer inquiries concerning other vaccine requirements, such as those for specific workplaces. Many of these requirements are codified in state law, requiring legislative approval. DeSantis has appointed Ladapo and his wife, Casey DeSantis, to a commission developing a broader “medical freedom” proposal expected in the next legislative session.

School nurses sound alarm

“If they’re successful, they’re essentially opening the door to a fully preventable health crisis,” stated Lynn Nelson, president of the National Association of School Nurses.

Schools reflect broader society, and when students return home, they have the potential to carry diseases to susceptible groups like infants and the elderly, Nelson added.

Measles, mumps and pertussis – also known as whooping cough — are among the preventable diseases Nelson is most concerned about if Florida’s plan succeeds. Measles, a highly contagious illness, can create life-threatening situations for infants and small children, she said.

“There are outbreaks all over the country right now, and they will spread in any state or community where the vaccine rate drops,” she said.

Florida already lags nation in vaccination rates

This is the worst year for measles in the U.S. in more than three decades, with more than 1,400 cases confirmed nationwide, most of them in Texas, and three deaths. Whooping cough has killed at least two babies in Louisiana and a 5-year-old in Washington state since winter, as it too spreads rapidly. There have been more than 19,000 cases as of Aug. 23, nearly 2,000 more than this time last year, according to preliminary CDC data.

Even before Wednesday’s announcement, Florida lagged the rest of the United States when it came to kindergarteners being immunized for diseases like measles, mumps and rubella, with 88.7% immunized in 2025, compared to more than 92% nationwide, according to state and federal health statistics.

New religious exemptions to vaccines have also increased, to 6.4% among children age 5-17 years old, and as much as 15% in some counties, as of April.

That’s according to the Florida Health Department’s monthly online “Vaccine-Preventable Disease Surveillance Report,” which was last updated on May 29. At the time, it showed cases of hepatitis A, whooping cough and chickenpox were increasing.

Parents are divided

“I’m pro-vaccine 100%,” Ivette Faes said as she waited with other parents to pick up their kids outside Bayview Elementary School in Fort Lauderdale on Thursday. Dropping the vaccine requirements is not a good idea, she said, because “we have to protect our kids to protect the other ones.”

But Ebony Walker, the mother of a first-grader at the school, said she’s “all for” removing the mandates. She said “it was scary” when her son had to get so many vaccines shortly after being born. Now she’s got him a religious exemption from other inoculations.

“Florida’s always setting the trend, doing different stuff … and setting the bar for the other states to follow along,” Walker said.

Lidia Clark, who said her 7-year-old grandchild had never been vaccinated, said she’s “ecstatic” that her family won’t have to keep securing exemptions. “If you want to vaccinate your child, you can, but I don’t believe that it should have ever been enforced on any of us,” she said.

Why are vaccines needed?

Since the first safe and effective polio vaccine was released for use in the U.S. in 1955, vaccines have become a cornerstone of public health, keeping schoolchildren and adults safe from infectious diseases that had afflicted populations for centuries.

Timely required vaccinations “are essential to protecting school-age children, youth, and the public from preventable, serious infectious diseases,” according to a recent position paper from the National Association of School Nurses. “Vaccine exemptions should be eliminated, except when necessary for validated medical contraindications,” the group said.

Doctors have an important role in battling the misinformation spreading online, by “trying to explain how vaccines work and how they’re developed,” said Dr. Joshua Laban, a primary care physician in Miami.

How could this affect Florida’s tourism industry?

It’s unclear how a decline in vaccinations might affect Florida’s top business – its $128 billion tourism industry. Florida is among the top U.S. destinations, with 143 million visitors last year.

Walt Disney World, Universal Orlando and other Orlando theme parks no longer require proof of COVID vaccinations for employees, due to Florida laws passed in 2021 during the height of the pandemic that limit employers’ power to require such protection. Representatives for Disney and Universal didn’t respond to inquiries Thursday asking them about the potential impact of more unvaccinated children.

Florida also is home to a $24 billion cruise line industry, according the Cruise Lines International Association. Most cruise lines don’t have any vaccine requirements. But the CDC has recommended that passengers be vaccinated against COVID and flu, and that they check which other vaccines may be recommended based on the countries they’re visiting.

Tourism relies on stability, whether it’s economic, political or dealing with health conditions, and the change in vaccine mandates introduces an element of uncertainty, said Alan Fyall, an associate dean at the University of Central Florida’s hospitality college.

“It’s like dropping a stone in a pond,” Fyall said. “You’re not quite sure how those ripples are going to impact.”