Doctors and Activists Clash at Lake Mary Hearing on Florida Plan to Drop Four School Vaccine Requirements

Doctors and parents' rights activists faced off for hours Thursday in Lake Mary as the Florida Department of Health held its only public hearing on a proposal to stop requiring four childhood vaccines for school and child care entry. The plan, which would revise state Rule 64D-3.046, would drop the requirements for chickenpox (varicella), hepatitis B, Haemophilus influenzae type b (Hib) and pneumococcal conjugate vaccines. Written comments remain open until 5 p.m. on Oct. 19, and the current requirements stay in force until a final rule is filed.

The hearing at the Orlando Marriott Lake Mary on Oct. 8 was requested by the Florida chapters of the American College of Physicians and the American Academy of Pediatrics, the two physician groups leading opposition to the change. State Surgeon General Joseph Ladapo, who proposed the rollback, attended in person. The rule covers students in public and private schools, preschools and day care programs, a population the Florida Trident put at more than 3 million children.

What the proposal would change

In a news release issued after the hearing, the Department of Health said hepatitis B, varicella, Hib and pneumococcal conjugate vaccines would no longer be required for school or child care entry under department rule. The department said parents could still choose those immunizations for their children, and that religious and medical exemptions would continue to be recognized.

The proposal would also update the state's immunization and exemption forms, guidelines, opt-out requirements, school compliance reporting and access to Florida SHOTS, the state's immunization registry, according to the department.

The four vaccines are on the chopping block because they are required by agency rule rather than by state law. Seven other requirements, covering polio, diphtheria, measles, rubella, pertussis, mumps and tetanus, are written into section 1003.22 of the Florida Statutes and would remain in place. Only the Legislature can change those.

The department released its revised plan in a Sept. 30 notice that dropped a proposed new exemption for parents with a "sincerely held moral or ethical belief." That language had been part of the version Ladapo launched in September 2025. Without it, Florida's exemptions remain limited to medical grounds and religious tenets and practices.

Inside the Lake Mary hearing

The department heard hours of public comment, according to the News Service of Florida, with each speaker given two minutes, WUSF reported ahead of the session. Parents' rights activists praised the proposal, while doctors and other health care professionals sharply criticized it.

Ladapo framed the change as a matter of parental authority rather than vaccine science. According to the Florida Phoenix, he told the audience that "this isn't about the scientific effectiveness of one vaccine or the other, the safety of one vaccine or the other," and cast the question as one of parents' rights. The News Service of Florida reported that he argued a system in which parents "are actively making decisions" produces "a much stronger public health system."

In the department's release, Ladapo said parents should be the ultimate decision-makers about their children's health and that the changes give them a greater ability to make those choices.

Supporters thanked Ladapo, and some asked him for selfies, the News Service reported. His wife, Brianna Ladapo, had urged followers on X to attend in support of what she called medical freedom. Several speakers also attacked the COVID-19 and MMR vaccines and repeated unfounded claims, including that vaccines cause autism, according to the report.

Physicians pushed back. Dr. Sarah Nosal, board president of the American Academy of Family Physicians, urged the department to reconsider and said the four vaccines "are still vital to protect children's health." Dr. Brandon Chatani, vice president of the Florida Chapter of the American Academy of Pediatrics, said the department had not provided adequate scientific answers and asked officials to consider children who cannot choose their own immune status. Parents of immunocompromised children also warned about the effect on their families.

Why doctors say the four vaccines matter

Hib and pneumococcal vaccines are given mainly in the first years of life, when those bacterial infections are most dangerous, which means child care centers could feel the effects of the change first. Hepatitis B vaccination begins at birth, and the varicella vaccine prevents chickenpox, which can cause serious complications in young children and in people with weakened immune systems.

Former Florida Surgeon General Scott Rivkees, a pediatrician who served under Gov. Ron DeSantis from 2019 to 2021 and now teaches at Brown University's School of Public Health, warned in an interview with WUSF published Oct. 7 that the change could cause "great harm to children." He called the proposal "very arbitrary" and said it "is not grounded in science."

Rivkees told WUSF that "these are not innocent illnesses," and said he had treated children who died or were left with permanent problems. He predicted that vaccine-preventable illnesses would begin to reappear and questioned why the change was being pursued "at the 11th hour of the DeSantis administration."

Cancer advocates have also weighed in. Susan Harbin of the American Cancer Society Cancer Action Network told the Florida Trident that immunocompromised patients depend on high community vaccination rates. A September 2026 survey by that group found that 86 percent of cancer patients and survivors supported school-entry requirements.

A measles year sharpens the debate

The hearing comes during a year of unusually heavy measles activity in Florida. Florida has reported 148 measles cases in 2026, according to Johns Hopkins Bloomberg School of Public Health tracking cited by the Florida Trident on Oct. 7. The bulk of the state's cases traced to an outbreak at Ave Maria University in Collier County that began in late January; by March, 104 of the state's cases were in Collier, according to state data reported by WUSF.

Measles itself is not part of the rule change. The measles, mumps and rubella requirement is set in state law. But pediatricians have pointed to the outbreak as evidence of what happens when vaccination coverage slips, and the Florida Trident reported that the state's vaccination rates are already below the level needed for community immunity.

Lawyers prepare for a challenge

Opponents are preparing for a legal fight. Jacksonville health care attorney Chris Nuland, who represents the Florida Chapter of the American College of Physicians, told the Florida Trident in a report published by WGCU on Oct. 7 that "the state should anticipate a DOAH hearing," a reference to the Florida Division of Administrative Hearings.

Nuland predicted months of litigation, possibly reaching an appellate court, and said he expects the existing requirements to remain in place at least until an administrative law judge rules. He said the central legal question would be whether the department can show "substantial, competent evidence" for the change. The physicians group had already opposed the rule in a letter before requesting Thursday's hearing.

Rivkees told WUSF that the rule would also need approval from the governor's office before taking effect.

The political backdrop

DeSantis, First Lady Casey DeSantis and Ladapo have all said they want to end vaccine mandates entirely, and Ladapo has compared mandates to slavery. But the Legislature has not gone along. A 2026 bill sponsored by Sen. Clay Scarborough, R-Jacksonville, that would have broadly expanded exemptions passed the Senate but was not taken up by the House, and no lawmaker filed a bill to repeal all of the requirements.

Sen. Carlos Guillermo Smith, D-Orlando, plans to refile a bill that would write all of the vaccine requirements, including the four now under review, into state law, putting them beyond the reach of agency rulemaking.

The fight also lands in the final weeks of the governor's race. DeSantis is term-limited and leaves office in January. Republican nominee Byron Donalds has said he is open to keeping Ladapo as surgeon general but has not committed either way on the mandates, while Democratic nominee David Jolly has said he would fire Ladapo immediately if elected, according to the Florida Trident. Election Day is Nov. 3.

What's next

The Department of Health is accepting written comments and materials until 5 p.m. on Monday, Oct. 19, at vaccinerule@flhealth.gov. After the comment period closes, the department can move to adopt the rule, but the current requirements for all four vaccines remain in effect until a final rule is filed with the Florida Department of State. No effective date has been set.

• Oct. 19, 5 p.m.: Deadline for written comments to the Department of Health.
• After the comment period: The department may adopt the rule; opponents are expected to challenge it before the Division of Administrative Hearings.
• Nov. 3: Florida voters choose DeSantis's successor, who will decide whether Ladapo stays.
• 2027 legislative session: Lawmakers could revisit the statutory vaccine requirements or codify the four rule-based ones.

Until then, Florida schools and child care centers are still required to collect proof of all current immunizations, or a valid exemption, for enrolled children.