Longtime allies of Robert F. Kennedy Jr., the nation’s health secretary, have launched a new effort to repeal laws that for decades have required children to be vaccinated against measles, polio and other diseases before they enter day care or kindergarten.
A newly formed coalition of vaccine activists is targeting laws that are considered the linchpin of protection from deadly diseases. States have long mandated childhood immunizations before children can start day care or school, though some exemptions are available.
“What we need to do is freaking burst the dam open,” Leslie Manookian, the backer of a law that banned medical mandates in Idaho, told supporters on a recent call. “And that is what this year is all about, bursting the dam open in the states where we think it can happen first.”
Ms. Manookian is a leader of the Medical Freedom Act Coalition, a new umbrella group of at least 15 nonprofit organizations advocating an end to state laws that codify what they call medical mandates, which largely pertain to vaccines.
So far, bills have been introduced in at least nine states that would eliminate all or nearly all school requirements, including Democratic states like New York where there is no chance of passage, to states such as New Hampshire, Georgia, Iowa and Idaho where the proposals have gained some traction.
Many vaccine proponents view the state-level push as a second stage in the dismantling of the nation’s vaccine infrastructure, building on Mr. Kennedy’s significant reduction of federally recommended vaccines.
While not entirely new, the strategy demonstrates a sophisticated grasp of how to try to unravel more than 100 years of progress in protecting children from deadly pathogens, said Sara Rosenbaum, a health law professor emerita at George Washington University and former Clinton administration health official.
“They’re drunk on their apparent power, because they have one of their own sitting in the secretarial office of H.H.S.,” Ms. Rosenbaum said, referring to Mr. Kennedy’s position at the Department of Health and Human Services. “They think this is the time for them to go for broke and just simply make the default no requirements at all.”
Groups in the new coalition include Children’s Health Defense, the nonprofit that Mr. Kennedy co-founded, and two others created to support his MAHA, or Make America Healthy Again, initiative. One of them, the MAHA Institute, works on state policy and said it is hiring people to support the agenda.
Mr. Kennedy’s retreat from longstanding federal vaccine advice has prompted a flurry of activity at the state level. As his policies take hold, some Democratic leaning states have created their own alliances to reject the new federal vaccine guidance, while some Republican-led states have moved to enshrine it.
At a Heritage Foundation event featuring Mr. Kennedy this month, Kim Mack Rosenberg, general counsel for Children’s Health Defense, said a high priority would be undoing state requirements.
“Ultimately, the goal is to remove mandates,” Ms. Mack Rosenberg said.
“Particularly when you tie those mandates to school attendance, that creates an incredibly difficult situation for families,” she added.
Asked at an event in Tennessee earlier this month about the push to repeal school-entry requirements, Mr. Kennedy said he was not involved in the effort. But he added, “I believe in freedom of choice,” drawing applause from the audience. He said he supported allowing people to make vaccine decisions with their families and physicians.
Ms. Manookian said the coalition’s effort is meant to end what she considered coercion related to all medical interventions. “It’s about putting the power back in the hands of the individual,” she said in an interview.
Proposals to eliminate school-entry vaccine requirements have met mixed fates, with some efforts stalling, in Oklahoma and Indiana, and others pending, including in West Virginia. A bill in Arizona is also pending but is expected to face a veto from the governor, a Democrat, and one in New York is unlikely to clear the Democratic-controlled state legislature. Backers of the coalition say they expect a bill to be introduced in Louisiana next month.
In Florida, despite state officials’ declared intent to end childhood vaccine mandates, no bill has been introduced that would eliminate school-entry rules. One proposal, though, would allow a “conscience” or personal-belief exemption that would make it easier for parents to opt out of immunizations.
The moves to overturn state laws have alarmed pediatricians and other vaccine supporters, who maintain that there is widespread acceptance among parents and the public of immunizing young children.
Eliminating school requirements is viewed by public health experts as a sure way to reduce vaccine coverage, resulting in a surge of measles and whooping cough cases, followed later by potential outbreaks of rubella and polio. The consequences are on display in South Carolina, where a measles outbreak has affected more than 900 people, including at least 19 who were hospitalized with complications including pneumonia and brain swelling.
At several schools in the center of the outbreak, fewer than 80 percent of students had received all of the required childhood immunizations, well short of the 95 percent needed to stem the spread of measles, a highly contagious virus.
Yet one potent guardrail against weakening immunization mandates has emerged. A number of polls show that voters would penalize lawmakers who favor eliminating school requirements. In one recent poll, conducted by The Wall Street Journal, voters gave Democrats a 9 percent advantage over Republicans when asked which party is best suited to handle vaccine policy.
Two polls commissioned by vaccine backers and conducted by Republican-leaning firms found that voters in Florida and Tennessee would not support lawmakers who want to end school-vaccine mandates. One poll by Fabrizio Ward, a firm that President Trump relies on, found that swing voters in tight congressional races would strip about 20 percentage points from a Republican candidate who was critical of vaccines.
“Vaccine skepticism is bad politics,” the Fabrizio Ward memo said.
Vaccine backers are still concerned about proposals in New Hampshire, Iowa, Idaho, Georgia and potentially other states that could end or sharply limit vaccine requirements for school entry.
“Prior to vaccines, one in five kids didn’t make it to their fifth birthday,” said Jennifer Herricks, advocacy director for American Families for Vaccines, a nonprofit that receives some of its funding from vaccine makers. “Having these policies in place has really served to protect kids at the time when they are the most vulnerable to these diseases.”
In New Hampshire, vaccine skeptics dominated a lengthy hearing on a bill that would eliminate required vaccines for school, but was amended to keep the polio vaccine. Health department officials said the proposal would put the state out of compliance with federal grant requirements and cost it several million dollars used to immunize low-income children each year.
If the bill passed, there could be “widespread uncontrolled illness,” said Megan Petty, chief of the New Hampshire Bureau of Infectious Disease Control.
Idaho passed a law in 2025 eliminating medical mandates for vaccines or other interventions, but it did not specifically address or change day care or school vaccine requirements, Ms. Manookian said.
She said she planned to support a new Idaho proposal that would. Some Idaho school districts have continued to stand firm on vaccine requirements despite the existing law’s general prohibition against medical mandates, she said.
“The more that the schools and the day cares actually play parent and intrude,” she said, “the more they’re actually harming themselves.”
Chris Anders, a Republican lawmaker in West Virginia, introduced a bill this month that would eliminate school vaccination mandates, including the requirement that county health departments offer free shots to low-income children. He said other lawmakers were unlikely to advance the measure.
“If people decide not to be vaccinated, that is their choice,” he said. “Just like if they decide not to wear a seatbelt or a motorcycle helmet or anything else. If they decide that, they suffer the consequences.”
Last year in Texas, Gov. Greg Abbott quietly signed a bill that opened the door to lawsuits against vaccine makers that advertise in the state.
A 1986 federal law created a special court, the Vaccine Injury Compensation Program, that handles vaccine-injury claims. Mr. Kennedy, who worked on a large lawsuit against one vaccine maker, has long been a critic of the special court, saying vaccine lawsuits should be easier to pursue.
In Florida, Dr. Joseph Ladapo, the surgeon general, announced last fall that the state would end vaccine requirements. With no proposal in the legislature to make that happen, a pared-down effort to change state rules is moving forward.
Florida officials are seeking to repeal the requirement that children be vaccinated against varicella, or chickenpox; hepatitis B, pneumococcal bacteria and Haemophilus influenzae type B, or Hib, a condition that can be deadly.
The state held a contentious hearing in December on the plan. Among those testifying was Jamie Schanbaum, whose fingers and lower legs were amputated after she became severely ill from meningitis, which is prevented by the pneumococcal vaccine. She has advocated the vaccine extensively and in December asked Florida leaders to keep their vaccination requirements in place.
“It’s very frustrating,” she said in an interview, “to see and experience the reality of today and that our most prominent, most respected medical guidances are being not taken seriously.”
Emily Cochrane and Teddy Rosenbluth contributed reporting.
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