RFK Jr. Vaccine Schedule Revision Puts State School Requirements Into Flux

Health Secretary Robert F. Kennedy Jr.'s revisions to the Centers for Disease Control and Prevention (CDC) childhood immunization schedule have raised fresh questions about state school vaccination requirements. Historically, state health departments and school systems relied on CDC guidance, but the politicization of vaccines under Kennedy may prompt more states to set independent policies.

What Changed

The revised federal schedule reduces the number of recommended childhood shots from 17 to 11 and reclassifies several vaccines. Shots for diphtheria, tetanus, pertussis (whooping cough), measles and chickenpox remain on the recommended list. Vaccines for rotavirus, COVID-19 and meningococcal disease were moved into a new category emphasizing “immunizations based on shared clinical decision-making,” and the guidance reduces the recommended number of HPV doses by one.

States Responding Diversely

Many states take cues from the CDC, but legal and statutory differences mean responses will vary. "There could be an impact, probably starting the new school year, on what's required," said Jen Kates, Senior Vice President at KFF. She noted roughly half of states already decouple their school requirements from federal recommendations and will need to review statutes that tie school mandates to ACIP or federal guidance.

"States will have to review the language of their laws and rules to determine whether their school requirements are explicitly tied to federal recommendations," Kates said. "Where no such linkage exists, schools may adopt whatever standards state health authorities set."

Some states are signaling rollbacks: Florida announced it would consider ending public school vaccine mandates, with Surgeon General Joseph Ladapo criticizing existing requirements. If enacted, Florida could become the first state with no school vaccine mandates overseen by its health department. In West Virginia and other states, debates continue about expanding exemptions or changing rules.

Regional Pushback

By contrast, several "blue" states are moving to reinforce their own guidance. Oregon, Washington and California — joined by Hawaii — formed the West Coast Health Alliance to provide unified, evidence-based recommendations and maintain public confidence in vaccine safety and efficacy. After the CDC released the revised schedule, the alliance reaffirmed its commitment to guidance based on the American Academy of Pediatrics.

Public-Health Concerns

Public-health experts warn that mixed messages could increase confusion and hesitancy among parents. "The ping-pong between recommendations is going to add to that kind of confusion and vaccine hesitancy," said Lynn Nelson, President of the National Association of School Nurses.

Vaccination coverage among schoolchildren is already slipping. In the 2024–2025 school year, kindergarten vaccination rates fell to 92.1% for DTaP and 92.5% for MMR and polio, down from about 95% in 2019–2020. The conventional threshold for herd immunity is roughly 95%, and at least 17 states report exemption rates above 5%.

Practical Effects And Coverage

In the short term, the federal change may have limited practical effect unless states alter their laws. The national insurance trade group AHIP said insurers will continue to cover all shots the CDC recommended in September at least through the end of 2026. Still, experts note that inconsistent state policies can allow outbreaks to cross borders: "Diseases don’t respect state borders," Kates said.

The Hill sought comment from the U.S. Department of Health and Human Services. Updated at 7:27 a.m. EST.