In Florida, a move by the state's health leadership to roll back school vaccine mandates has prompted concern among parents, medical professionals and public health officials about the potential impact on vulnerable children and wider community health.

Cammi Norwood says her four-year-old son Mason was "jumping with joy" at the idea of starting public school. Born with Stage 4 kidney disease, Mason has been healthy for two years and has not needed hospital care during that time.

But Norwood is reconsidering the plan to enroll him after Florida's surgeon general announced an effort to remove vaccine requirements for schoolchildren. "It's just scary," Ms Norwood said. "If these kids aren't vaccinated ... he can get very, very sick if someone were to come in with the measles."

The proposal has divided parents. Some welcome greater choice, while others worry reduced vaccination coverage will make schools and communities less safe for people who cannot be immunised because of medical conditions.

Dana Fernandez, who moved to Florida in part so her unvaccinated six-year-old triplets could attend public school, said she was "delighted" by the policy. "I support a parent's right to decide for themselves what they feel is right for their child," she said. "But I don't support you mandating what I should do."

By contrast, Meghan Bichard, a mother of two in Lake County, described the prospect of more vaccine-preventable illness in her community as troubling. "To hear that there's going to be the potential of some of these very preventable diseases becoming a petri dish here in our location is troublesome," she said. "Why wouldn't we want to protect ourselves, and why wouldn't we want to protect our neighbours?"

State Surgeon General Joseph Ladapo announced the plan, arguing parents should have final authority over whether their children receive mandated vaccines and likening existing mandates to "slavery". The measure has the support of Governor Ron DeSantis but has drawn opposition from major medical organisations including the American Academy of Pediatrics.

Florida's health department told news outlets it would -- within 90 days -- lift school mandates for vaccines against hepatitis B, chickenpox, Hib, influenza and pneumococcal disease. Medical experts said removing mandates for additional routine childhood vaccines would require changes to the Florida Administrative Code and would likely need involvement from the state legislature.

Ladapo has not provided a full analysis of how the changes might affect disease transmission. In an interview he told CNN: "Do I need to analyze whether it's appropriate for parents to be able to decide what goes into their children's bodies? I don't need to do an analysis on that."

Public health specialists and former officials warn lower vaccine uptake could produce localised outbreaks and put immunocompromised people and others at risk.

Physicians in Florida report an increase in cases of vaccine-preventable illnesses in recent years. Meghan Martin, a paediatric emergency medicine doctor, said pertussis (whooping cough) incidents have risen -- from 85 cases in 2023 to over 700 in 2024 in the state -- and that there have been several measles cases amid a larger national outbreak that led to three deaths, including two children in Texas.

The state-level push in Florida is occurring as national vaccine policy is being reshaped by the US Department of Health and Human Services under Health Secretary Robert F Kennedy Jr, who is associated with the so-called "Make America Healthy Again" (MAHA) movement. Kennedy, a vaccine sceptic, has removed many senior public health officials, replaced members of an independent vaccine advisory committee and narrowed Covid-19 booster recommendations.

Scott Rivkees said Kennedy's positions have helped create momentum for similar efforts at state level: "When you have somebody in Washington, somebody who's responsible for the health of the entire country, doing things to undermine vaccination at many different levels, this certainly will hit a resonant chord for individuals who are like minded," he said.

For some Floridians, Kennedy's stance resonates. "I'm thrilled with their stance," Ms Fernandez said, referring to both Ladapo and Kennedy.

Dr Rana Alissa, president of the Florida chapter of the American Academy of Pediatrics, warned of international scrutiny and potential harm. "The world is watching," she said. "It's dangerous ... It's going to cost lives."

If Florida proceeds with rescinding school vaccine mandates, the immediate changes announced would affect several routine immunisations for children, while further rollbacks would require formal regulatory changes. Health officials, clinicians and parents say they will be watching vaccine uptake, hospital admissions and any changes in the frequency of outbreaks as the policy discussion continues.