Now that Florida is taking steps to be the first state to get rid of school vaccine mandates, some states are looking at following its lead while others are promising to protect vaccines for children and adults.

Florida’s announcement on Wednesday along with U.S. Health Secretary Robert F. Kennedy’s attempts to advance anti-vaccine policies have widened the debate over vaccine mandates — long a centerpiece of fighting infectious diseases.

The U.S. Centers for Disease Control and Prevention has said that roughly 4 million deaths are prevented annually worldwide by childhood vaccinations.

While most Americans say kids should be vaccinated to attend school, adults nationwide are now less likely to think those immunizations are important. At the same time, routine childhood vaccine rates are falling.

Here is a rundown of what states are saying about vaccine mandates:

Massachusetts moves to protect access to vaccines

The state’s Democratic governor issued a bulletin Thursday saying that Massachusetts insurance carriers will be required to cover vaccinations recommended by the state’s department of public health regardless of whether those vaccines are endorsed by the federal government. Gov. Maura Healey said she wants to make sure the state’s residents can afford the vaccines they want. Vaccinations that Massachusetts insurers would be required to cover include routine shots for children, like measles, chickenpox and Hepatitis B. Healey said her state is also leading a bipartisan coalition of eight Northeast states that met over the summer to discuss coordinating vaccine recommendations.

West Coast governors band together

The Democratic governors in Washington, Oregon and California announced this week that they have created an alliance to establish their own recommendations for who should receive vaccines. They plan to coordinate their vaccine recommendations and immunization plans based on science-based evidence from respected national medical organizations, according to a joint statement.

Illinois seeks advice from medical experts

The state health department in Illinois said it plans to issue specific guidance by the end of September that will help health care providers and residents make informed decisions about vaccinations. The state’s health director said they will consult with medical experts.

New Mexico plans to “remove obstacles” to vaccines

The state’s chief health official says New Mexico is updating its protocols to allow pharmacists to consider recommendations from the state’s health department when administering vaccines rather than just the federal government’s immunization advisory committee. Health Secretary Gina DeBlassie said the order “will remove obstacles to vaccination access.”

Pennsylvania, Colorado and Washington protect COVID-19 shots

Pennsylvania’s pharmacy board voted this week to protect the availability of COVID-19 vaccines for those most in need and make it accessible across the state, at the urging of Gov. Josh Shapiro. Colorado Gov. Jared Polis also directed health officials to make sure residents are able to be vaccinated against the virus. A new order that went into effect Friday allows pharmacists in Colorado to provide the vaccines without individual prescriptions. Health leaders in Washington state on Friday issued a similar order that it said covers COVID-19 shots for most residents.