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 Wednesday along with 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 Centers for Disease Control and Prevention has said roughly 4 million deaths are prevented annually worldwide by childhood vaccinations.

While most Americans say children 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 Gov. Maura Healey, a Democrat, issued a bulletin Thursday saying insurance carriers will be required to cover vaccinations recommended by the state's department of public health regardless of whether they are endorsed by the federal government. Healey said she wants to make sure 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.

The Democrat 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.

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

In New Mexico, pharmacists have received the go-ahead to administer COVID-19 shots based on state health department guidelines rather than just the federal government's immunization advisory committee. Health Secretary Gina DeBlassie said Friday in a statement that New Mexico "cannot afford to wait for the federal government to act on this matter.”

Drugstore giant CVS responded by saying it will ensure the shots are in its pharmacies across the state as soon as possible.

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, a Democrat.

Colorado Gov. Jared Polis, a Democrat, 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 to provide the vaccines without individual prescriptions.

Health leaders in Washington state issued a similar order covering COVID-19 shots for most residents.