President Donald Trump on Monday issued an executive order that aims to reduce the number of universally recommended vaccines for children — a move that reaffirms the dramatic overhaul Health Secretary Robert F. Kennedy Jr. announced earlier this year that has been blocked in the courts.
Similar to that vaccine schedule change, the new order recommends that the list of diseases that all children should be vaccinated against drop from 18 to 11. The other shots would be recommended for high-risk groups or subject to so-called shared clinical decision-making between a parent and their child’s doctor.
The proposed changes, in theory, do not prohibit access to vaccines. Rather, Kennedy said Monday that they are meant to give parents choices. The recommended childhood immunization schedule in the U.S. is not a mandate, though many schools and daycares follow the guidelines in crafting their own requirements.
In his announcement, Trump drew a link between the vaccine changes described in the order and concerns about rising rates of autism in the U.S., despite decades of research showing there is no link between autism and vaccines.
“While we do not know exactly what the cause is with respect to autism, it is essential to our research efforts that we have the very best vaccine recommendations in the entire world, so we’re reducing them,” Trump said.
The order recommends that vaccines for Covid, rotavirus, the flu, hepatitis A, hepatitis B and bacterial meningitis be administered based on shared clinical decision-making.
A separate set of vaccines will remain recommended universally: those for measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B (Hib), pneumococcal disease, HPV and chickenpox.
For certain high-risk groups, the order says, vaccines for RSV, hepatitis A, hepatitis B, dengue and two types of bacterial meningitis are recommended, as well.
Heidi Overton, deputy assistant to the president for domestic policy, said during the announcement Monday that because Kennedy’s previous vaccine overhaul is held up in court, Trump is “correcting that wrong” with this executive order.
The order recommends that all childhood immunizations be administered at separate medical visits, which in practice could more than double the number of doctor visits for children — and potentially mean more copays, as well.
Additionally, the order suggests that the combined measles, mumps and rubella (MMR) vaccine should be separated into three shots, given individually. No such individual vaccines are currently Food and Drug Administration-approved or available. The order tasks Kennedy with coming up with options for making separate shots available.
In his second term, Trump has frequently repeated misinformation that babies get too many vaccines and the combined measles vaccine is less safe than individual shots. His deputy chief of staff Stephen Miller also suggested, without evidence, on Monday that giving kids “shot after shot after shot” leads to vaccine injuries.
The American Academy of Pediatrics says it bases its vaccine schedule, which aligns with the guidance the CDC issued before Kennedy took office, on when vaccines will work best with a child’s immune system and when they most need protection from a given disease.
The combined MMR vaccine — recommended for children at 12 to 15 months and 4 to 6 years — has been available since 1971, in part to reduce the number of injections that children receive. Breaking up the shots would mean children would receive six injections instead of two.
Measles cases in the U.S. this year are already higher than the annual totals recorded in any of the last 35 years.
Trump’s executive order says the attorney general can take legal action against states that do not offer religious and medical exemptions from vaccination requirements.
It builds on an earlier order aimed at aligning the childhood vaccine recommendations in the U.S. with those of peer, developed countries.
Some current and former Trump administration officials have pointed to Denmark as an example, where vaccines for the flu, Covid, RSV, chickenpox and several others aren’t included in the universal childhood schedule. However, many public health experts say the burden of infectious diseases is different in the U.S. given the size and diversity of its population. Denmark also has a universal healthcare system, while the U.S. does not.
