Former President Donald Trump has signed an executive order that calls for reshaping childhood vaccine recommendations, proposing fewer diseases be covered and that vaccines be administered across separate medical visits. The order, announced Monday, suggests children receive vaccines for 11 diseases, a reduction from the 18 recommended by the Centers for Disease Control and Prevention (CDC) in 2024. It also recommends separating the measles, mumps, and rubella (MMR) vaccine into three distinct shots given during separate doctor appointments.
However, separate measles, mumps, and rubella vaccines are not currently available or licensed in the U.S., according to the CDC. This recommendation comes at a time when measles cases are on the rise, which medical professionals attribute to lower vaccine uptake. Pediatricians have expressed concerns that the order could sow confusion among parents and make it more difficult for children to receive necessary immunizations.
Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, noted that these recommendations align with proposals previously advocated by Robert F. Kennedy Jr. Offit suggested that the shifting of vaccines for rotavirus, COVID-19, and influenza to “shared clinical decision-making” means they are now considered optional rather than routine. He also indicated that other vaccines, such as those for RSV, hepatitis A, hepatitis B, and meningococcal disease, might be restricted to high-risk groups.
"It doesn't make sense," Offit stated regarding the recommendation to spread out vaccines, adding, "Everybody's at risk." Offit, who is also a co-inventor of the rotavirus vaccine, believes the push to separate the MMR vaccine stems from disproven claims linking vaccines to autism, claims he associates with Kennedy and Trump.
The executive order suggests that 1-year-old children might have their vaccinations spread across five separate visits. Offit countered the notion that spacing out vaccines is safer for children's immune systems, explaining that the number of immunological challenges—instances where the immune system malfunctions—is more critical than the number of vaccines. He pointed out that modern vaccines present fewer immunological challenges compared to those from the mid-20th century.
While the executive order refers to the CDC's recommendations as the “Gold Standard,” it does not formally override the Advisory Committee on Immunization Practices or the CDC. Offit advised paying attention to recommendations from organizations like the American Academy of Pediatrics, which he said base their guidance on scientific evidence rather than attempting to promote a specific agenda.
During a press call, Dr. Andrew Racine, president of the American Academy of Pediatrics, and Dr. Aaron Milstone, a member of the AAP’s Committee on Infectious Diseases, emphasized that the order's primary effect would likely be confusion, not improved health outcomes. Racine challenged claims that children receive as many as 72 to 79 shots, stating that children receive about 30 vaccinations between birth and age 18 to protect against 17 or 18 diseases. He also argued that increasing the number of doctor visits required for vaccinations would create additional logistical hurdles for families.
The White House directed inquiries about the executive order to comments made by the former president in the Oval Office.