U.S. President Donald Trump signed an executive order on Monday calling for fewer childhood vaccinations by limiting the inoculation schedule to 11 immunizations, which he said would give U.S. children “gold-standard” protection and align the country with peer nations that recommend fewer shots.
The order advances a long-standing goal of Health Secretary Robert F. Kennedy Jr., an anti-vaccine activist who has promoted a link between vaccines and autism that scientists have repeatedly debunked.
It also recommended splitting the childhood MMR (measles, mumps and rubella) vaccine into three shots and delivering the shots at separate medical visits.
Kennedy had in January cut the U.S. immunization schedule to remove shots against six out of 17 diseases — a move halted by a federal court ruling. The Trump order says that the federal government will now only support the remaining 11 shots.
Even as the order calls for revised vaccine recommendations, it is the states, not the federal government, that have the authority to require vaccinations for schoolchildren. The order advises states with school vaccine mandates consider updating their laws to reflect the administration’s preferred schedule, according to a White House fact sheet.
Oklahoma Gov. Kevin Stitt, a Republican, praised the order for “bringing greater clarity and transparency to vaccine recommendations,” but Democratic governors J.B. Pritzker of Illinois and Josh Shapiro of Pennsylvania criticized the order.
“Measles are already on the rise in our country, and they want to continue to spread dangerous misinformation instead,” Pritzker said on social media.
The order directs the Justice Department to challenge state vaccination laws, instructing the attorney general to sue over state laws the administration says conflict with parental authority, religious freedom, disability accommodations and equal protection, including rules on religious and medical exemptions from immunization mandates.
“Here in Pennsylvania, we trust experts, doctors, and parents to make the best decisions for our families — not conspiracy theorists,” said Shapiro.
‘This executive order is wrong’
Medical associations, public health experts and vaccine makers also criticized the order.
The main outcome would be “confusion for parents,” said Dr. Aaron Milstone of the American Academy of Pediatrics (AAP) Committee on Infectious Diseases. Conflicting messages, he added, would likely lead parents to delay vaccination.
Merck said there is no published scientific evidence showing any benefit to splitting the combination MMR shot into three, and that using the individual components increases the number of injections and can lead to delayed or missed immunizations.
Kennedy has previously led efforts to drop universal recommendations for hepatitis B shots for children and reduce the list of recommended vaccines, citing links to autism that scientists have repeatedly debunked.
Dr. Elizabeth Mack, a pediatric critical care physician in Charleston, S.C., said there were no licensed single-antigen measles, mumps or rubella vaccines available in the United States, making the recommendation unfeasible as written.
“We don’t have a system that supports this,” Mack said, questioning whether parents would be asked to make more visits and whether those visits would be reimbursed.
Mike Ybarra, chief medical officer of pharmaceutical lobby group PhRMA, said the schedule was built on decades of rigorous research and any changes “should be driven by the same high standard of evidence.”
Republican Senator Bill Cassidy of Louisiana, a physician who chairs the Senate health committee, also condemned the order.
“I’m a doctor. This executive order is wrong. The president does not have the expertise to make these changes,” Cassidy said.
Cassidy, however, has shepherded Trump’s slate of health agency leaders through confirmation despite his own warnings about vaccine skepticism. He cast a decisive vote to confirm Kennedy in 2025.
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The World Health Organization on Tuesday defended the science-based process used to determine childhood immunization schedules. WHO spokesperson Tarik Jašarević told a press briefing in Geneva that vaccination recommendations were based on more than 60 years of research by WHO, national authorities and independent expert groups.
The timing of individual vaccines was determined through extensive scientific review of when people were most vulnerable to particular diseases and the development of the immune system, Jašarević told reporters in Geneva.
“We hope that all countries will use this best scientific evidence that we have,” he said.
Trump, Kennedy and other White House officials said the order means U.S. children would receive far fewer than the 72 injections recommended under the previous schedule.
Vaccine experts say that figure is inflated, because it counts combination shots such as MMR as multiple injections even though they are given in one shot, and assumes annual flu and COVID-19 doses.
The National Microbiology Lab in Winnipeg, currently the only facility in Canada that can handle the most extreme infectious pathogens, is expanding. A new medical countermeasures lab, expected to open in 2033, will aim to better defend against the threat of future pandemics.
AAP President Dr. Andrew Racine called the administration’s plans to again look for a link between vaccines and autism misguided, adding that 40 well-designed studies had already examined the question over a long period of time and found no link.
“The issue is not that the science isn’t done. The science is done,” added Dr. Alycia Halladay, chief science officer at the Autism Science Foundation. “The issue is that some people choose not to believe what the studies clearly show because the results don’t conform to their beliefs.”
