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.
“Effective immediately, my administration is recognizing gold-standard childhood vaccine recommendations for only 11 core vaccinations against the most serious and dangerous diseases, along with the MMR, which hopefully will be split up,” Trump said during a White House signing ceremony where he repeatedly cited a growing number of U.S. autism diagnoses.
“There are some groups that have virtually no problem with autism,” Trump said. “They’re groups that aren’t big into the world of vaccines, so there is something wrong.”
Physicians roundly rejected the action, saying no new science warranted a change, and that the U.S. schedule reflects decades of evidence and the specific health needs of Americans, rejecting the comparison to other countries. Fewer recommended shots will leave more children exposed to preventable diseases, they said.
The order also recommends splitting the measles, mumps and rubella vaccine into three shots taken at separate visits.
Kennedy 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 executive order says it reaffirms Kennedy’s overhaul despite the ongoing litigation.
Existing coverage under the Vaccines for Children program relied on by many families will continue, a senior administration official said. The government-funded program provides vaccines for those who may not be able to afford them.
The order directs the Justice Department to challenge state vaccination laws, escalating a federal fight over school immunization requirements set by states. It instructs 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.
HEALTH EXPERTS REJECT CHANGES
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 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 MMR shot into three, and that using the individual components increases injections and can lead to delayed or missed immunizations.
Dr. Elizabeth Mack, a pediatric critical care physician in Charleston, South Carolina, said no licensed single-antigen measles, mumps or rubella vaccines were available in the United States, making the recommendation unfeasible as written.
“We don’t have a system that supports this,” she said, questioning whether extra visits would be required and if they would be reimbursed by insurers.
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.”
The order was also criticized by Republican Senator Bill Cassidy of Louisiana, a physician who chairs the Senate health committee and shepherded Trump’s health agency nominees through, casting the decisive vote to confirm Kennedy.
“I’m a doctor. This executive order is wrong. The president does not have the expertise to make these changes,” Cassidy, who lost his Republican primary to a Trump-endorsed challenger and will leave office in January, said in a statement.
