US President Donald Trump has signed an executive order seeking to reduce the number of routine childhood vaccinations and directing the Justice Department to challenge state vaccine laws.
The move, announced Monday, advances a long-standing objective of Health Secretary Robert F. Kennedy Jr. and revives elements of a vaccine schedule overhaul introduced by the administration in January but later halted by a federal court.
The order has drawn swift opposition from doctors, public health experts and vaccine manufacturers, who said there was no new scientific evidence to justify changing the established vaccination schedule.
The administration has also continued to promote claims linking vaccines to autism, despite decades of scientific research finding no evidence of such an association.
What Does the Executive Order Say?
The order recommends universal childhood vaccination against 11 diseases, down from the 18 diseases covered by the US Centers for Disease Control and Prevention’s recommended schedule in late 2024.
The vaccines retained on the universal list include those protecting children against measles, polio, tetanus and whooping cough.
Vaccines against COVID-19, influenza, rotavirus, hepatitis A, hepatitis B, bacterial meningitis and respiratory syncytial virus have been moved to categories covering high-risk groups or shared clinical decision-making.
Under the new approach, some vaccines would be recommended only for children considered at increased risk because of an underlying medical condition or exposure, while others would be administered following consultation between parents and their doctors.
Some vaccines, including those for hepatitis A and hepatitis B, fall into both categories.
The order also calls for the combined measles, mumps and rubella vaccine known as MMR to be split into three separate injections and for childhood vaccinations to be spread across different medical visits.
On the legal front, the order directs the Attorney General to challenge state laws that the administration says interfere with parental authority, religious freedom, disability accommodations and equal protection.
It specifically targets state vaccine mandates and exemption provisions, including religious and medical exemptions.
What Will Change for Families?
The immediate impact on families may be limited.
Parents will still be able to request vaccines placed under the shared clinical decision-making category, while the White House says the executive order will not affect the federal Vaccines for Children programme, which provides free vaccines to eligible families who cannot afford them.
However, the administration has not guaranteed that private insurers will continue covering all vaccines moved out of the universal category.
Some major insurers and healthcare companies have said they will continue covering CDC-recommended childhood vaccines without co-payments while they assess the new policy.
Health experts, however, warn that spreading vaccinations across multiple visits could increase the number of appointments required and potentially raise costs for families.
Trump has suggested that children could require as many as five separate visits around the age of one.
Pediatricians also fear that conflicting messages from federal health authorities could encourage some parents to delay or skip vaccinations altogether.
Some provisions cannot be implemented immediately.
For example, there are currently no licensed standalone measles, mumps or rubella vaccines commercially available in the United States. Federal health officials said the Department of Health and Human Services would work with manufacturers on developing a solution within 90 days.
Because school-entry vaccination requirements are determined by individual states, rather than the federal government, the executive order seeks to pressure states to adopt the narrower schedule.
Medical Groups Reject the Move
Major medical organisations have broadly rejected the administration’s decision, arguing that there is no new scientific evidence supporting a reduction in routine childhood vaccinations.
The American Academy of Pediatrics warned that the policy could confuse parents and lead to delays in childhood immunisation.
The group also reiterated that decades of scientific research have found no link between vaccines and autism.
It estimates that replacing the combined MMR vaccine with separate measles, mumps and rubella shots could take about a decade to implement fully.
The Infectious Diseases Society of America and the National Foundation for Infectious Diseases were among other organisations warning that the policy could expose more children to preventable diseases and deaths.
Why Do Experts Recommend the Current Schedule?
Public health experts develop vaccination schedules by studying how diseases spread, who is most vulnerable and the ages at which children are most likely to be exposed.
Most childhood vaccines are therefore administered during the first 12 to 18 months of life, when children are particularly vulnerable to serious infections.
The American Academy of Pediatrics says the timing and combination of vaccines are designed to provide protection when children need it most and when the vaccines are most effective.
Experts also reject the suggestion that receiving several vaccines at once overwhelms a child’s immune system.
Vaccination schedules differ between countries because of differences in disease patterns, population demographics, healthcare systems, costs and access to vaccines.
The previous US schedule covered 18 diseases, compared with an average of about 14 across comparable countries.
However, South Korea and Brazil also had schedules covering 18 diseases, weakening the administration’s argument that the United States was an international outlier.
