Trump Issues Order to Change the Childhood Vaccine Schedule — Here’s What Doctors Want Parents to Know

The executive order recommends vaccines against 11 preventable diseases, instead of the 17 currently identified by the Centers for Disease Control and Prevention (CDC).

Multiple major medical organizations and lawmakers have spoken out against the changes.

“Altering a proven vaccination schedule without credible evidence risks weakening public confidence and putting children’s health at risk,” said Willie Underwood III, MD, MPH, the president of the American Medical Association, in a statement shared with Everyday Health.

What the Executive Order Said

The executive order split its vaccine recommendations into categories:

• Vaccines recommended for all children: Measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, pneumococcal disease, human papillomavirus, and varicella (chicken pox)
• Recommended for “certain high-risk groups or populations”: Respiratory syncytial virus (RSV) monoclonal antibodies, hepatitis A, hepatitis B, meningococcal B, meningococcal ACWY, and dengue
• Vaccines that should be given only with shared clinical decision-making: Hepatitis A, hepatitis B, rotavirus, meningococcal disease, influenza, and COVID-19. Shared clinical-decision making means the default is not to vaccinate, and parents have to specifically request these vaccines.

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The order also recommends splitting the combined MMR vaccine into “three separate single-disease shots” — an option not currently available in the United States. “To the maximum extent feasible, all childhood immunizations should be administered at separate medical visits,” the order states.

The order cites vaccine guidance from “peer nations” as part of the rationale for the changes, which Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security in Baltimore, calls an “interesting” claim.

Finally, the order called on the U.S. Department of Health and Human Services Task Force on Safer Childhood Vaccines to present plans to the president to “improve” vaccine research related to the sequence, safety, and timing of childhood vaccines. It stressed that states have “obligations to provide religious and medical exemptions from childhood and adolescent immunization requirements,” and threatens "appropriate action” if these are not granted.

Ultimately, though, only the states have the authority to determine which vaccinations are required for school attendance, not the federal government, notes Dr. Adalja.

Trump Offers Disproven Autism Link as Rationale for Changes

“Today’s executive order will do nothing to support families of children with autism or advance understanding of the condition,” he added. AAP said it will not change its vaccine recommendations in response to the executive order.

Doctors Oppose the Recommendations for Many Reasons

Experts say their biggest concern about the executive order is that it isn’t based on science.

“We know that the current childhood vaccination schedule is supported by years of scientific evidence. These new recommendations are not,” says Jennifer M. Walsh, DNP, an assistant professor at George Washington University School of Nursing in Ashburn, Virginia, and a primary care pediatric nurse practitioner.

As for dividing the MMR shot into three separate vaccines administered in separate medical visits, “Spacing them out doesn’t make any sense to reduce the burden on the immune system,” Walsh says. She points out that time spent on the playground can expose children to more antigens (substances that can trigger an immune response) than vaccination does.

Besides, the combination shot is safe, Adalja says. “The combined shot exists because giving three antigens at once is exactly as safe as giving them separately,” he says.

The changes would pose logistical and cost issues for families, too, Walsh says. “Spacing vaccines out leads to more incomplete vaccinations for kids,” she says. “It’s also a higher cost, and more of a burden on parents and healthcare practices because you have to have the staff come in for those multiple visits.”

Parents will have to take more time off from work for all those vaccination visits, which can lead to a drop in earnings, and they may need to take additional time off if their child develops a fever or other reaction to the vaccines, she says.

Other countries may also have different childhood vaccination schedules for a reason, Walsh adds. “They are different countries with different healthcare access and infrastructure,” she says. “It is not comparing apples to apples.”

Order Unlikely to Impact Health Insurance Coverage

Health insurers follow recommendations from the Advisory Committee on Immunization Practices (ACIP) when deciding on coverage, Adalja notes, and these guidelines predate the Trump administration.

As a result, the executive order “will not have any impact on insurance coverage.”

Consult With Your Healthcare Provider, Experts Say

Walsh stresses the importance of getting vaccination advice from medical providers, not politicians. “Talk to your pediatric provider about vaccine recommendations,” she says. “We want to talk to parents about any concerns they have. It is our life mission to educate about why we do this, and to help kids thrive.”

Adalja also recommends talking to your healthcare provider. “Follow the schedule your pediatrician and the American Academy of Pediatrics still publish independently of this order — that’s the one built from data, rather than politics,” he says.