U.S. President Donald Trump signed an executive order that sharply narrows who is recommended for childhood vaccinations and directs that shots be spaced out instead of giving multiple vaccines at once. Trump raised the possibility of a link between vaccination practices and autism, but the medical and scientific communities say there is no reliable scientific evidence to support that and worry about the spread of infectious diseases.
On the 10th (local time), Trump signed an executive order at the White House to overhaul the childhood vaccination recommendation system. As a result, the number of diseases for which vaccines are uniformly recommended for all children will be cut from 17 to 11 under U.S. Centers for Disease Control and Prevention (CDC) standards.
The 11 diseases are measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B (Hib), pneumococcal disease, human papillomavirus (HPV), and chickenpox.
Vaccines such as hepatitis B and hepatitis A will be recommended only for certain high‑risk groups. In other cases, physicians and guardians will decide whether to vaccinate through a "shared clinical decision‑making" process that considers a child's health status after consultation. Some vaccines, including hepatitis B, COVID‑19, and influenza, will not be uniformly recommended for all children.
The way vaccines are administered will also change. Instead of the combined MMR vaccine that prevents measles, mumps, and rubella at once, each disease's vaccine will be given separately at different times.
Trump argued that instead of giving several vaccines on the same day during the first year of life, they should be split into five visits. "At one visit, we will administer only 20% of the current dose and put time between visits so the body can handle it," he said.
Trump cited autism as the backdrop for the policy change. "Decades ago, children received only a small fraction of the number of vaccine doses required today," he said. "People were much healthier then, and the high autism rates observed today did not exist."
He added that while the exact cause of autism is unknown, "there is a reason autism has spread to this epidemic level," and said he would reduce autism incidence closer to past levels.
Trump said his own children also did not get their vaccinations all at once but split them into five rounds, adding, "It's inconvenient, but I think this will have a tremendous effect on autism."
However, the medical and scientific communities say there is no reliable scientific evidence supporting a link between vaccines and autism. Trump and Health and Human Services Secretary Robert F. Kennedy Jr. have repeatedly raised the possibility of a connection between vaccination and autism.
There are also concerns about spreading out vaccination timing. If intervals between shots get longer, the period during which children are exposed to vaccine‑preventable diseases can also lengthen. Some also point out that if the scope of recommended vaccines shrinks, overall vaccination rates could fall and infectious diseases could spread again.
There is also the potential for confusion in the actual vaccination process. The Associated Press noted that although the Trump administration directed separate administration of the MMR components, individual measles, mumps, and rubella vaccines are currently unavailable in the United States.
It is also unclear how much real effect the executive order will have. According to the New York Times (NYT), the authority to mandate childhood vaccinations required for school enrollment lies with state governments, not the federal government.
The order also allows the attorney general to take legal action against state governments that infringe on rights to exemptions from vaccination for religious or medical reasons.
The Trump administration's attempt to scale back vaccination recommendations has already been blocked in court. In January, when the CDC reduced its list of recommended childhood vaccinations, six medical groups including the American Academy of Pediatrics filed suit, and in March a federal court temporarily halted the revised recommendations.