By Ahmed Aboulenein
WASHINGTON, Aug 11 (Reuters) - President Donald Trump on Monday signed an executive order calling for fewer routine childhood vaccinations and directing the Justice Department to challenge state vaccine laws, a move physicians and vaccine makers swiftly rejected.
The order advances a long-standing goal of Health Secretary Robert F. Kennedy Jr. and reaffirms a January vaccine schedule overhaul later halted by a federal court.
It reflects Trump and Kennedy's claim of a link between
vaccines and autism that contradicts decades of scientific studies showing no association between the two, as well as many benefits of immunization against major diseases.
WHAT DOES THE EXECUTIVE ORDER SAY?
The order recommends universal childhood immunization against 11 diseases, down from 18 the U.S. CDC recommended in late 2024, such as measles, polio, tetanus and whooping cough.
Those dropped from the universal list are vaccines for COVID-19, the flu, rotavirus, hepatitis A, hepatitis B, bacterial meningitis and RSV.
They move into a "high-risk groups or populations" category, recommended only for children at heightened risk from an underlying condition or exposure, or a "shared clinical decision-making" category, recommended in consultation with a doctor. Some, including hepatitis A and B shots, fall into both.
It also recommends splitting the combination measles, mumps and rubella vaccine, or MMR, into three single-disease shots and spreading immunizations across separate visits to a healthcare provider.
On the legal front, the order instructs the attorney general to sue over state laws it says conflict with parental authority, religious freedom, disability accommodations and equal protection, including religious and medical exemptions from vaccine mandates.
WHAT CHANGES FOR FAMILIES DECIDING HOW TO IMMUNIZE CHILDREN?
The immediate mechanics change little: parents can still request vaccines moved to the "shared clinical decision-making" list, and the White House says the order does not affect the Vaccines for Children program, which provides free shots to families who cannot afford them and is tied to CDC guidance.
The administration expects, but has not guaranteed, that private insurers will keep covering the shifted vaccines. Blue Cross Blue Shield and CVS said they would keep covering CDC-recommended childhood vaccines without copays while reviewing the order.
The bigger effects are indirect. Splitting shots across separate medical visits (Trump suggested five at age 1) means more appointments and potential out-of-pocket costs for families, with officials not saying how they would be covered. Pediatricians warn the conflicting federal message will lead some parents to delay or skip shots.
Some elements cannot take effect right away. Splitting MMR is not currently possible because no company sells licensed standalone measles, mumps or rubella vaccines in the United States. Officials said the federal health department would work with manufacturers on a solution within 90 days.
Because states, not Washington, set school-entry requirements, the order pressures states to adopt the narrower schedule, backed by the Justice Department directive to sue over their exemption laws.
WHAT DO MEDICAL EXPERTS SAY ABOUT THE ORDER?
Major medical groups broadly rejected the order, saying no new science justifies a change.
The American Academy of Pediatrics said it would sow parental confusion and delay vaccination. It reiterated that decades of studies show no link between vaccines and autism. It estimates replacing the combined MMR shot with single-disease versions would take about a decade.
Several groups, including the Infectious Diseases Society of America and the National Foundation for Infectious Diseases, said it would expose more children to preventable illness and death.
WHAT IS THE SCIENCE BEHIND THE SCHEDULE?
Public health experts build a schedule by studying how a disease spreads and who gets sick, and at what age, to protect children at the safest, most effective times. That is why most immunizations come in the first 12 to 18 months, before likely exposure.
The AAP says the timing and combination of shots matches when they work best and when children are most vulnerable, and that multiple vaccines do not overwhelm a child's immune system.
Schedules differ by country because of varying disease threats, demographics, costs and delivery systems.
The previous U.S. schedule targeted 18 diseases versus an average of about 14 across comparable nations, with South Korea and Brazil also at 18, undercutting the administration's claim that the U.S. is an outlier.
(Reporting by Ahmed Aboulenein; Additional reporting by Julie Steenhuysen in Chicago; Editing by Michele Gershberg and David Gaffe)
