Trump signs executive order overhauling childhood vaccine schedule

The order, called "Delivering Gold Standard Childhood Vaccine Recommendations for Americans," would end the universal recommendation for several childhood vaccines and instead split up recommendations into three categories:

• All children are recommended to receive the MMR, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, pneumococcal disease, human papillomavirus, and varicella vaccines
• High-risk groups are recommended to receive respiratory syncytial virus (RSV) monoclonal antibodies, hepatitis A and B vaccines, meningococcal B and ACWY vaccines, and the dengue vaccine
• Shared decision-making is recommended for hepatitis A and B, rotavirus, meningococcal disease, influenza, and COVID-19 vaccines

The order also calls for the MMR vaccine to be "administered in three separate single-disease shots" during "separate medical visits." However, separate MMR vaccines for children are not currently available in the United States.

During a signing ceremony for the order in the Oval Office on Monday, Trump said the MMR vaccine could be "quite lethal" but later acknowledged he had no evidence for that statement and added that there are "some people that say it is that way."

"The worst thing that would happen would be, nothing happens," Trump said. "We're not going to lose anything. At the same time, we could gain tremendous — save hundreds of thousands of lives, millions of lives."

Trump also said, "[d]ecades ago, children received only a small fraction of the vaccines required today. In those times, people were much [healthier], and of course, the high rates of autism now observed did not exist," Trump said.

"So there's a reason for such epidemic rates of autism, and we're going to bring it back to where it was," he added.

The order is not the administration's first attempt at revamping the childhood vaccine schedule. In January, CDC reduced the number of vaccinations recommended for children from 17 to 11; however, that decision was blocked by a federal judge who said that Kennedy's decision to fire all 17 members of ACIP and replace them with eight new appointees and CDC's overhaul of the childhood vaccine schedule were both likely illegal.

Reaction

The order was widely criticized by medical groups, with the American Academy of Pediatrics (AAP) calling the recommendations "dangerous."

"As measles cases reach a 35-year high in the U.S. and with cold and flu season quickly approaching, today's executive order on vaccines is not only disheartening but dangerous," AAP president Andrew Racine said in a statement.

"Instead of ensuring every family can access life-saving vaccines for measles, influenza, RSV and more, federal leaders are once again spreading misleading claims," he added.

Racine also noted that "dozens of studies involving millions of people show there is no link between vaccines and autism, yet federal leaders continue to promote this outdated, disproven idea to scare families."

Similarly, American Medical Association President Willie Underwood III said the order will put "children's health at risk."

"Vaccines are among the most thoroughly studied, effective tools we have to protect children from serious vaccine-preventable diseases," Underwood said in a statement. "Decisions about how and when vaccines are used should be driven by rigorous scientific evidence, patient safety, and independent medical and public health expertise. Altering a proven vaccination schedule without credible evidence risks weakening public confidence and putting children’s health at risk."

Jan Carney, president of the American College of Physicians, said that if the order is implemented, "the changes could increase costs to patients and families, including additional copays while also placing a greater burden on families needing to schedule multiple appointments for a multiple-dose MMR vaccine."

After the order was signed, a White House official told reporters that the new policy complies with previous court orders and would prevail in any future legal challenges because the president has the right to make recommendations of "what he understands the best view of the science and the hold standard for vaccination to be."

However, Dorit Reiss, an expert on vaccine policy and law at the University of California College of Law, San Francisco, said the president can't legally circumvent ACIP, which is empowered by Congress to make vaccine recommendations.