WASHINGTON — President Donald Trump on Monday signed an executive order calling for revamped childhood vaccine recommendations that promote his long-held but discredited theory that childhood shots should be spaced out into separate medical visits.
The order advocates separating the measles, mumps and rubella (MMR) vaccine into three different single-disease shots and administering all childhood immunizations at separate appointments whenever possible. It also directs the nation's health department to improve research on vaccines, which are already extensively studied, and present a plan to offer separate measles, mumps, and rubella vaccines for children, since that is not currently an option in the United States.
The renewed focus on vaccines marks a departure from the Trump administration's recent efforts to emphasize less controversial health policies related to healthy eating, drug price negotiations and medical fraud crackdowns ahead of November's midterm elections.
Public health experts have raised concerns that spacing out shots as Trump suggests can lead to an increased risk that children become infected with a vaccine-preventable disease before returning for another visit. Childhood vaccines — and how and when to give them in combination — go through rigorous studies, and safety tracking continues for years as the shots are used.
Trump called the announcement a “major victory for parents rights, religious and constitutional rights, and for the gold standard science.”
Speaking about the order at the Oval Office on Monday, Trump repeatedly suggested the number or timing of vaccines could play a role in rising rates of autism spectrum disorder, even as scientific consensus and decades of studies have firmly concluded there is no link. The order also includes several changes to the childhood vaccine schedule that his health department has already attempted, but that have been blocked by a federal judge. A White House official who insisted on anonymity to brief reporters said Trump was within his right to provide his own recommendation through the executive order and said the lawsuit blocking the health department's schedule was a separate issue.
Dr. Andrew Racine, president of the American Academy of Pediatrics, said the announcement spreads uncertainty, fear and confusion where “there doesn't need to be any of that.” He disputed Trump's recommendations and said previous ones should stand.
“Science about vaccines and their efficacy has not changed,” he said. “The distribution of viruses and other pathogens in our environment has not changed. Children in this country have not changed in the last 48 hours."
Sen. Bill Cassidy, the Republican chair of the Senate health committee, slammed the executive order in a social media post, saying vaccines are safe and do not cause autism.
“I'm a doctor. This executive order is wrong,” the Louisiana senator wrote. “The President does not have the expertise to make these changes.”
Who is in charge of vaccine policy?
Even as the order calls for revised vaccine recommendations, states, not the federal government, have the authority to require vaccinations for schoolchildren. The order advises states with school vaccine mandates to consider updating their laws to reflect the administration's preferred schedule, according to a White House fact sheet.
Last December, Trump ordered the Department of Health and Human Services to review how peer nations approach vaccine recommendations and consider revising U.S. guidance accordingly. The department responded by cutting the number of vaccines it recommends for every child, a move that has since been blocked in court.
Changes to federal childhood vaccine recommendations customarily require approval from the director of the Centers for Disease Control and Prevention. The newly Senate-confirmed CDC director, Dr. Erica Schwartz, oversaw policies promoting vaccination of service members while in a leadership position at the U.S. Coast Guard.
However, public health law expert Lawrence Gostin at Georgetown University said the Supreme Court's interpretation of Trump's power may allow him to supersede Schwartz if she does not agree to new recommendations.
“This is clearly the first test for Dr. Erica Schwartz,” Gostin said in an email. “The President is placing her in an untenable position.”
Asked on a call with reporters why the president was advocating splitting MMR into three single-disease vaccines, the White House official did not provide any studies supporting the decision. They said that was Trump's long-held view and that some countries provide individual measles vaccines in certain circumstances.
Kush Desai, a Trump spokesperson, told The Associated Press that the president is “one of countless parents who have voiced questions and concerns about the combined MMR vaccine" and said the plan to develop single-disease vaccines would “give parents more options on timing and frequency for their children,” ultimately increasing vaccine uptake.
Studies of babies and toddlers in the U.S. have shown that the use of combination shots for childhood vaccines, rather than single ones, increased the likelihood of completing all recommended vaccinations by the age of 2.
Announcement follows other Trump administration vaccine actions
Health Secretary Robert F. Kennedy Jr., an anti-vaccine activist before he entered politics, set out to overhaul immunization guidance at DHS in the first year of Trump's term. He fired an entire 17-member vaccine advisory committee, installing replacements who made far more restrictive recommendations that have since been halted by a federal judge. He also personally directed the CDC to abandon its position that vaccines do not cause autism, without supplying any new evidence to support the change.
Throughout his second term, Trump has been fixated on connecting autism to vaccines. He has recently ramped up pressure on Kennedy to identify the cause of autism, something Kennedy had pledged to do with new research unveiled last year. Trump publicly prodded the health secretary for an update on autism research in a Cabinet meeting last month.
“How are you doing on the autism research?” Trump asked.
“We will have an answer for you,” Kennedy said.
Scientific consensus and decades of studies have firmly concluded there is no link between childhood vaccines and autism. Racine reiterated that point on Monday, noting that the potential link had been studied in “over 40 methodologically well-designed studies in over seven countries involving over 5 million children.”
“I'm not sure that there is anything that has been as thoroughly looked at as this question," he said. “And the answer is unequivocally no."
In the Oval Office, Kennedy repeated his assertion that he believes an unknown environmental factor is to blame for rising autism diagnoses and said that his department will deliver research findings “as soon as they are ready.”
Monday's order comes as students are returning to classrooms around the country and the nation contends with a measles outbreak that experts say could result in the U.S. losing its measles elimination status.
Doctors have raised concerns that Trump's falsehoods on vaccines could stoke vaccine hesitancy. Federal data shows U.S. kindergarten vaccination rates have been dropping, with the share of children with exemptions rising to an all-time high in the 2024-25 school year.
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Associated Press writers Laura Ungar and Mike Stobbe contributed to this report. Swenson reported from New York.