Trump Signs an Order Cutting the Universal Childhood Vaccine List From 18 Diseases to 11 — and Splitting the MMR Shot in Three

President Donald Trump signed an executive order Monday that rewrites the federal government's childhood vaccine recommendations, cutting the list of diseases every American child is advised to be immunized against from 18 to 11 and directing that the measles, mumps and rubella shot be broken into three separate injections.

The order splits the childhood schedule into three tiers. Under the first, all children are recommended to receive vaccines against measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Hib, pneumococcal disease, HPV and varicella. A second tier reserves respiratory syncytial virus monoclonal antibodies and vaccines against hepatitis A, hepatitis B, meningococcal B, meningococcal ACWY and dengue for high-risk children only — a reversal of current practice, which recommends most of those shots for everyone. A third tier, covering rotavirus, meningococcal disease, influenza and Covid-19, leaves the decision to what the administration calls shared clinical decision-making between parents and a doctor.

Speaking from the Oval Office flanked by Health and Human Services Secretary Robert F. Kennedy Jr. and other top health officials, Trump described the change in blunt terms. "We're reducing them," he said. "It's not only that you're doing fewer vaccines, or jabs, as they say, but you're doing them in a series of visits to the doctor." Pressed on the reasoning behind spreading infant immunizations across five appointments, he said he had done the same with his own children and "had no problem." He went further: "Large amounts of vaccine, large amounts of — like vats — of vaccine are currently pumped into your child's body," he said, at one point likening the volume to "the size of a bottle of soda." He also suggested the MMR shot could be "quite lethal," a claim unsupported by the scientific record, and said of the order, "Nothing bad can happen from what we're doing. Nothing bad can happen."

The pushback was immediate and came from inside his own party. Sen. Bill Cassidy, a Louisiana Republican and a physician who voiced hesitancy last year about confirming Kennedy over his vaccine positions, wrote on X: "This executive order is wrong. The President does not have the expertise to make these changes. Vaccines are overwhelmingly safe. Vaccines are effective. Vaccines DO NOT cause autism." Cassidy added that breaking combination shots apart "will mean children have to get more shots to get the same protection, not fewer shots. It will increase hesitancy and make children less safe."

There is a practical obstacle to the MMR provision: the three component vaccines are not sold separately in the United States. A White House official said HHS is working with manufacturers to make standalone shots commercially available and that Kennedy is expected to deliver a plan within 90 days. "The president has long held that the MMR vaccine should be separated and wants that available as an option," the official said.

Monday's order closely tracks an HHS attempt in January to pare back the childhood schedule. Medical groups sued and a federal judge ruled against the department, writing that there were "glaring gaps" in the expertise of the advisers Kennedy appointed to the government's independent vaccine panel last year. This time the administration intends to route around the courts. White House adviser Heidi Overton said officials "are going to be working directly with states so that we're not reliant on the court case to resolve. We are doing it right away so that parents get the benefit from state laws changing."

The signing landed the same day Senate Republicans released 2021 text messages from Dr. Anthony Fauci's government phone in which the former official weighed potential Covid-19 vaccine risks for pregnant women; subsequent studies found the vaccines safe in pregnancy. Asked about the GOP push to charge Fauci with contempt of Congress, Trump said he had not yet discussed it with U.S. Attorney for the District of Columbia Jeanine Pirro. The vaccine order also arrives against the advice of Trump's own political operation, which has warned for months that vaccine fights poll badly heading into November's midterms. Decades of studies have found no link between vaccines and autism.