President Donald Trump signed an executive order on Monday to drastically change the childhood vaccine schedule by recommending shots be administered in separate visits to the doctor's office. The executive order acts on Trump’s long-held belief that splitting up routine childhood vaccinations across multiple visits lessens the risk of acquiring autism. Scientists have found no credible risk between vaccinations and autism. “I’ve seen vaccinations the size of a bottle of soda poured into a little child’s body. And bad things happen,” Trump said at the Oval Office signing on Monday, where he thanked Health and Human Services Secretary Robert F. Kennedy Jr. and “the MAHA moms.” Trump said that, for instance, a 1-year-old would go in for five separate visits to get his or her routine 1-year vaccinations rather than get them all on the same day as is practice now. The order instructs agencies to take actions to advance the White House’s recommendations. The executive order's effect on pediatricians' offices may be limited, though. State health departments, not the federal government, dictate school vaccine mandates and vaccination schedules. States consider federal recommendations when updating their vaccine schedules, but are not required to follow the White House’s guidance. For instance, the Centers for Disease Control and Prevention in January recommended reducing the number of vaccines recommended to all children to 11, down from 17 in 2024 — which the executive order also recommends. Trump, Kennedy and the MAHA movement have long argued that kids in the United States get more vaccines than children in other Western nations. But more than two dozen states and the District of Columbia have rejected the new CDC vaccine recommendations, with most of those following guidelines from the American Academy of Pediatrics instead, according to health policy research organization KFF. That prior attempt to overhaul the childhood vaccine schedule was also blocked in court. The order also includes guidance that vaccination for measles, mumps and rubella be divided into three separate shots for each disease once such products are domestically available. The current MMR vaccine is only available as a combined shot. The vaccines will still likely be covered by insurance and the CDC's Vaccines for Children program, White House officials told reporters Monday evening, but that is dependent on forthcoming guidance from HHS. And recommendations from HHS would likely include ways to ensure that parents don't have to pay more for co-pays from multiple visits, officials said. The move drew sharp criticism from Sen. Bill Cassidy, R-La., chair of the Senate Health, Education, Labor and Pensions Committee, a gastroenterologist by training who has clashed with the administration on the issue of vaccines. He said Trump does not have the expertise to make these changes and said the policy change would “increase hesitancy and make children less safe.” “Parents should listen to their child’s pediatrician about vaccines rather than listening to an inaccurate executive order. This is so wrong,” Cassidy said on the social platform X. Public health experts worry that splitting up childhood vaccinations across multiple visits will make it difficult for children to receive the dozens of vaccine doses recommended in their first 18 years. Pediatricians now typically administer multiple vaccines per visit. “This executive order is part of a troubling pattern by the administration to attempt to unilaterally change vaccine guidance, particularly for children, rather than relying on the transparent, scientific review,” said Jan Carney, president of the American College of Physicians. Harold Wimmer, president and CEO of the American Lung Association, said the policy could exacerbate already growing childhood vaccination gaps and lead to increased pediatric deaths. He noted that measles cases are currently at a 35-year high in the United States and that the U.S. saw a record number of pediatric flu deaths during the 2024-25 respiratory virus season since they started being reported in 2004. Both diseases are vaccine-preventable. "The executive order will cause more confusion for parents and healthcare providers, reduce vaccination rates and increase the spread of vaccine-preventable illnesses," Wimmer said in a statement. The move comes as the CDC gets a new director. Erica Schwartz was confirmed by the Senate just days before the announcement in a mostly party-line vote. She was not present at Monday’s Oval Office event.
