Health experts have condemned United States President Donald Trump’s latest move to direct childhood vaccinations via a decree rather than a scientific process.

Trump signed an executive order on childhood vaccinations on Monday, which he claims will align the US with the “best practices from peer, developed countries”.

The order recommends fewer vaccinations, one vaccination per clinic visit for kids and – most controversially – that the combined measles, mumps, rubella (MMR) vaccine be “administered in three separate single-disease shots”, describing this as the “gold standard”.

Virtually the entire world, bar Japan, administers single MMR vaccinations, which is easier for parents and children.

Making the announcement, Trump and Health Secretary Robert F Kennedy Jr repeated the debunked notion that vaccines may be linked to autism.

Trump also claimed that the combined MMR vaccine was “quite lethal” and said that, “by the age of one year, children should have five separate visits for vaccinations, not all their vaccinations in one day”.

Three categories of vaccinations

The order divides immunisations into three categories. The first recommends 11 immunisations for all children, instead of the current 17. These are for measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, pneumococcal disease, human papillomavirus, and varicella (chicken pox).

The second category recommends a further six immunisations, including for hepatitis A and B, for “certain high-risk groups”.

Finally, Trump said that six vaccinations – for hepatitis A and B, rotavirus, meningococcal disease, influenza, and COVID-19 – are “no longer recommended for all children”.

Instead, they should be given based on “shared clinical decision-making”,  meaning decisions taken by both parents and healthcare providers.

The order aims to encourage “maximal parental choice over childhood vaccines” and also directs the US Attorney General to take appropriate legal action to enable “religious and medical exemptions from childhood and adolescent immunization requirements”.

‘Disheartening’, ‘dangerous’ and ‘troubling’

Dr Andrew Racine, president of the American Academy of Pediatrics (AAP), described the order as “not only disheartening but dangerous” – particularly as “measles cases reach a 35-year high in the US and with cold and flu season [is] quickly approaching”.

“Today’s executive order is not based on ‘gold-standard science’,” Racine added. “There is no new evidence to justify significant changes to childhood immunization guidance. Dozens of studies involving millions of people show there is no link between vaccines and autism, and yet federal leaders continue to promote this outdated, disproven idea to scare families.”

Although the order does not refer to autism, both Trump and his vaccine-sceptical Health Secretary Robert F Kennedy Jr, alluded to possible links between vaccines and autism during the signing ceremony.

Dr Jan Carney, president of the American College of Physicians (ACP), described the order as “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 that has guided the US childhood vaccine schedule for decades”.

“ACP asserts that these changes cannot be allowed to move forward,” he added, alluding to more legal action for the Trump administration, which is already facing legal action from the AAP over its “unilateral changes” to vaccinations for children and pregnant women.

Trump ‘doesn’t have the expertise’

Republican Senator Bill Cassidy, who chairs the Senate Health Committee, said on X that Trump “does not have the expertise to make these changes”, urging parents to “listen to their child’s pediatrician about vaccines rather than listening to an inaccurate executive order”.

“Vaccines are overwhelmingly safe. Vaccines are effective. Vaccines do not cause autism,” said Cassidy, adding “this is so wrong”.

“Breaking up vaccines 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.”

I’m a doctor. 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.

Breaking up vaccines will mean children have to get more shots to get the same… https://t.co/9RoPfVsU8h

— U.S. Senator Bill Cassidy, M.D. (@SenBillCassidy) August 10, 2026

‘Deadly mistake’

Dr Tom Frieden, CEO of Resolve to Save Lives, said that the new order “will result in more illness, hospitalizations, and deaths of American children”.

“There is no evidence that subjecting children to three shots instead of one with the measles, mumps, and rubella vaccine would do anything to protect children, and it would result in more stressful and painful vaccinations.” added Frieden, former head of the US Centers for Disease Control and Prevention (CDC).

Frieden also blasted the introduction of “shared clinical decision-making” for certain vaccines.

“It would be a deadly mistake,” said Frieden. “Shared decision-making is appropriate when the risks and benefits of an intervention are equally balanced. In the case of these and other vaccines, the risks are vastly lower than the benefits of vaccination. 

“Doctors don’t engage in shared clinical decision-making about whether to suture a bleeding wound. Parents are always free to accept physician recommendations or not, but failing to recommend something that is proven to be beneficial is an abdication of federal responsibility.”

“Parents deserve clear, evidence-based guidance about how to protect their children, not competing recommendations issued through political processes,” said Dr Michael Osterholm, head of the Vaccine Integrity Project and director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP).

Circumventing the courts

Trump states in the executive order that his administration’s previous directives on childhood vaccines have “been delayed due to litigation over the composition of the Advisory Committee on Immunization Practices (ACIP) and separate updates to the Federal vaccine schedule”.  

Kennedy has waged a relentless campaign to reduce US childhood vaccines, including by unilaterally changing the composition and terms of ACIP.

However, in March, US District Judge Brian Murphy ruled that the January changes to the vaccination schedule and Kennedy’s firing of all 17 ACIP members are likely to have violated the Administrative Procedure Act. 

Murphy also issued three temporary stays: on Kennedy’s appointment of 13 new ACIP members, mostly vaccine sceptics; changes to the vaccination schedule, and all decisions of the Kennedy-appointed ACIP. 

These stays will be in place until Murphy can rule on a lawsuit brought by the American Academy of Pediatrics (AAP) and other medical organisations against Kennedy’s “unilateral changes” to vaccinations for children and pregnant women.

However, after Murphy’s ruling, a new charter for ACIP members was published on the CDC website in June. Instead of requiring vaccine-related expertise, the new terms simply require that “members shall collectively represent a balanced range of scientific, clinical, and public health expertise relevant to the committee’s mission”. 

Also in June, US Senator Bernie Sanders released 253 pages of emails showing how Kennedy’s Health and Human Services (HHS) staff pressured CDC officials to influence the country’s vaccine policies. 

This executive order is almost certain to face legal action by health groups.