Trump Vaccine Order Cuts Recommended Shots to 11, Faces Legal Fight

President Trump signed an executive order Monday cutting recommended childhood vaccines from 18 to 11, moving Covid-19, flu and hepatitis B shots to a shared-decision category parents may skip.

"There are many, many, many years of scientific data highlighting the safety of vaccines in children," said Dr. Aaron Milstone, a member of the American Academy of Pediatrics' Committee on Infectious Diseases. The AAP, which has sued the administration over its vaccine moves, denounced the order.

The order directs Health Secretary Robert F. Kennedy Jr. and a revived vaccine task force to propose new timing and sequencing recommendations within 90 days and to find alternatives to aluminum, a common vaccine ingredient. It encourages states to mandate fewer vaccines for school attendance and calls for the combined measles, mumps and rubella shot to be split into three separate injections, none of which are currently FDA-approved. Splitting MMR would mean six injections instead of two.

The order comes months before midterm elections on an issue Trump's own pollsters have warned is unpopular, and it follows a January CDC overhaul that a federal judge blocked in March. For vaccine makers, the shift could reduce demand for Covid-19, flu, hepatitis B and MMR shots for children, though the 90-day timeline and pending litigation leave the practical impact uncertain.

In Oval Office remarks, Trump linked the changes to rising autism rates, despite decades of research finding no connection. "Decades ago, children received only a small fraction of the vaccines required today," he said. "In those times, people were much healthier, and of course, the high rates of autism now observed did not exist."

Autism affected roughly one in 31 8-year-olds in the U.S. in 2022, according to the CDC, up from about one in 150 in 2000. Scientists have yet to pinpoint a definitive cause for the rise. Multiple studies have found no link between vaccines and autism, including a 2019 Annals of Internal Medicine study of more than 600,000 children in Denmark and a 2021 Cochrane review of 138 studies. A separate study of more than one million children in Denmark last year found no link between aluminum in vaccines and childhood chronic diseases, though Kennedy denounced it.

Legal Challenges Loom Over 90-Day Vaccine Review

The order is the latest in a series of administration actions that have run into court. In January, the CDC recommended reducing childhood vaccinations for 11 diseases, a change the American Academy of Pediatrics rejected by continuing to recommend shots against 18 diseases. A federal judge blocked parts of the CDC's new schedule in March.

Dorit Reiss, a law professor at the University of California College of the Law at San Francisco, said the latest effort will likely face similar challenges. "The president's familiarity with the administrative law is limited," Reiss said. "The problem is that this isn't likely to hold up in court."

The administration has pointed to Denmark, where vaccines for flu, Covid, RSV and chickenpox aren't included in the universal childhood schedule. Public health experts counter that the U.S. faces a different burden of infectious disease given the size and diversity of its population, and that Denmark has universal healthcare while the U.S. does not.

The order groups vaccines into three buckets: those recommended for all children, those for high-risk children only, and those subject to shared clinical decision-making between parents and doctors. The recommended U.S. childhood immunization schedule has never been mandatory, and the order does not prohibit access to shots.

For vaccine manufacturers, the practical effect depends on how states and pediatricians respond. The AAP has continued to recommend the full 18-disease schedule, and many pediatricians have disregarded the January CDC changes. Trump dismissed critics who predicted a resurgence of childhood diseases, saying "nothing bad can happen from what we're doing."

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