Donald Trump signed an executive order on Friday directing the Centers for Disease Control and Prevention to cut the number of recommended childhood vaccines almost in half, setting up a new review that could reshape the federal schedule used by doctors and states across the country.
The order lands as parents, pediatricians and health officials are already searching for what it means for the shots children are told to get. It tells the CDC and its Advisory Committee on Immunization Practices to review an HHS scientific assessment and the clinical data behind it, then update the vaccine schedule for children and adolescents.
That assessment, published in January by the health and human services department and co-authored by Dr Tracy Beth Høeg, said the CDC director should keep vaccines for 10 diseases in the category recommended for all children: measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Haemophilus influenzae type B, pneumococcal disease and human papillomavirus. It also included varicella in that group and went further by recommending that the human papillomavirus vaccine be reduced from two or three doses to one.
The White House said the policy is meant to align the core childhood vaccine schedule with scientific evidence and best practices from peer developed countries while preserving access to vaccines currently available to Americans. Critics say the same shift would do the opposite, stripping vaccines of their universally recommended status and leaving children sicker. Fifteen states with Democratic governors have already sued HHS and Robert F. Kennedy Jr. over the administration’s proposed changes, arguing that the move would create senseless complexity and equivocation and strain state resources.
That lawsuit also complains about a CDC memo that downgraded the recommendation for a vaccine against respiratory syncytial virus, adding another layer to a fight that is no longer just about one order. Dr William Schaffner said in January that there seemed to be little scientific basis for altering the recommendations and warned that if children are not progressively vaccinated against certain diseases, there will be a resurgence of illnesses such as measles.
For now, the central question is narrower than the politics around it: which childhood vaccines, if any, come off the schedule or return in reduced form after the CDC and its advisers finish their review. The order’s language does not spell that out, but it does force the next move, and that could decide whether the nation’s childhood immunization schedule stays broad or starts to shrink.
