WASHINGTON — President Donald Trump has signed an executive order calling for the measles, mumps and rubella (MMR) vaccine to be separated into three individual shots, part of a broader effort to reduce the number of vaccines recommended routinely for U.S. children. The order was signed on Aug. 10 and directs federal health agencies to revise childhood immunization guidance.
The measure recommends that the components of the combined MMR vaccine be administered separately and at different visits, according to reports on the order and statements from the administration. It also reduces the number of diseases for which federal agencies recommend routine childhood vaccination, while retaining access to vaccines that are no longer universally recommended.
Trump has argued that separating the vaccines could reduce risks associated with the combined shot. At the signing, he made claims about the safety of the MMR vaccine and again raised a connection between vaccination and autism, although major medical organizations and decades of research have found no evidence that MMR vaccination causes autism.
Medical experts have criticized the change, saying there is no established health benefit from breaking up the MMR vaccine and warning that additional appointments could make it harder for children to receive timely protection against measles, mumps and rubella. The American Academy of Pediatrics and other public health specialists have continued to support the established combined vaccine schedule.
The Centers for Disease Control and Prevention has previously described MMR as a standard combined vaccine. Its vaccine guidance also distinguishes MMR from MMRV, the combination vaccine that protects against measles, mumps, rubella and chickenpox. For some young children, the CDC has recommended separate MMR and varicella vaccines rather than MMRV because of a higher risk of febrile seizures associated with MMRV.
The administration's latest action follows a May executive order directing the CDC and its Advisory Committee on Immunization Practices to review the U.S. childhood vaccine schedule against practices in other developed countries and consider greater flexibility in the timing and sequencing of routine immunizations. That order said vaccines included in the schedule adopted by the CDC should continue to receive federal coverage.
The latest order does not itself establish a new nationwide vaccination requirement. Changes to federal recommendations must be implemented through the relevant health agencies, while states retain authority over many school vaccination requirements. The administration's effort to revise the childhood schedule remains under implementation.
