WASHINGTON — President Donald Trump on Monday signed an executive order calling for changes to U.S. childhood vaccine recommendations, including administering routine immunizations at separate visits when possible and eventually replacing the combined measles, mumps and rubella (MMR) vaccine with three individual shots.
The order directs the Department of Health and Human Services to develop a plan for making separate measles, mumps and rubella vaccines available in the United States and calls for additional research into childhood vaccines. Trump has argued that giving vaccines separately would provide parents with greater choice.
The order comes as the administration seeks to overhaul the federal childhood immunization schedule. In May, Trump signed an executive order directing the Centers for Disease Control and Prevention and its Advisory Committee on Immunization Practices to review the U.S. schedule and consider recommendations on the timing and sequencing of routine vaccinations.
The latest order says the MMR vaccine should be administered as three separate single-disease shots once such products are domestically available.
No individual measles, mumps or rubella vaccines are currently licensed for routine use in the United States. Merck stopped producing its separate vaccines in 2008, leaving combined MMR products from Merck and GSK as the available U.S. options. Merck said developing and commercializing individual vaccines could take years and potentially as long as a decade because of regulatory and manufacturing requirements.
Merck and GSK have said there is no published scientific evidence supporting separation of the combined vaccine and cited decades of evidence supporting the safety of MMR shots. The CDC and major medical organizations have long recommended combination vaccines, in part because they reduce the number of injections and the chances that children will miss doses.
The American Academy of Pediatrics criticized the administration's approach. Its president, Dr. Andrew Racine, said the scientific evidence on vaccine safety and efficacy had not changed and warned that the new recommendations could create uncertainty for families.
Trump has also repeatedly raised questions about a possible connection between vaccines and autism. Scientific studies have found no causal link between childhood vaccines and autism, and public health experts have rejected that association.
The executive order does not give the federal government authority to impose school vaccination requirements. States retain authority over school-entry mandates, although the order encourages states to consider aligning their policies with the administration's preferred schedule.
The administration's proposed changes face regulatory, manufacturing and legal hurdles. Separate MMR vaccines would first have to be developed, tested and approved before they could become available in the United States.
