Trump signs executive order to break up measles, mumps, rubella vaccine
Sarah
Boden and Chris
Dall, MA
Separating out
the MMR vaccine is among the recommendations in an executive order signed by the president today that urges all
childhood vaccines be administered at separate visits.
“For example, at
one year, you should have five separate visits for vaccines rather than getting
them all in the same day," President Trump said at the signing.
There are no data to show that spacing out the MMR
immunizations—or other childhood immunizations—is beneficial, but doing so
could increase the risk of infection or lead to kids missing doses. And it adds
to vaccination costs.
Also, breaking up
the MMR vaccine could be difficult, at least in the short term, as this would
require buy-in from pharmaceutical manufacturers to make three separate
vaccines. And the proposed three separate vaccines are not currently licensed
in the United States nor approved by the Food and Drug Administration, which
would take some time.
‘None of this
is reality-based’
The executive order will do nothing to support families of children with autism or advance understanding of it, said a statement from Andrew D. Racine, MD, PhD, president of the American Academy of Pediatrics (AAP).*
Racine added that pediatricians recommend that children receive certain vaccines at specific ages based on when children's immune systems will respond best and when they are most vulnerable to certain diseases.
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| "Nobody has studied?" That's a bald-faced lie |
The president
also said that the United States recommends more immunizations than peer
nations. This is confusing at best. As Stat News explained earlier this year, many other wealthy
countries, including the United Kingdom, Israel, and Australia, recommend kids
receive more immunizations than the United States would if an HHS immunization
recommendation in January were to go into effect.
“None of this is
reality-based,” said Amesh Adlaja, MD, a senior scholar at the Johns Hopkins Center for
Health Security, on Bluesky. “It is all just nihilistic pandering to the
anti-vaccine movement and will do nothing but lower standards of living for
everyone.”
Medical
experts warn of harm to kids
To date, at least 23 states have said they plan to follow
vaccine recommendations from AAP, which continues to recommend immunization
policies that predate the Trump administration. The order advises states and
territories to consider updating their vaccine laws and regulations, and it
directs the attorney general to take legal action against states with laws that
violate religious freedom, disability accommodations, or parental
authority.
The president's
directive is designed to restore parental autonomy and repair the relationship
between parents and public health, said Jay Bhattacharya, MD, PhD, director of
the National Institutes of Health.
But public health
experts worry that the order will create more confusion for parents.
"Parents
deserve clear, evidence-based guidance about how to protect their children, not
competing recommendations issued through political processes," said
Michael Osterholm, PhD, MPH, head of the Vaccine Integrity Project and director
of the University of Minnesota's Center for Infectious Disease Research and
Policy, which publishes CIDRAP News.
Osterholm said
the executive order does not change the underlying decades of scientific
evidence on the safety and real-world effectiveness of childhood immunization,
and that confidence in vaccination suffers when families receive conflicting
messages, and children ultimately bear the consequences.
Parents
deserve clear, evidence-based guidance about how to protect their children, not
competing recommendations issued through political processes.
Jan K. Carney,
MD, MPH, the president of the American College of Physicians, agrees that the
administration's dismissal of proven science is troubling, and warned that the
executive order could increase medical costs for patients and families,
including additional copays, due to needing to schedule multiple appointments.
“Children and
caregivers deserve better consideration for the downstream impact of these
proposed changes,” he said in a statement.
Order does not
trump states' legal authority
The executive
order comes as the president grapples with a historically low approval rating ahead of the midterm
elections.
At the same
time, public trust in vaccines has dropped, and an important part
of the coalition that led to Trump's second term is Kennedy's Make America
Healthy Again movement, which includes voters who are skeptical of vaccines and
resistant to government influence.
Still, it is the
Centers for Disease Control and Prevention, not the president, that sets
federal vaccine recommendations, said Dorit Reiss, PhD, who specializes in
vaccine law at the University of California College of the Law, San
Francisco.
But, Reiss noted,
the executive order could create political pressure on states to make changes
to vaccine policy.
Under the order,
vaccines for 11 diseases—including measles, polio, and whooping cough— would be
recommended for all children. Other vaccines, like those for meningococcal
disease and hepatitis B, are recommended only for high-risk children, while flu
and COVID vaccination should be based on discussions between doctors and
parents.
That part of the
order is similar to the new childhood vaccine schedule announced by HHS on January 5. Those changes, which were based on an
HHS scientific assessment, were blocked by a federal judge on March 16.