President Donald Trump signed an executive order Aug. 10 overhauling childhood vaccine schedules at the federal level, calling for separate shots in place of the combined measles-mumps-rubella vaccine and narrowing the list of immunizations recommended for all children.
The Gold Standard Childhood Vaccine Recommendations follow previous moves by the Trump administration to update the federal vaccine schedule and redefine immunization requirements to align with “scientific evidence and best practices from peer, developed countries” and support “maximal parental choice,” the executive order said.
Here are six things to know from the latest executive order:
- The Gold Standard Childhood Vaccine Recommendations categorize vaccinations into three tiers, with some recommended for all children and others only recommended for high-risk populations:
- Immunizations recommended for all children: measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, pneumococcal disease, human papillomavirus and varicella
- Immunizations recommended for certain high-risk groups or populations: respiratory syncytial virus monoclonal antibodies, hepatitis A, hepatitis B, meningococcal B, meningococcal ACWY and dengue
- Immunizations based on shared clinical decision-making: hepatitis A, hepatitis B, rotavirus, meningococcal disease, influenza and COVID-19
- Immunizations recommended for all children: measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, pneumococcal disease, human papillomavirus and varicella
- The order recommends that the combined measles, mumps and rubella vaccine be administered in three separate single-disease shots once those products are available. It also recommends that all childhood immunizations should be administered at separate medical visits, “to the maximum extent feasible.”
The U.S. in 2026 had 2,318 confirmed measles cases as of July 23, already ahead of the 2,289 cases reported in the full 2025 calendar year with 93% of cases involving people who are unvaccinated or whose vaccination status is unknown, according to CDC data.
- The order advises all states and territories to review the new vaccine recommendations and consider updating relevant immunization requirement laws and regulations.
Vaccination requirements for schoolchildren, though informed by CDC recommendations, are set and enforced at the state level. - The order instructs HHS and the Justice and Education departments to ensure compliance among “contractors and grantees, including States and localities,” to provide religious and medical exemptions from childhood and adolescent immunization requirements.
The attorney general has also been instructed to “further meritorious legal actions” against state laws that prevent or fail to provide religious and medical exemptions from childhood and adolescent immunization requirements. - Within 90 days of the executive order, HHS Secretary Robert F. Kennedy Jr. will present a plan to President Trump through the HHS Task Force on Safer Childhood Vaccines that:
- Offers options to administer core childhood vaccines, starting with the measles, mumps and rubella vaccine, as single vaccines rather than combination products. The plan should ensure the continued availability of combination vaccines and vaccines recommended for shared clinical decision-making.
- Adjusts the federal childhood and adolescent vaccine schedule based on “gold-standard science.”
- Develops and conducts safety and efficacy studies on alternative adjuvants to aluminum.
- Offers options to administer core childhood vaccines, starting with the measles, mumps and rubella vaccine, as single vaccines rather than combination products. The plan should ensure the continued availability of combination vaccines and vaccines recommended for shared clinical decision-making.
- Sen. Bill Cassidy, MD, R-La., was among the first lawmakers to react to the vaccine recommendations on X: “I’m a doctor. This executive order is wrong. The President does not have the expertise to make these changes.”
The American Academy of Pediatrics called the executive order “not only disheartening but dangerous,” in an Aug. 10 statement.
“Instead of ensuring every family can access life-saving vaccines for measles, influenza, RSV and more, federal leaders are once again spreading misleading claims,” the AAP statement said. “Today’s executive order is not based on ‘gold-standard science.’ There is no new evidence to justify significant changes to childhood immunization guidance.”
“Decisions about how and when vaccines are used should be driven by rigorous scientific evidence, patient safety and independent medical and public health expertise,” American Medical Association President Willie Underwood III, MD, said in an Aug. 10 statement shared with Becker’s. “Altering a proven vaccination schedule without credible evidence risks weakening public confidence and putting children’s health at risk.”
Read the full executive order here.
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