On Monday, Donald Trump signed an executive order pushing for revisions to how children in the US are vaccinated. The executive order calls for several changes. These include fewer vaccinations overall and a recommendation that the combined measles, mumps and rubella (MMR) vaccine be replaced with separate shots for each disease administered during separate medical visits.
The latter direction is currently impossible to implement because no stand-alone shots for these diseases are licensed in the US. Critically, the executive order does not actually “change anything about current recommendations”, says Dr James Campbell, chair of the committee on infectious diseases for the American Academy of Pediatrics (AAP). While the executive order puts pressure on states to change their vaccine policies, it is the Centers for Disease Control and Prevention (CDC) rather than the president that sets federal recommendations.
For now, the proposed changes do not limit access to vaccines or limit insurance coverage. Because of the Trump administration’s attempts to change vaccine policy, many states have opted not to follow CDC childhood vaccine recommendations. As of January 2026, at least 28 states, as well as the District of Columbia, announced that they would follow vaccine recommendations from other entities; most of these states indicated they would follow AAP guidance.
Regardless of the executive order, “[the AAP] guidelines will be what we continue to follow. We know these are backed by decades of studies, studying millions of patients, showing the vaccine schedule is safe and effective,” says Dr Katherine Piwnica-Worms, system chief of pediatrics at NYC Health + Hospitals. This is the latest attempt to change the US childhood vaccine schedule.
In March, a court blocked similar changes advocated for by the US health secretary, Robert F Kennedy Jr. The MMR vaccine protects against three viral infections: measles, mumps and rubella. Measles can be serious for all age groups, but can be especially dangerous for babies and young children.
In early stages, it’s characterized by a high fever, small spots inside the mouth and a rash. Severe complications, like pneumonia or brain swelling, can lead to hospitalization and death. While measles was declared eliminated from the US in 2000, cases are now increasing: in August, approximately 2,465 cases were confirmed, a rise linked to slumping immunization rates.
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