Trump signs order on childhood vaccine recommendations, citing autism

Washington — President Trump signed an executive order on Monday laying out new recommendations for childhood vaccinations, and during his remarks, he mentioned that autism had a role in the guidance. The order recommends limiting the number of vaccines recommended for children and splitting vaccines into tiers so that some are recommended for all children and others would be advised for children considered to be at higher risk. 

Shots against RSV and hepatitis A and B are examples of vaccinations that would just be recommended for high-risk children, according to the order.

It also suggests that the measles, mumps and rubella shot, known as MMR, should be given as three separate shots, and that when possible, children should be vaccinated in separate visits. 

But CBS News medical correspondent Dr. Céline Gounder says it's not currently possible to administer the MMR vaccine as three different shots today.

"Merck stopped making the standalone measles, mumps and rubella vaccines in 2009," Gounder said. "There's no licensed version in this country. No company has said it's building one, and the order only takes effect once those products exist."

Gounder also warned that splitting the shot has been tried in the past, with some unfortunate results. "Japan split its shot in the 1990s," she said. "Mumps vaccination there fell to about a third of children — and doctors documented hundreds of kids who lost their hearing."

The recommendations would upend decades of federal guidance on which vaccines are administered to children, just as the school year is about to begin in many states. The American Academy of Pediatrics called the order "disheartening" and "dangerous" in a statement issued later Monday.

The executive order, obtained by CBS News before the president signed it, also directed the Health and Human Services Department to reassess vaccine sequencing and timing within 90 days. The order didn't mention autism, but the president did — repeatedly.  

"Today, we're proud to officially announce the United States of America's Gold Standard Childhood Vaccination Recommendations and that has to do with many subjects, but including autism in particular," the president said in the Oval Office with the executive order in front of him. 

"Decades ago, children received only a small fraction of the vaccines required today," Mr. Trump said. "In those times, people were much healthier and of course, the high rates of autism now observed did not exist. So, there's a reason for such epidemic rates of autism. And we're going to bring it back to much closer to where it was."

"While we do not know exactly what the cause is with respect to autism, it is essential to our research efforts that we have the very best vaccine recommendations in the entire world," he continued. "So we're reducing them, we're changing it to visits over the period of a year, a year and a half, so they get 20% of what they would have gotten in one big shot." 

The president cited no evidence for his claims. 

Research has found no evidence of increased rates of autism among those who are vaccinated compared to those who are not. Vaccines also undergo intensive safety testing. Research shows that genetics play a role in autism diagnoses. The NIH says some possible risk factors for autism include prenatal exposure to pesticides or air pollution, extreme prematurity or low birth weight, certain maternal health conditions, or parents conceiving at an older age. 

HHS Secretary Robert F. Kennedy Jr. said next month, the federal government's Advanced Research Projects Agency for Health is "preparing a major new initiative focused on foundational causes and biology of autism."

"We will examine every biologically plausible hypothesis and leave no legitimate, scientific question unexplored," Kennedy said. "Mr. President, you have told us you want answers, so do I. We have just over two years to finish the work and I know you're impatient. And we are moving with an urgency that that deadline demands. We will bring you actions and findings as soon as they are read." 

Mr. Trump promised "nothing bad can happen" from the research his administration is doing on autism. 

Gounder noted that studies have failed to show a link between autism and vaccines. A 2019 Danish study followed 657,461 children and found the autism rate in vaccinated kids was slightly lower. And a 2015 study of 95,727 American children included nearly 2,000 who had an older sibling with autism. If a vaccine had triggered autism in a genetically vulnerable child, links would have appeared, but their risk was no higher. The study found the MMR vaccine does not increase a child's risk of autism. 

While the CDC advises states on policy, states — not the federal government — set policies for school immunization schedules.  

The announcement comes after the Centers for Disease Control and Prevention in January recommended reducing the number of childhood vaccinations, to cover 11 diseases. The American Academy of Pediatrics broke with the CDC and continued to recommend vaccination against 18 childhood diseases. 

In March, a federal judge blocked the CDC's recommended changes to the childhood vaccine schedule, saying the agency violated the legally required process and "undermined the integrity of its actions."

Monday's executive order cited recent efforts to align the vaccine schedule with what it calls "best practices" from peer nations, along with protecting religious liberty and parental authority. But it acknowledges that litigation has delayed implementation of that push, leading the Trump administration to pursue additional measures. 

"In many cases, we were requiring 72 jabs for our beautiful, healthy, lovely, delicate little children," the president said. 

Pediatricians warn, "Delaying or skipping shots is risky"

The American Academy of Pediatrics disputed many of the president's claims and said the executive order could "sow confusion so that more people doubt the importance of vaccines."

"There is no new evidence to justify significant changes to childhood immunization guidance. Dozens of studies involving millions of people show there is no link between vaccines and autism, and yet federal leaders continue to promote this outdated, disproven idea to scare families," the group's president, Dr. Andrew Racine, said in a statement. "Delaying or skipping shots is risky, especially as measles continues to spread and children go back to school."

In the past, the American Academy of Pediatrics has pointed out that so-called "peer nations" have different vaccination needs, and best practices vary. It said vaccine guidance may differ across countries because they face threats from different diseases and have different population demographics, healthcare systems and vaccine availability.

Republican Sen. Bill Cassidy, a doctor, blasted the president's executive order in a post on X. 

"I'm a doctor. This executive order is wrong," he wrote. "The President does not have the expertise to make these changes. Vaccines are overwhelmingly safe. Vaccines are effective. Vaccines DO NOT cause autism. Breaking up vaccines will mean children have to get more shots to get the same protection, not fewer shots. It will increase hesitancy and make children less safe. Parents should listen to their child's pediatrician about vaccines rather than listening to an inaccurate executive order. This is so wrong."

Dr. Richard Besser, a pediatrician and the president and CEO of the Robert Wood Johnson Foundation, told CBS News, "What we're seeing now is the injection of politics into something that should be a very personal conversation between a parent and their child's doctor."

Besser, who spent years working at the CDC, including a stint as acting director, said of Mr. Trump's remarks, "He is injecting fear, he is injecting concern where there shouldn't be." 

Asked about the idea of spacing out the shots in the childhood vaccine schedule, Besser said, "It's really important to explore that with your child's doctor. In terms of the effectiveness of the vaccines, there's no benefit in spacing them out." 

Dr. Jay Bhattacharya, director of the National Institutes of Health, was asked about plans for the executive order Sunday on CBS News' "Face the Nation with Margaret Brennan."

"I think that parents, for most kids, especially for the measles vaccines, the DTP, all the standard childhood vaccines, it's very important that parents vaccinate their kids," Bhattacharya said.

"I trust the science" on childhood vaccines, Bhattacharya added, and noted that he has vaccinated his own children.

The executive order comes as measles cases have risen to their highest levels in 35 years. Bhattacharya, who's also been serving as acting CDC director in recent months, acknowledged that the U.S. may lose its measles elimination status, while pointing to other countries that have also recently lost their status.