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US President Donald Trump has directed his administration to reduce the number of routine childhood vaccinations and examine whether the combined measles, mumps and rubella (MMR) vaccine should instead be administered as separate injections.
President Trump defended the move by arguing that American children were given far fewer vaccines in previous decades and claiming, without scientific evidence, that children were healthier at the time and autism was less common.
His comments have renewed controversy over vaccine safety, particularly his long-standing doubts about the MMR immunisation.
Health researchers, however, have repeatedly found no credible evidence connecting the vaccine with autism.
The directive proposes cutting the number of vaccines routinely advised for children from 18 under the current American Academy of Pediatrics (AAP) recommendations to 11.
The vaccines retained under the proposed framework protect against illnesses including measles, mumps, rubella, diphtheria, tetanus, whooping cough, polio, chickenpox, pneumococcal disease, Haemophilus influenzae type B and human papillomavirus.
President Trump also argued that administering several vaccines during the same visit could be harmful and suggested that the MMR injection might pose a serious danger when given as a single dose.
However, when asked to provide evidence supporting his claim, the president acknowledged that his assertion was based on what he had heard from others.
US health authorities state that the MMR vaccine is generally safe.
Although a small number of young children can experience fever-related seizures after vaccination, the Centers for Disease Control and Prevention (CDC) says serious complications are uncommon.
The agency maintains that vaccination carries considerably less risk than contracting measles, mumps or rubella.
The CDC has also said there is no scientific evidence demonstrating a health advantage from administering the three components of the MMR vaccine separately.
Medical specialists have warned that dividing the vaccinations could create practical problems for families while leaving children unprotected for longer periods.
Additional appointments may also increase costs and make it easier for parents to miss scheduled doses.
Dr William Schaffner of Vanderbilt University said the proposed approach could place an unnecessary burden on families and healthcare workers without providing a proven medical advantage.
The order is not itself a nationwide requirement for children to receive fewer vaccines. Rules governing immunisations required for school entry are primarily determined by individual states.
President Trump’s directive comes as his administration continues to pursue changes to federal vaccine policy.
Health and Human Services Secretary Robert F Kennedy Jr has also advocated greater parental choice in vaccination decisions.
Kennedy recently rejected suggestions that he had challenged the effectiveness of the MMR vaccine, saying the administration’s proposals were intended to expand parental choice rather than remove access to immunisations.
The proposals have nevertheless drawn criticism from medical organisations and some Republicans.
Dr Andrew Racine, president of the American Academy of Pediatrics, described the directive as dangerous and said it was not grounded in the strongest available scientific evidence.
He warned that postponing or missing vaccinations could be particularly hazardous as measles infections continue to occur.
Republican Senator Bill Cassidy, a physician who played a crucial role in Kennedy’s confirmation as health secretary, also criticised the president’s decision.
He said vaccines are highly effective and overwhelmingly safe, while rejecting any suggestion that they cause autism.
The scientific consensus is that childhood vaccination does not cause autism.
A major Danish study published in 2019 examined more than 657,000 children and found no evidence that MMR vaccination increased the likelihood of developing autism.
Under the existing CDC schedule, American children are advised to receive two MMR doses, with the first generally administered between 12 and 15 months of age and the second between four and six years.
The AAP says the timing of childhood immunisations is designed around when children are most vulnerable to particular infections and when vaccines are expected to provide the strongest protection.
It maintains that there is no medical justification for routinely postponing or abandoning recommended vaccinations.
President Trump’s directive further calls for research into alternatives to aluminium-containing substances used in some vaccines.
These compounds, known as aluminium salts, help strengthen the body’s immune response, allowing vaccines to work effectively with relatively small quantities.
The AAP says research has not identified significant health dangers from the small amounts of aluminium salts contained in vaccines, noting that aluminium occurs naturally in the environment, including in food, water and soil.
Public-health experts remain concerned that changes to vaccination guidance, particularly if driven by unsupported claims about autism, could lead to falling immunisation rates and increase the likelihood of preventable diseases such as measles returning on a wider scale.
By: Magdalene Agyeiwaa Sarpong