President Donald Trump has signed an executive order calling for revamped childhood vaccine recommendations that promote his long-held but discredited theory that childhood shots should be spaced out into separate medical visits, reports The Associated Press.
The order advocates separating the measles, mumps and rubella (MMR) vaccine into three different single-disease shots and the administering of all childhood immunisations at separate appointments.
Notably, the MMR is not available as three separate shots in the United States, but he wants the Health Department to submit a plan to separate them, and to improve its research on vaccines – already extensively studied.
Public health experts have raised concerns that spacing out shots could increase the risk of children becoming infected with a vaccine-preventable disease before returning for another visit.
On Monday, Trump repeatedly suggested the number or timing of vaccines could play a role in rising rates of autism spectrum disorder, even as scientific consensus and decades of studies have firmly concluded there is no link.
Health Secretary Robert F. Kennedy Jr has previously personally directed the CDC to abandon its position that vaccines do not cause autism, without supplying any new evidence to support the change.
Dr Andrew Racine, president of the American Academy of Paediatrics, said the announcement spreads uncertainty, fear and confusion where “there doesn’t need to be any of that”.
“Science about vaccines and their efficacy has not changed,” he said. “The distribution of viruses and other pathogens in our environment has not changed. Children in this country have not changed in the past 48 hours.”
Racine added that the potential link had been studied in “more than 40 methodologically well-designed studies in at least seven countries involving more than 5m children”.
“I’m not sure there is anything that has been as thoroughly looked at as this question,” he said. “And the answer is unequivocally no.”
Who is in charge of vaccine policy?
Despite the order calling for revised vaccine recommendations, states, not the federal government, have the authority to require vaccinations for schoolchildren.
So the order advises states with school vaccine mandates to consider updating their laws to reflect the administration’s preferred schedule, according to a White House fact sheet.
Last December, Trump had ordered the Department of Health and Human Services to review how peer nations approach vaccine recommendations and consider revising US guidance accordingly. The department responded by cutting the number of vaccines it recommends for every child, a move that has since been blocked in court.
Changes to federal childhood vaccine recommendations also customarily require approval from the director of the Centres for Disease Control and Prevention.
However, public health law expert Lawrence Gostin at Georgetown University said the Supreme Court’s interpretation of Trump’s power may allow him to supersede newly appointed CDC director Dr Erica Schwartz (formerly in a leadership position at the US Coast Guard) if she does not agree to these latest recommendations.
Asked by reporters why the president wanted to split the MMR into three single-disease vaccines, a White House official did not provide any studies supporting the decision.
Kush Desai, a Trump spokesperson, said the president is “one of countless parents who have voiced questions and concerns about the combined MMR vaccine”, and that the plan to develop single-disease vaccines would “give parents more options on timing and frequency for their children”, ultimately increasing vaccine uptake.
Studies of babies and toddlers in America have shown that using combination shots for childhood vaccines, rather than single ones, increased the likelihood of completing all recommended vaccinations by the age of two.
‘Gold standard’
Trump’s latest order – the “Gold Standard Childhood Vaccine Recommendations” – will split the universal recommendation for multiple childhood immunisations into three categories:
• All children: measles, mumps, rubella, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, pneumococcal
disease, human papillomavirus, and varicella
• High-risk groups: respiratory syncytial virus (RSV) monoclonal antibodies, hepatitis A and B vaccines, meningococcal B and ACWY vaccines, and dengue
• Shared decision-making: hepatitis A and B, rotavirus, meningococcal disease, influenza, and Covid-19
The call to downgrade the flu jab recommendation comes after the country, last year, experienced the highest number of paediatric flu deaths in 15 years.
See more from MedicalBrief archives:
US experts dispute calls for MMR jab to be split into three
Comprehensive study debunks, again, the MMR/autism link
US jab committee green-lights flu shots, omits those ‘tied to autism’