Timing is everything, and the executive order calling for pediatricians to change how they space out childhood vaccines comes at a difficult time.
On Monday, President Trump signed an order adopting new recommendations of 11 childhood vaccines, down from 18 — and called for the Measles, Mumps and Rubella vaccine to be split into three separate shots, given at separate times.
Despite more than 55 years of safety data since the introduction of the combined MMR vaccine in 1971, the nation is experiencing a resurgence of measles cases.
As of Aug. 6, 2,465 confirmed measles cases have been reported in the United States in 2026, already above the total US cases in 2025 with four months to go. This year has seen 38 new outbreaks and the most cases the US has seen in 35 years.
The outbreaks put the country at risk for losing its measles elimination status, which we’ve held since 2000. It’s a public health accomplishment that means the US hasn’t seen very large outbreaks and hadn’t had 12 months or more of uncontrolled domestic transmission of the virus since before that time.
But it may not last.
The outbreaks are happening as medical professionals tasked with treating measles patients consider the medical fallout of the virus.
Even a child who recovers can later experience severe delayed neurological and organ damage, fatal brain inflammation and vulnerability to other dangerous infections. These vaccine-preventable problems can follow children well into adulthood.
Then there are questions that arise from government messaging.
The executive order refers to a new “gold standard” in vaccine administration that includes administration of 11 vaccines instead of the standard 18.
The newly confirmed director of the CDC has affirmed her support for vaccines, saying she believes that “vaccines are safe and effective” at her recent Senate confirmation hearing. It is unclear whether Dr. Erica Schwartz is referring to the full list of childhood vaccines as recommended by the CDC or the American Academy of Pediatrics.
Thankfully, the mainstream medical community shares strong, consistent consensus on both the number and schedule of childhood vaccines.
The AAP response to the executive order states that vaccine recommendations are “tailored to the health of children living in the United States and are based on decades of research and systematic tracking of real-world experiences.”
It reiterates that children receive certain vaccines at specific ages based on when children’s immune systems respond best, and whether they might be medically vulnerable to certain diseases.
The AAP acknowledges that it may sometimes be beneficial for a child to receive a single shot, and sometimes they may receive better protection through multiple vaccines at one visit.
Twelve major national health organizations representing more than a million clinicians, physicians and pharmacists formally endorse the AAP immunization schedule, alongside a large coalition of more than 230 public health and medical groups.
This unity comes from a recognition of the importance of making clinical decisions based solely on science.
It is also worth noting that there is no scientific evidence that vaccines lead to autism.
Practitioners and families still have space to discuss vaccination needs and the optimal schedule based on the health of individual children, science and data.
The cost and insurance coverage of vaccines is unchanged and isn’t dependent on the vaccine schedule, though spacing out shots would mean more visits to the doctor, which may carry additional financial and time burdens on the family and limit the time pediatricians have with patients.
The public health timing of the executive order is difficult, but as clinicians, we are trained to focus on guiding families to safe medical choices. That’s why now is the time for the medical community to respond not to political winds, but to how we can most effectively advocate for children’s health.
Matthew Harris, MD, FAAP, FAEMS is a pediatric emergency medicine attending physician in the Department of Pediatrics, Division of Pediatric Emergency Medicine for Northwell Health. He also serves as the Medical Director for Northwell Health’s Clinical Preparedness Team.
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