Trump’s Latest Vaccine Order Is Making Things More Confusing

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In January, the Trump administration attempted to fundamentally change the way the United States handles childhood immunizations.

Following a memo from the Department of Health and Human Services, the CDC updated its vaccine schedule to recommend that some shots no longer be given to all children.

A federal court undid the effort in March.

In an executive order in May, Donald Trump called on states to adopt the narrower schedule anyway.

On Monday, Trump issued a new executive order on the same subject, focused on lowering the number of vaccines that the government recommends for all children.

As I wrote earlier this week, this White House has a habit of doubling down when it doesn’t get its way.

But only states have the power to put these proposals into practice—and many state policy makers, concerned that the White House is contradicting existing research, aren’t keen to follow its guidance.

According to the new executive order, preventive shots for hepatitis A, hepatitis B, dengue, and other diseases should be recommended for “high-risk” groups only.

The order also calls to split up vaccinations for measles, mumps, and rubella—the two-dose MMR shot that has been a standard recommendation for U.S. children for decades—into three separate stages, and directs the attorney general to pursue legal action against states that don’t respect “parental authority, religious freedom, disability accommodations, and equal protection under the law.” (The order says it will align U.S. policy with the best practices of other countries, such as Denmark, but the experts I spoke with highlighted that what works in one country won’t necessarily work in another .) The mandate may not have any legal authority to compel states to change their guidelines in the near term, although the invocation of the attorney general suggests that litigation may be on the horizon.

And the single-disease vaccines that the executive order encourages aren’t yet available in the U.S.

But this week’s order risks creating even more uncertainty about vaccines than already exists.

“If you set out to write a policy that confuses people, it would look a lot like this one,” Jake Scott, an infectious-disease specialist at Stanford, told me.